Neoplasia in pregnancy
Hung N. Winn, Frank A. Chervenak, Roberto Romero in Clinical Maternal-Fetal Medicine Online, 2021
Patients with non-Hodgkin’s lymphoma commonly present with high- or intermediate-grade diffuse histologic patterns and have a poorer prognosis than those with a nodular pattern (53). They are histologically distinguished from Hodgkin’s lymphoma by the absence of Reed–Sternberg cells. They comprise a heterogeneous group of lymphoid malignancies and differ in their presentation, stage at diagnosis, and prognosis. The classification system now used is based on the WHO classification system and uses morphologic, genetic, immunophenotypic, and clinical features. This has been shown to provide a higher degree of diagnostic accuracy and reproducibility (257).
Paper 4
Aalia Khan, Ramsey Jabbour, Almas Rehman in nMRCGP Applied Knowledge Test Study Guide, 2021
Non-Hodgkin’s lymphoma is a group of lymphomas which are predominantly B-cell proliferations. It typically presents in adults with lymphadenopathy. Fever, weight loss, lethargy and night sweats may also be present. Investigations may show pancytopenia and a mediastinal mass on CXR. Node biopsy is essential and staging may require CT or MRI scanning. Reed-Sternberg cells are present in Hodgkin’s lymphoma. Histologically low-grade lymphomas are slow growing but often incurable and the high-grade lymphomas are more aggressive but curable with chemotherapy regimes.
Lymphomas
Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven in Succeeding in Paediatric Surgery Examinations, 2017
The classical subtype of Hodgkin’s lymphoma is characterised by Reed–Sternberg cells. The cells are unique in appearance because of their large size and characteristic ‘owl’s-eye’ nucleus. Reed–Sternberg cells are derived from germinal centre B lymphocytes and frequently express CD15 and CD30. Although Reed–Sternberg cells are considered the malignant cells in this disease, they make up only a small portion of the cellularity of the tumour. The rest consists of a mixture of inflammatory cells including lymphocytes, granulocytes, histiocytes, plasma cells and eosinophils.
Infectious mononucleosis-related tonsillar hyperplasia mimicking T-cell lymphoma on histopathology: A rare case and review
Published in Acta Oto-Laryngologica Case Reports, 2020
Usman Asad, Irfan Warraich, Winslo Idicula
Pleomorphic binucleated cells resembling Reed-Sternberg cells, as well as single atypical cells seen in some Hodgkin and T-cell lymphomas, were observed (Figure 2(B)). Mitotic figures were numerous. However, only scattered cells were seen staining for both CD15 and CD30, making the diagnosis of a classical Hodgkin lymphoma unlikely. The CD30 negativity argued against the case of anaplastic large cell lymphoma (a peripheral T cell lymphoma). ALK-1 was also negative. This combination of minimal CD30 staining and negative ALK-1 staining made the diagnosis of anaplastic large cell lymphoma unlikely. An EBV-encoded RNA in-situ hybridization (EBER ISH) was strongly and diffusely positive in large EBV-infected cells (Figure 2(F)). Therefore, the diagnosis of infectious mononucleosis-related tonsillar hyperplasia was made rather than lymphoma.
Multifocal vertebral sclerosing bone changes and soft tissue masses caused by Hodgkin’s lymphoma in a patient with systemic lupus erythematosus: a case report
Published in Scandinavian Journal of Rheumatology, 2019
S Krabbe, J Helweg-Larsen, A Loft, S Jacobsen
After these unsuccessful treatments, the vertebral biopsies were reviewed. This time, a few, scattered, large cells, some with double nuclei and eosinophilic nucleoles, reminiscent of Hodgkin cells, but not classic Reed–Sternberg cells, were observed in a tissue sample taken from Th4. By immunohistochemical staining, the cells were positive for CD30, epithelial membrane antigen, Epstein–Barr virus, and paired box-5. Based on this, a diagnosis of Hodgkin’s lymphoma was finally made. Treatment with escalated-dose BEACOPP chemotherapy (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) led to remission of Hodgkin’s lymphoma with no progression of the sclerosing bone changes at follow-up after 3 years. The patient’s sensory and motor deficiencies are unchanged.
Advances in Hodgkin’s lymphoma pharmacotherapy: a focus on histone deacetylase inhibitors
Published in Expert Opinion on Pharmacotherapy, 2023
Thuy Ho, Cara Coleman, Palak Shah, Victor Yazbeck
Despite the excellent prognosis for the majority of patients with Hodgkin lymphoma, outcomes for patients with refractory or relapsed HL, especially after autologous or allogeneic stem cell transplantation, remain poor with traditional chemotherapy. More recently approved therapies, such as brentuximab vedotin and PD1 inhibitors, have shown promising results in this setting. However, drug resistance to chemotherapy, targeted and immunotherapy agents eventually arise, necessitating novel therapeutic approaches. Additionally, Hodgkin Reed Sternberg cells survive through multiple mechanisms, including escape from immune detection. Targeting the TME in addition to the primary tumor is also crucial for effective disease control. One strategy to overcome these resistance mechanisms and disrupt the tumorigenic niche is through epigenetic regulation, in which histone acetylation plays a major role. To date, a great number of histone deacetylase inhibitors have been developed. These agents have demonstrated a unique safety profile as monotherapy and as part of combination treatments in relapsed/refractory Hodgkin lymphoma and other hematologic and solid malignancies. The most frequent toxicity from HDAC inhibitors is thrombocytopenia, the severity of which varies depending on the individual HDACI and the nature of the synergizing agent(s). Overall, HDAC inhibitors appear to have a more tolerable safety profile than cytotoxic chemotherapy. In terms of efficacy in relapsed/refractory HL, the results have been variable, but with a promising signal of clinical activity based on disease control rate.
Related Knowledge Centers
- Antibody
- B Cell
- Biopsy
- Germinal Center
- Microscopy
- Somatic Hypermutation
- Hodgkin Lymphoma
- Cell Nucleus
- Giant Cell
- V(D)J Recombination