hodgkin's lymphoma | Hodgkin's lymphoma

Hodgkin's lymphoma



Summary
Thomas Hodgkin was observed in six patients a painless increase of the volume of the lymph nodes and spleen; He described gross anatomy in 1832. Two of the six cases described by it are what we now call Lymphoma Hodgkin (LH): is that the microscopic anatomy is widespread only after 1860. Characteristic cells have been described in detail by Carl Sternberg in 1898 and Dorothy Reed in 1902 - that's why they wear today their name, Sternberg or Reed-Sternberg (CRS) cells.

Hodgkin's lymphoma

Thomas Hodgkin was observed in six patients a painless increase of the
volume of the lymph nodes and the spleen; He described in macroscopic Anatomy
1832 two of the six cases described by it are what we now call Lymphoma
Hodgkin (LH): is that the microscopic anatomy is spread
after 1860. The characteristic cells have been described in detail by Carl
Sternberg in 1898 and Dorothy Reed in 1902 - that's why they wear
today their name, Sternberg or Reed-Sternberg (CRS) cells.
Hodgkin's lymphoma is a cancer of the lymph nodes characterized by the disappearance
of their normal architecture and the presence of CRS very little many (1
3%) in the middle of inflammatory cells. Hodgkin's lymphoma has been almost
constantly fatal well into the 1960s. Currently, the condition of a
initial ranking a therapeutic strategy and adequate, it can heal
in the vast majority of cases.

Epidemiology
The annual incidence of the LH varies by country: low in Asia, higher in
North America. In France, its impact was estimated to be 1 544 case in 2005, is
about 0.5% of all cancers; his mortality is significantly reduced (thanks
treatment) in thirty years, from 671 death in 1975 to 218 in 2005 [1]. The
LH mainly affects adults, with two peaks of frequency observed in
the country industrialized, but not elsewhere, around 30 years old and the other after
60. He reached both sexes with a recent and slight female predominance
in France (sex ratio: 0.92). The incidence in children is low in
developed countries, more important in developing countries with
a strong male predominance, in the order of 4 boys for a girl.
The LH is more common in the real twins than in dizygotic twins
[2]; in Northern Europe, it has been established from 1 283 047 cancer than subjects
The LH ranked 3rd (after cancers of the eye and the testicle, before those of)
thyroid and far ahead of breast or colon cancers) among cancers involving
a family susceptibility [3]. The intervention of environmental factors
(occupation, exposure to chemicals or particles,
tonsillectomy, etc.) does not carry conviction, apart from that of an agent
viral.
It remains that lifestyle plays a role: Japanese immigrants in the Canada
first generation are achieved with a lower frequency than the
Canadian, but higher than the Japanese residing in Japan [4]. Improving
J-f Morère and al., cancer therapy
© Springer-Verlag France 2011
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the standard of living (for example, in the United States during the 20th century, or more)
recently in some industrialized countries) has been accompanied by a decrease
the proportion of children with greater frequency among young people
adults. This shift in peak incidence resembles what has been observed for
polio in the 20th century, which suggests an association between HL and a
exposure to a ubiquitous agent, exposure has become less frequent with the
development of hygiene: this is the "poliovirus hypothesis", applied to a
potentially oncogenic virus, the virus of Epstein - Barr (EBV) [5].
Independent epidemiological, serological, and molecular studies the
each other, provide arguments in favour of the involvement of the EBV in
the genesis of the LH [6]. The EBV is able to capture lymphoid cells; the
transfection of her LMP gene in a lymphoblastoide lineage made him express
the phenotypic characters of Sternberg cells [7]. The relationship is not
direct, since it is only in 30-50% of cases it is possible
to highlight the genome, RNA and EBV-specific proteins (particularly
the latent membrane protein or LMP) in malignant cells.
The EBV - LH connection is more common in underdeveloped countries than in
France [8] and in developed countries [8]. This research has already benefits
practices: treatment by lymphoid T cells cytotoxic autologous
having a specificity anti-EBV has been tried in LH EBV-positive and resistance
treatment [9].
The scarcity and the special features of the CRS have long been discussing
the nature of the LH, but their origin lymphoid B from germinal centers
lymph node follicles is established since 1999 [10], which like him
LH to other malignant lymphomas. The basic research on the CRS and
their inflammatory environment [11-15] lead to imagine treatments
targeting the menanismes of their survival [16].

Pathological classification and diagnosis
The ganglion puncture shows most often one or several CRS, cells
large size, kernel plurisegmente, containing many nucleoli and a
the chromatin is finely reticulated. Ganglionic, always essential, biopsy
must be made on as typical as possible Lymphadenopathy. The broad flushing
are unnecessary and sometimes causing mechanical damage (big leg of the floaters
inguinal/retrocruraux, fall and anteversion of the stump of the shoulder after
cervical biopsy). Pathological examination allows to state the diagnosis
most often with a simple colouring panoptic: destruction of the architecture
ganglionic, presence of 1% to 3% of CRS in a Granuloma
inflammatory more or less important. It also allows to specify the histological type.
The histological classification established in Rye in 1965 by an international Committee
[17] is always used, because it is easily reproducible. It is based on the presence
or not to ring MS so identifying nodules, as well as on
wealth or poverty in lymphocytes. Type 1 (Lymphocytic predominance,
(PL), type 3 (mixed cellularity, CM) and type 4 (Lymphocytic depletion,