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07-SEPTEMBER-2008 03:17:44 - Hodgkin's lymphoma Redirected from Hodgkin's disease Hodgkin's lymphoma Classification and external resources Lymph node biopsy showing Hodgkin's lymphoma. ICD-10 C81. ICD-9 201 ICD-O: 9650/3-9667/3 DiseasesDB 5973 MedlinePlus 000580 eMedicine med/1022 MeSH D006689 Hodgkin's lymphoma, also known as Hodgkin's disease, is a type of lymphoma first described by Thomas Hodgkin in 1832. Hodgkin's lymphoma is characterized clinically by the orderly spread of disease from one lymph node group to another and by the development of systemic symptoms with advanced disease. Pathologically, the disease is characterized by the presence of Reed-Sternberg cells RS cells. Hodgkin's lymphoma was one of the first cancers to be cured by radiation. Later it was one of the first to be cured by combination chemotherapy. The survival rate is generally around 90% when the disease is detected relatively early, making it one of the most curable forms of cancer. Later-stage cancers show a significantly worse prognosis 1. The Handbook of Cancer Chemotherapy, Sixth ion states that the potential for cure should not lead clinicians and patients to lose sight of the fact that Hodgkin's lymphoma is a malignancy and that approximately 20% to 25% of patients die of the disease.2 Nevertheless, recent trials are showing much higher 5-year survival rates than have previously been seen, often on the order of 98% for many patients. 3 Contents 1 Epidemiology 2 Symptoms 3 Diagnosis 4 Pathology 4.1 Macroscopy 4.2 Microscopy 5 Types 6 Staging 7 Prognosis 8 Treatment 9 Notable cases 10 Cultural references 11 See also 12 References 13 External links Epidemiology Unlike some other lymphomas, whose incidence increases with age, Hodgkin's lymphoma has a bimodal incidence curve; that is, it occurs most frequently in two separate age groups, the first being young adulthood age 15-35 and the second being in those over 55 years old although these peaks may vary slightly with nationality.4 Overall, it is more common in males, except for the nodular sclerosis variant see below, which is more common in females. The annual incidence of Hodgkin's lymphoma is about one in 25,000 people, and the disease accounts for slightly less than 1% of all cancers worldwide. The incidence of Hodgkin's lymphoma is increased in patients with HIV infection.5 In contrast to many other lymphomas associated with HIV infection it occurs most commonly in patients with higher CD4 T cell counts. Symptoms Patients with Hodgkin's lymphoma may present with the following symptoms: Lymph nodes: the most common symptom of Hodgkin's is the painless enlargement of one or more lymph nodes. The nodes may also feel rubbery and swollen when examined by a physician. The nodes of the neck and shoulders cervical and supraclavicular are most frequently involved 80-90% of the time, on average. The lymph nodes of the chest are often affected and these may be noticed on a chest radiograph. Splenomegaly: enlargement of the spleen occurs in about 30% of people with Hodgkin's lymphoma. The enlargement, however, is seldom massive and the size of the spleen may fluctuate during the course of treatment.6 Hepatomegaly: enlargement of the liver, due to liver involvement, is present in about five percent of cases. Hepatosplenomegaly: the enlargement of both the liver and spleen caused by the same disease. Pain: Pain following alcohol consumption: classically, involved nodes are painful after alcohol consumption, though this phenomenon is rare7. Back pain: nonspecific back pain pain that cannot be localized or its cause determined by examination or scanning techniques has been reported in some cases of Hodgkin's lymphoma. Systemic symptoms: about one-third â…“ of patients with Hodgkin's disease may also present with systemic symptoms, including low-grade fever; night sweats; unexplained weight loss of at least 10% of the patient's