This document discusses Hodgkin lymphoma and its subtypes, classification, pathogenesis, and treatment. It classifies Hodgkin lymphoma into classical subtypes including nodular sclerosis, mixed cellularity, lymphocyte rich, and lymphocyte depleted. The pathogenesis involves activation of the NF-kB transcription factor which is common in classical Hodgkin lymphoma and can be activated by EBV infection, EBV tumor cells, or mutations. Reed-Sternberg cells possess diverse chromosomal aberrations with gain of the REL protooncogene contributing to increased NF-kB activity. Treatment for aggressive diffuse large B-cell lymphoma includes intensive chemotherapy and adjuvant anti-CD20, with myc translocations associated with a worse prognosis.
16. Classification (WHO)
Nodular Sclerosis Classical Hodgkin
Mixed cellularity
Lymphocyte rich
Lymphocyte depleted
Lymphocyte predominance
First 4 types – Reed- sternberg cells have similar
immunotype, Lymphocyte predominance have
distinctive B cell immunophenotype.
17. Pathogenesis
Activation of the transcription factor NF-kB is common event in
classical hodgkin.
NF-kB can be activated by –
1. EBV infection
2. EBV tumor cells LMP-1
3. Loss of function mutations in IkB or A20(alpha induced protein 3)
Activation of NF-kB by EBV or other mechanism rescues crippled
germinal centre B cells from apoptosis, further mutations turn these to
RS cells.
RS cell – aneuploid and possess diverse aclonal chromosomal
aberrations.
Most common is gain in REL protooncogene that contribute to increase
in NF-kB activity.
49. Treatment
DLBCL are aggressive tumor that are rapidly fatal
without t/t
Intensive chemotherapy
Adjuvant anti- CD20
DLBCL with myc translocation have worse prognosis.
