Hodgkin lymphoma is a cancer that develops in certain white blood cells (lymphocytes) in the lymphatic system. A vast network of nodes, vessels and organs that extends throughout the body, the lymphatic system eliminates waste and toxins and plays a key role in fighting infection. The cancer begins when a lymphocyte develops a mutation that instructs the cell to multiply very rapidly, creating many oversized, abnormal lymphocytes that accumulate in the lymphatic system, where they may crowd out healthy cells and circulate throughout the body.
There are two main types of Hodgkin lymphoma: classical and nodular lymphocyte predominant. A physician can determine the type after identifying the cells affected and evaluating their behavior. Because each type of Hodgkin lymphoma may be treated differently, this information is important to consider when evaluating treatment options.
Classical Hodgkin lymphoma
The most common type of Hodgkin lymphoma, classical Hodgkin lymphoma is characterized by the presence of Reed-Sternberg cells, which are abnormally large B lymphocytes (white blood cells that produce infection-fighting antibodies). Many Reed-Sternberg cells have two nuclei, creating a distinctive “owl eye” appearance. When performing a biopsy, a physician can identify Reed-Sternberg cells by examining a tissue sample under a microscope.
Painless lymph node swelling that persists beyond a few weeks is the most common symptom of classical Hodgkin lymphoma. In many cases, the swollen lymph node is in the neck, chest or groin area. Some people also experience unintended weight loss, drenching night sweats and fever. Collectively, these symptoms are referred to as "B symptoms."
Classical Hodgkin lymphoma can be further categorized into four main subtypes:
The most common subtype of classical Hodgkin lymphoma, nodular sclerosing Hodgkin lymphoma can be identified by the presence of broad bands of connective tissue (sclerosis) in an affected lymph node, which create a nodular appearance. This form of cancer often affects lymph nodes in the central part of the chest (mediastinum).
Known for having many different types of cells, including a large number of Reed-Steinberg cells, mixed cellularity Hodgkin lymphoma often develops in lymph nodes in the midsection. This subtype of classical Hodgkin lymphoma occurs most frequently in older adults.
In addition to Reed-Sternberg cells, lymph nodes affected by lymphocyte-rich Hodgkin lymphoma typically contain many normal lymphocytes. This subtype of classical Hodgkin lymphoma usually affects lymph nodes in areas of the body other than the mediastinum.
Lymph nodes affected by lymphocyte-depleted Hodgkin lymphoma usually contain almost all Reed-Sternberg cells. This relatively uncommon subtype of classical Hodgkin lymphoma occurs most often in older adults, individuals who have human immunodeficiency virus (HIV) and people in non-industrialized nations.
Nodular lymphocyte-predominant type
Relatively uncommon and slow-growing, nodular lymphocyte-predominant Hodgkin lymphoma is marked by the presence of lymphocyte-predominant cells (“popcorn” cells), which are a distinctive variant of Reed-Sternberg cells.
Hodgkin lymphoma treatment at Moffitt
At Moffitt Cancer Center, we provide a comprehensive range of treatment options for all types of Hodgkin lymphoma. The multispecialty team in our Malignant Hematology Program develops an individualized treatment plan for each patient, and every selected therapy is administered by a highly experienced medical oncologist, hematologist or radiation oncologist. Through our robust portfolio of clinical trials, our patients also have access to groundbreaking new treatment options that are not yet available in other settings.
As a high-volume cancer center, Moffitt sees and treats patients with all types of Hodgkin lymphoma, including those that are highly complex. As a result, our team has acquired extensive experience, which directly leads to better outcomes and quality of life for our patients.