total body mass in six months or less, itchy skin pruritus due to increased levels of eosinophils in the bloodstream; or fatigue lassitude. Systemic symptoms such as fever, night sweats, and weight loss are known as B symptoms; thus, presence of fever, weight loss, and night sweats indicate that the patient's stage is, for example, 2B instead of 2A8. Cyclical fever: patients may also present with a cyclical high-grade fever known as the Pel-Ebstein fever9, or more simply P-E fever. However, there is debate as to whether or not the P-E fever truly exists10. Diagnosis Hodgkin's lymphoma must be distinguished from non-cancerous causes of lymph node swelling such as various infections and from other types of cancer. Definitive diagnosis is by lymph node biopsy Usually excisional biopsy with microscopic examination. Blood tests are also performed to assess function of major organs and to assess safety for chemotherapy. Positron emission tomography PET is used to detect small deposits that do not show on CT scanning. In some cases a Gallium Scan may be used instead of a PET scan. Pathology Macroscopy Affected lymph nodes most often, laterocervical lymph nodes are enlarged, but their shape is preserved because the capsule is not invaded. Usually, the cut surface is white-grey and uniform; in some histological subtypes e.g. nodular sclerosis a nodular aspect may appear. Microscopy Microscopic examination of the lymph node biopsy reveals complete or partial effacement of the lymph node architecture by scattered large malignant cells known as Reed-Sternberg cells typical and variants admixed within a reactive cell infiltrate composed of variable proportions of lymphocytes, histiocytes, eosinophils, and plasma cells. The Reed-Sternberg cells are identified as large often bi-nucleated cells with prominent nucleoli and an unusual CD45-, CD30+, CD15+/- immunophenotype. In approximately 50% of cases, the Reed-Sternberg cells are infected by the Epstein-Barr virus. Characteristics of classic Reed-Sternberg cells include large size 20-50 micrometres, abundant, amphophilic, finely granular/homogeneous cytoplasm; two mirror-image nuclei owl eyes each with an eosinophilic nucleolus and a thick nuclear membrane chromatin is distributed at the cell periphery. Variants: Hodgkin's cell atypical mononuclear RSC is a variant of RS cell, which has the same characteristics, but is mononucleated. Lacunar RSC is large, with a single hyperlobated nucleus, multiple, small nucleoli and eosinophilic cytoplasm which is retracted around the nucleus, creating an empty space lacunae. Pleomorphic RSC has multiple irregular nuclei. Popcorn RSC lympho-histiocytic variant is a small cell, with a very lobulated nucleus, small nucleoli. Mummy RSC has a compact nucleus, no nucleolus and basophilic cytoplasm. 11 Hodgkin's lymphoma can be sub-classified by histological type. The cell histology in Hodgkin's lymphoma is not as important as it is in non-Hodgkin's lymphoma: the treatment and prognosis in Hodgkin's lymphoma depend on the stage of disease rather than the histotype. Types Classical Hodgkin's lymphoma excluding nodular lymphocyte predominant Hodgkin's can be subclassified into 4 pathologic subtypes based upon Reed-Sternberg cell morphology and the composition of the reactive cell infiltrate seen in the lymph node biopsy specimen. M9650/3 Family Name Description ICD-10 ICD-O Classical Nodular sclerosing CHL Is the most common subtype and is composed of large tumor nodules with lacunar RS cells subtype composed of numerous classic often pleomorphic RS cells with only few reactive lymphocytes which may easily be confused with diffuse large cell lymphoma. C81.1 M9663/3 Classical Mixed-cellularity subtype Is a common subtype and is composed of numerous classic RS cells admixed with numerous inflammatory cells including lymphocytes, histiocytes, eosinophils, and plasma cells. C81.2 M9652/3 Classical Lymphocyte-rich Is a rare subtype. C81.0 