Aetiology and epidemiology

Hodgkin lymphoma is characterized by the presence of Reed–Sternberg cells within the neoplastic tissue (Fig 32.1a). It is more prevalent in males than in females (M : F ratio is 1.5–2.0 : 1) and has a peak incidence in age range 15–40 years. The cause is not known, but Epstein–Barr virus infection may be a cofactor.

Histological classification

This is well defined and of prognostic significance (Box 32.1). Reed–Sternberg (RS) cells are usually outnumbered by a non-malignant reactive infiltrate of eosinophils, plasma cells, lymphocytes and histiocytes. The RS cells are CD30⁺ (Fig. 32.1b); HL is of B-cell origin. The (classic) disease is classified histologically into mixed cellularity, nodular sclerosis, lymphocyte rich and lymphocyte depleted (Box 32.1). Prognosis for lymphocyte-rich HL is favourable, whereas lymphocyte-depleted HL is less favourable.

Clinical features

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