From the Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
Br J Haematol. 2019 Jan;184(1):45-59. doi: 10.1111/bjh.15614. Epub 2018 Nov 8.
The Hodgkin lymphomas are a family of unique lymphoma subtypes, in which the nature of the neoplastic cell was enigmatic for many years. Much of the mystery has been solved, with all forms now considered to be of B-cell origin, in most cases of germinal centre derivation. Today we recognize Hodgkin lymphoma as an eponym that encompasses multiple entities. One of the unifying themes is the major contribution from the tumour microenvironment. Both the character of the neoplastic cells and the nature of the immune environment are critical to accurate diagnosis. Moreover, an understanding of the molecular alterations that characterize both the neoplastic cells and their microenvironment have led to therapeutic advances, targeting both neoplastic and reactive components. Other conditions may foster a similar inflammatory milieu and lead to lymphoproliferations that mimic the Hodgkin lymphomas. In this review we provide an update on the diagnostic features of the various subtypes and include additional information relevant for prognostic evaluation and investigation of potential therapeutic targets. Additionally, we also discuss those conditions that often cause confusion in diagnosis and need to be distinguished from the Hodgkin lymphomas.
霍奇金淋巴瘤是一组独特的淋巴瘤亚型，其中肿瘤细胞的性质多年来一直是个谜。随着所有形式的霍奇金淋巴瘤现在都被认为起源于 B 细胞，大多数情况下起源于生发中心，大部分谜团已经被解开。如今，我们认识到霍奇金淋巴瘤是一个包含多种实体的名称。其中一个统一的主题是肿瘤微环境的主要贡献。肿瘤细胞的特征和免疫环境的性质对准确诊断都至关重要。此外，对特征性肿瘤细胞及其微环境的分子改变的认识，导致了针对肿瘤细胞和反应性成分的治疗进展。其他情况可能会促进类似的炎症环境，并导致类似于霍奇金淋巴瘤的淋巴增殖。在这篇综述中，我们提供了各种亚型的诊断特征的最新信息，并包括了与预后评估和潜在治疗靶点研究相关的其他信息。此外，我们还讨论了那些在诊断中经常引起混淆并需要与霍奇金淋巴瘤区分开来的情况。