M9651/3 Classical Lymphocyte depleted Is a rare subtype. C81.3 M9653/3 Non-classical Nodular lymphocyte predominant Hodgkin's lymphoma NLPHL Is no longer classified as a form of classic Hodgkin's lymphoma. This is because the RSC variants popcorn cells that characterize this form of the disease invariably express B lymphocyte markers such as CD20 thus making NLPHL an unusual form of B cell lymphoma, and that unlike classic HL NLPHL may progress to diffuse large B cell lymphoma. There are small but clear differences in prognosis between the various forms. Lymphocyte predominant HL is an uncommon subtype composed of vague nodules of numerous reactive lymphocytes admixed with large popcorn-shaped RSC. Unlike classic RSC, the non-classic popcorn-shaped RS cells of NLPHL are CD15 and CD30 negative while positive for the B cell marker CD20. C81.7 M9659/3 Although the traditional B cell markers are not expressed, Reed-Sternberg cells are usually of B cell origin.1213 Staging After Hodgkin's lymphoma is diagnosed, a patient will be staged: that is, they will undergo a series of tests and procedures which will determine what areas of the body are affected. These procedures will include documentation of their histology, a physical examination, blood tests, chest X-ray radiographs, computed tomography CT scans or magnetic resonance imaging MRI scans of the chest, abdomen and pelvis, and a bone marrow biopsy. Positron emission tomography PET scan is now used instead of the gallium scan for staging. In the past, a lymphangiogram or surgical laparotomy which involves opening the abdominal cavity and visually inspecting for tumors were performed. Lymphangiograms or laparotomies are very rarely performed, having been supplanted by improvements in imaging with the CT scan and PET scan On the basis of this staging, the patient will be classified according to a staging classification the Ann Arbor staging classification scheme is a common one: Stage I is involvement of a single lymph node region I or single extralymphatic site Ie; Stage II is involvement of two or more lymph node regions on the same side of the diaphragm II or of one lymph node region and a contiguous extralymphatic site IIe; Stage III is involvement of lymph node regions on both sides of the diaphragm, which may include the spleen IIIs and/or limited contiguous extralymphatic organ or site IIIe, IIIes; Stage IV is disseminated involvement of one or more extralymphatic organs. The absence of systemic symptoms is signified by adding 'A' to the stage; the presence of systemic symptoms is signified by adding 'B' to the stage. For localized extranodal extension from mass of nodes which does not advance the stage, subscript 'E' is added. Prognosis Treatment of Hodgkin's disease has been improving over the past few decades. Recent trials that have made use of new types of chemotherapy have indicated higher survival rates than have previously been seen. In one recent European trial, the 5-year survival rate for those patients with a favorable prognosis was 98%, while that for patients with worse outlooks was at least 85%. 14 In 1998, an international effort15 identified seven prognostic factors that accurately predict the success rate of conventional treatment in patients with locally extensive or advanced stage Hodgkin's lymphoma. Freedom from progression FFP at 5 years was directly related to the number of factors present in a patient. The 5-year FFP for patients with zero factors is 84%. Each additional factor lowers the 5-year FFP rate by 7%, such that the 5-year FFP for a patient with 5 or more factors is 42%. The adverse prognostic factors identified in the international study are: Age = 45 years Stage IV disease Hemoglobin 10.5 g/dl Lymphocyte count 600/µl or 8% Male Albumin 4.0 g/dl White blood count = 15,000/µl Other studies have reported the following to be the most important adverse prognostic factors: mixed-cellularity or lymphocyte-depleted