Nodular sclerosing Hodgkin lymphoma

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Nodular sclerosing Hodgkin lymphoma
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Lymphadenopathy, fever, night sweats, weight loss
Complications	Secondary malignancies, cardiovascular disease
Onset	Typically young adults
Duration	Variable
Types	Classical Hodgkin lymphoma
Causes	Unknown, potential Epstein-Barr virus association
Risks	Family history, immunosuppression
Diagnosis	Lymph node biopsy, immunohistochemistry
Differential diagnosis	Non-Hodgkin lymphoma, infectious mononucleosis
Prevention	None specific
Treatment	Chemotherapy, radiation therapy
Medication	N/A
Prognosis	Generally good with treatment
Frequency	Most common subtype of Hodgkin lymphoma
Deaths	N/A

Nodular sclerosing Hodgkin lymphoma (NSHL) is a subtype of Hodgkin lymphoma, which is a type of lymphoma, a cancer originating from lymphocytes, a type of white blood cell. NSHL is characterized by the presence of large, abnormal cells known as Reed-Sternberg cells in a background of fibrous tissue and nodular architecture.

Pathophysiology

Nodular sclerosing Hodgkin lymphoma is distinguished by its unique histological features. The lymph nodes affected by NSHL typically show a nodular pattern due to bands of fibrosis that divide the lymphoid tissue into nodules. The presence of Reed-Sternberg cells, which are large, abnormal, multinucleated cells, is a hallmark of the disease. These cells are often surrounded by a mixed inflammatory infiltrate, including eosinophils, plasma cells, and histiocytes.

Clinical Presentation

Patients with nodular sclerosing Hodgkin lymphoma often present with painless lymphadenopathy, most commonly in the cervical or mediastinal regions. The disease may also present with B symptoms, which include fever, night sweats, and weight loss. These symptoms are indicative of systemic involvement and are important for staging the disease.

Diagnosis

The diagnosis of NSHL is typically made through a combination of clinical evaluation, imaging studies, and histopathological examination of a lymph node biopsy. The biopsy will reveal the characteristic nodular sclerosis and the presence of Reed-Sternberg cells. Immunohistochemistry is often used to confirm the diagnosis, with Reed-Sternberg cells typically expressing CD15 and CD30 markers.

Treatment

The treatment of nodular sclerosing Hodgkin lymphoma usually involves a combination of chemotherapy and radiation therapy. The most common chemotherapy regimen used is ABVD, which includes doxorubicin, bleomycin, vinblastine, and dacarbazine. The choice of treatment depends on the stage of the disease, the presence of B symptoms, and the overall health of the patient.

Prognosis

The prognosis for patients with nodular sclerosing Hodgkin lymphoma is generally favorable, especially when diagnosed at an early stage. The overall survival rate is high, with many patients achieving long-term remission. However, the prognosis can vary based on factors such as the stage of the disease at diagnosis and the patient's response to treatment.

See also

• Hodgkin lymphoma
• Reed-Sternberg cell
• Lymphadenopathy
• Chemotherapy
• Radiation therapy