HaematologyTier 1Disease (DEADMAN)

Haematological malignancies - Hodgkin lymphoma

Description

  • Germinal-centre B-cell malignancy in which the malignant cells are <1% of the tumour mass - the rest is a reactive inflammatory infiltrate
    • This is why it is chemo- and radiosensitive, and why checkpoint blockade works
Classical Hodgkin lymphoma (~90%)
SubtypeFrequencyNotes
Nodular sclerosis~70%Young adults, mediastinal mass, F=M
Mixed cellularity~20%Older, EBV-associated, HIV
Lymphocyte-rich~5%Best prognosis
Lymphocyte-depleted<1%Elderly, HIV, advanced at presentation, worst
Nodular lymphocyte-predominant (~10%)
  • Renamed nodular lymphocyte-predominant B-cell lymphoma (WHO 5th ed) - no longer classified as Hodgkin lymphoma
  • LP ("popcorn") cells: CD20+, CD45+, EMA+, CD15-, CD30-
  • Indolent, late relapses, transforms to DLBCL in ~5-10%
Immunophenotype - the exam point
Classical HLNLPHL
CD30+-
CD15+ (~80%)-
CD20- / weak+
CD45-+
PAX5Weak +Strong +

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