histologies, male sex, large number of involved nodal sites, advanced stage, age of 40 years or more, the presence of B symptoms, high erythrocyte sedimentation rate, and bulky disease widening of the mediastinum by more than one third, or the presence of a nodal mass measuring more than 10 cm in any dimension. Treatment See also: ABVD Patients with early stage disease IA or IIA are effectively treated with radiation therapy or chemotherapy. The choice of treatment depends on the age, sex, bulk and the histological subtype of the disease. Patients with later disease III, IVA, or IVB are treated with combination chemotherapy alone. Patients of any stage with a large mass in the chest are usually treated with combined chemotherapy and radiation therapy. Currently, the ABVD chemotherapy regimen is the gold standard for treatment of Hodgkin's disease. The abbreviation stands for the four drugs Adriamycin, bleomycin, vinblastine, and dacarbazine. Developed in Italy in the 1970s, the ABVD treatment typically takes between six and eight months, although longer treatments may be required. Another form of treatment is the newer Stanford V regimen, which is typically only half as long as the ABVD but which involves a more intensive chemotherapy schedule and incorporates radiation therapy. However, in a randomized controlled study, Stanford V was inferior.16 Another form of treatment, mainly in Europe for stages II is BEACOPP. The cure rate with the BEACOPP esc. regimen is approximately 10-15% higher than with standard ABVD in advanced stages. Although this was shown in a landmark paper in The New England Journal of Medicine Diehl et al., the US physicians still favor ABVD. Probably because some physicians think that BEACOPP induces more secondary leukemia. However, this seems negligible compared to the higher cure rates. Also, BEACOPP is more expensive because of the requirement for concurrent treatment with GCSF to increase production of white blood cells. Currently, the German Hodgkin Study Group tests 8 cycles 8x BEACOPP esc vs. 6x BEACOPP esc vs. 8x BEACOPP-14 baseline HD15-trial.17 The high cure rates and long survival of many patients with Hodgkin's lymphoma has led to a high concern with late adverse effects of treatment, including cardiovascular disease and second malignancies such as acute leukemias, lymphomas, and solid tumors within the radiation therapy field. Most patients with early stage disease are now treated with abbreviated chemotherapy and involved-field radiation therapy rather than with radiation therapy alone. Clinical research strategies are exploring reduction of the duration of chemotherapy and dose and volume of radiation therapy in an attempt to reduce late morbidity and mortality of treatment while maintaining high cure rates. Hospitals are also treating those who respond quickly to chemotherapy with no radiation. Notable cases Luke Menard, American Idol Season 7 contestant. Diagnosed with Hodgkin's lymphoma in 2008. Mark Fields Former NFL player forced to retire in 2004 from the disease. Paul Allen, Microsoft co-founder, was diagnosed and treated for Hodgkin's lymphoma in 1983.1 The actor Richard Harris died of Hodgkin's lymphoma in 2002 after filming Harry Potter and the Chamber of Secrets as main character Albus Dumbledore. Former NHL star Mario Lemieux was diagnosed with Hodgkin's lymphoma in January 1993. Even after taking 2 months off, Lemieux ended up winning the scoring title that year. Lynden David Hall died of Hodgkin's lymphoma in 2006. Barry Watson, an actor who gained fame in the television series 7th Heaven, had successfully treated Hodgkin's lymphoma. Delta Goodrem, Australian singer, was diagnosed with Hodgkin's lymphoma in July 2003. Former head of NBC Entertainment, Brandon Tartikoff, died in 1997 after a 25 year battle with Hodgkin's disease. U.S. Senator Arlen Specter R-PA was diagnosed with Phase IVB Hodgkin's Disease in 2005, underwent 5 months of chemotherapy, and received a clean bill of health. On April 15, 2008, he announced that his Hodgkin's had returned. British actor Roger Tonge who played the disabled Sandy Richardson in the cult British soap opera Crossroads in the 1960s and 1970s died of Hodgkin's Disease in 1981 at the age of 35. Alese Coco 2One of the most notable non-celebrities to have Hodgkin's disease. Known worldwide as a torch bearer for Hodgkin's research. Died at 23 years old. WWE wrestler Rowdy Roddy Piper was announced to have been diagnosed with Hodgkin's lymphoma on November 27, 2006. John Millington Synge, the Irish author best known for the play The Playboy of the Western World, died in 1909 from the disease. Dinu Lipatti, the Romanian pianist, died of Hodgkin's disease in 1950, 33 years old. Wayne Shelford, aka 'Buck' Shelford, former All Black rugby player for New Zealand. Elizabeth Madox Roberts, a noted Kentucky poet and novelist, died from Hodgkin's in 1941. Joy Hester, a noted Australian artist, died from Hodgkin's in 1960. Emma Lazarus, Jewish American poetess, writer of the New Colossus, died of Hodgkin's disease on 19 November 1887. Martin Fry, vocalist with ABC, was treated for Hodgkin's Disease in 1985/86. Journalist Giles Smith describes his bout with Hodgkin's in his memoir Lost in Music; he refers to the fact that Martin Fry above had the same condition. James Whitham, motorcycle racer, was treated for Hodgkin's Disease in 1995/96. Glen Goins, singer and guitarist for Parliament Funkadelic died from Hodgkin's Disease in 1978. Alexander Litvinov, a Russian rock poet and musician, died from Hodgkin's Disease in 1999. Jamie Tape AFL Footballer Freida Riley, an American schoolteacher who inspired the Rocket Boys, died of Hodgkin's Disease in 1969 at the age of 31. The movie October Sky was made in honor of her and the Rocket boys. Jane Austen, one of the most famous authors of English literature, died in 1817 aged 41. The cause of death was officially recorded as Addison's disease; however, modern speculation has suggested that it may have been Hodgkin's disease.18 Seumas McNally, a computer game programmer and president of Longbow Digital Arts, died on March 21, 2000; he was diagnosed with the disease three years earlier. Famous American writer Dale Carnegie died of Hodgkin's disease in 1955. Michael Cuccione, member of the spoof boy band, 2ge+her, was treated for Hodgkin's Lymphoma in 1994/95. He died from complications related to his treatment in 2001. Cultural references A main character in the movie October Sky and the book Rocket Boys, Miss Riley, was diagnosed with Hodgkin's lymphoma. In the novel Don't Die, My Love, by Lurlene McDaniel, one of the main characters, Luke, is diagnosed with Hodgkin's and dies after about a year and a half. In the latter part of the television series Party of Five, Charlie Salinger played by Matthew Fox, was diagnosed with Hodgkin's and, through rigorous regimens and treatments, went into remission. In the movie Sweet November, the character of Charlize Theron is in a terminal stage of Hodgkin's lymphoma. In Desperate Housewives, the character of Lynette Scavo, played by Felicity Huffman is diagnosed with Hodgkin's lymphoma, which she tries to keep a secret. Bang the Drum Slowly by Mark Harris is a novel about a baseball player's last season when only he and his best friend know he is dying of Hodgkin's disease. It was later made into a film of the same name. In the television show Curb your Enthusiasm episode The Five Wood Larry David believes his friend's father suffered from the good hodgkin's, and that he learned about it from an episode of Party of Five. In Jeffrey Archer's Kane and Abel, Matthew Lester is diagnosed with Hodgkin's, but does not disclose his discovery to anyone. His best friend, William Kane, is told by Doctor MacKenzie abut the illness shortly before Matthew's death. In the 1996 film Infinity with Matthew Broderick and Patricia Arquette, Arline Greenbaum Arquette is suspected of having Hodgkin's lymphoma. It later turns out to be lymphatic tuberculosis. Constable Deirdre 'Dash' McKinley in Australian Police Drama Blue Heelers was diagnosed with Hodgkins and shaved her head to save herself the trauma of going through hair loss. Actor DJ Qualls diagnosed with Hodgkin's lymphoma at 14, declared to be in remission after 2 years of treatment at 16 See also ABVD Stanford V Non-Hodgkin lymphoma References ^ Stein, RS.; Morgan, D 2003. Handbook of Cancer Chemotherapy, Sixth ion. Lippincott Williams Wilkins, 493, Table 21.2: Hodgkin's Disease: Incidence of stages and results of therapy. ISBN 0-7817-3629-3. ^ Ibid., 489. ISBN 0-7817-3629-3. ^ Edelson, Ed; Nov. 8, 2007. Doctors Report High Survival Rates for Hodgkin's Disease. MedicineNet.com.http://www.medicinenet.com/script/main/art.asp?articlekey=85095 ^ Mauch, Peter; James Armitage, Volker Diehl, Richard Hoppe, Laurence Weiss 1999. Hodgkin's Disease. Lippincott Williams Wilkins, 62-64. ISBN 0-7817-1502-4. ^ Biggar RJ, Jaffe ES, Goedert JJ, Chaturvedi A, Pfeiffer R, Engels EA 2006. Hodgkin lymphoma and immunodeficiency in persons with HIV/AIDS. Blood 108 12: 3786-91. doi:10.1182/blood-2006-05-024109. PMID 16917006. ^ Howard Terebelo, DO, FACP: discussion with patient, July 5, 2007. ^ Anonymous. Symptoms Signs. The Lymphomas. 2006: 11. ^ Ibid., 13,14. ^ RK Gupta, MB, PhD, FRCP; MK Gospodarowicz, MD, FRCPC; T. Andrew Lister, MD. Clinical Evaluation and Staging of Hodgkin's Disease. Hodgkin's Disease: 1999; 230-1. ISBN 0-7187-150204 ^ Asher, Richard July 6, 1995. Making Sense. The New England Journal of Medicine 333: 66-67. doi:10.1056/NEJM199507063330118. PMID 7777006. ^ Reed-Sternberg cell - Hodgkin lymphoma ^ Küppers R, Schwering I, Bräuninger A, Rajewsky K, Hansmann ML 2002. Biology of Hodgkin's lymphoma. Ann. Oncol. 13 Suppl 1: 11-8. PMID 12078890. ^ Bräuninger A, Schmitz R, Bechtel D, Renné C, Hansmann ML, Küppers R April 2006. Molecular biology of Hodgkin's and Reed/Sternberg cells in Hodgkin's lymphoma. Int. J. Cancer 118 8: 1853-61. doi:10.1002/ijc.21716. PMID 16385563. ^ Edelson, Ed; Nov. 8, 2007. Doctors Report High Survival Rates for Hodgkin's Disease. MedicineNet.com.http://www.medicinenet.com/script/main/art.asp?articlekey=85095 ^ Hasenclever D, Diehl V 1998-11-19. A Prognostic Score for Advanced Hodgkin's Disease. New England Journal of Medicine 339 21: 1506-14. doi:10.1056/NEJM199811193392104. PMID 9819449. ^ Gobbi PG, Levis A, Chisesi T, et al 2005. ABVD versus modified stanford V versus MOPPEBVCAD with optional and limited radiotherapy in intermediate- and advanced-stage Hodgkin's lymphoma: final results of a multicenter randomized trial by the Intergruppo Italiano Linfomi. J. Clin. Oncol. 23 36: 9198-207. doi:10.1200/JCO.2005.02.907. PMID 16172458. ^ Home | German Hodgkin Study Group ^ Upfal A 2005. Jane Austen's lifelong health problems and final illness: New evidence points to a fatal Hodgkin's disease and excludes the widely accepted Addison's. J Med Ethics Med Humanities 31: 3-11. doi:10.1136/jmh.2004.000193. External links Information Hodgkin's Lymphoma at the American National Cancer Institute Timeline of discovery and treatment of Hodgkin's Lymphoma Lymphomas in Children and Adolescents From the Centre for Cancer and Blood Disorders at Sydney Children's Hospital Hodgkin Disease from the Merck Manual Photos at Atlas of Pathology Anti-Tr antibody National charities Leukaemia CARE UK Lymphoma Association UK The Leukemia Lymphoma Society US Information from LLS. Australian Hodgkin's Lymphoma Network AU v d e Pathology: hematology, myeloid hematologic disease primarily D50-D77, 280-289 RBCs/ hemoglobinopathy + Polycythemia - Macrocytosis - Anemia Nutritional Iron deficiency anemia Plummer-Vinson syndrome, Megaloblastic anemia Pernicious anemia Hemolytic Herary enzyme: G6PD Deficiency - Pyruvate kinase deficiency - Triosephosphate isomerase deficiency hemoglobin: Thalassemia - Sickle-cell disease/trait membrane: Herary spherocytosis - Herary elliptocytosis - Herary stomatocytosis Acquired Autoimmune Warm, Cold, HUS, MAHA, PNH, PCH, Myelophthisic Aplastic Acquired PRCA, Diamond-Blackfan anemia, Fanconi anemia, Sideroblastic anemia Blood tests Normocytic - Microcytic - Macrocytic - Normochromic - Hypochromic Other Methemoglobinemia Coagulation/platelets/ coagulopathy/ bleeding diathesis + Hypercoagulability primary: Antithrombin III deficiency - Protein C deficiency/Activated protein C resistance/Protein S deficiency/Factor V Leiden - Hyperprothrombinemia acquired: DIC Congenital afibrinogenemia, Purpura fulminans - autoimmune Antiphospholipid Other Essential thrombocytosis - clotting factor: Hemophilia A/VIII, B/IX, C/XI Von Willebrand disease Hypoprothrombinemia/II - XIII platelet function: Bernard-Soulier syndrome - Glanzmann's thrombasthenia - Gray platelet syndrome - May Hegglin anomaly - Pelger-Huet anomaly Purpura: Henoch-Schönlein, ITP Evans syndrome, TTP Thrombocytopenia Heparin-induced thrombocytopenia Monocytes/ macrophages + Histiocytosis WHO-I Langerhans cell histiocytosis WHO-II/non-Langerhans-cell Juvenile xanthogranuloma, Hemophagocytic lymphohistiocytosis WHO-III/malignant Acute monocytic leukemia, Malignant histiocytosis, Erdheim-Chester disease Other Chronic granulomatous disease -cytosis: Monocytosis - -penia: Monocytopenia Granulocytes + -cytosis: granulocytosis Neutrophilia, Eosinophilia, Basophilia - -penia: Granulocytopenia/agranulocytosis Neutropenia, Kostmann syndrome See also hematological malignancy and immune disorders v d e Hematological malignancy/leukemia histology ICD-O 9590-9989, C81-C96, 200-208 Lymphoid/ Lymphoproliferative Lymphomas/ Lymphoid leukemias 9590-9739, 9800-9839 B cell lymphoma, leukemia most CD19, CD20 TdT+ ALL Precursor B acute lymphoblastic leukemia/lymphoma CD5+ SLL/CLL - mantle zone Mantle cell CD22+ Prolymphocytic - Hairy cell leukemia CD79a+ marginal zone Splenic marginal zone, MALT, Nodal marginal zone germinal center Follicular, Burkitt's, Diffuse large Other B Primary effusion - Lymphomatoid granulomatosis Plasma cells Plasmacytoma - Multiple myeloma - Waldenström macroglobulinemia T cell/NK cell lymphoma, leukemia most CD3, CD4, CD8 TdT+ ALL Precursor T acute lymphoblastic leukemia/lymphoma TdT- Cutaneous - Mycosis fungoides/Sézary's disease, Angioimmunoblastic - Anaplastic large cell - Hepatosplenic - Lymphomatoid papulosis Adult - Large granular lymphocyte - Prolymphocytic - Acute lymphoblastic Aggressive NK-cell leukemia Other Hodgkin's lymphoma usually B cell - Post-transplant lymphoproliferative disorder - Acute biphenotypic leukaemia Myeloid Myeloid leukemias 9840-9939 AML: Acute myeloblastic leukemia M1, M2 - APL/M3 - monocyte M4, AMoL/M5 - Erythroleukemia/M6 - AMKL/M7 - megakaryoblast - granulocyte Acute basophilic, Acute eosinophilic, Mast cell leukemia CML: CMoL, Philadelphia chromosome - Myeloid sarcoma Myelodysplastic- myeloproliferative 9945-9946 Juvenile myelomonocytic leukemia - Chronic myelomonocytic leukemia Myeloproliferative 9950-9964 Polycythemia vera - Essential thrombocytosis - Myelofibrosis - granulocyte CNL, Chronic eosinophilic leukemia/Hypereosinophilic syndrome Myelodysplastic 9980-9989 Sideroblastic anemia - Paroxysmal nocturnal hemoglobinuria Mast cell tumor 9740-9749 Mast-cell sarcoma - Malignant mastocytosis Malignant histiocytosis 9750-9759 Langerhans cell histiocytosis See also hematology and immune disorders Retrieved from http://en..org/wiki/Hodgkin%27s_lymphoma Categories: Hematology | Blood disorders | Types of cancer | Rare diseases Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages বাংলা Català Česky Deutsch Español Euskara Français Bahasa Indonesia Italiano اردو עברית Latina Nederlands 日本語 Polski Português РуÑ?Ñ?кий Simple English СрпÑ?ки / Srpski Suomi Svenska ไทย Türkçe This page was last modified on 25 August 2008, at 04:33
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