Alteration on the Normal cycle of the B-cell

HODGKINS LYMPHOMA
maturation in the germinal center found on
secondary lymphoid
Non-tissue occurs risk factors:
modifiable
Modifiable risk factors: Book and Net
Based 1. Age
1. Diet
 Malnutrition
Pathophysiology  15-35 years old
 Older than 55 years old
 Sharing food utensils
2. Genetics
2. Environment
 Can be inherited
 Crowded Areas
3. Gender
 Most common in the United
 Male usually are affected
states, Canada and Asia
4. Idiopathic
3. Lifestyle
 Usually the cause are
 Kissing other partners
unknown in nature
4. Current Infection
5. Current Infection
 Infectious Mononucleosis
 HIV infection
caused by EBV (Epstein-
barr virus)

Entry of EBV virus into the body either

through saliva or current infection of
Infectious Mononucleosis

POSSIBLE EFFECTS OF EBV in HL, Process on the germinal center:

although no direct study is of definite
to the direct effects 1. Activated B cells function from the lymph
follicle changes and begin monoclonal
1. Oncogenic function to the expansion in the environment of
Immune cells Follicular-dendritic cells( Non-migratory)
2. Dysregulation of several 2. After several days Somatic Hypermutation
signaling factors for B-cell occurs. A process in which a single clone is
3. Reprogramming of mature B-
created through normal immune- DNA
cell which allows prolonged
mutation and type switching or iso-
survival
switching occurs
4. EBV induced protein production
of :
 EBNA1
 LMP1 Not all B-cells iso- switching occurs and
 LMP2 normally apoptosis occurs for those who are
not switched
Aids in the regulation of Reed-
stenberg cells
Due to unknown cause or some suggests are
by EBV, B-cells still survives and proliferates
and they are now called RS cells
Decrease immune response RS cells have not undergone hypermutation, These cells become bigger
renders the body iso-switching and they immune response and either multinucleated
vulnerable to both bacterial function is diminished or nucleated
and viral invasion
These cells are very visible
Increase in growth and monoclonal rate of RS upon light microscopy
cells with help of unknown factor possibly by biopsy of the tumor growth
S/SX: from Hodgkin’s lymphoma
protein induced by EBV
1. Cough
2. Fever
3. Chills Immune response is activated as a result of
4. Sweating foreign or threat detection
5. Fatigue
6. . Painful or swollen They travel through the lymph vessels and some
lymph nodes are lodgedRSand
However are
cells trapped
still in theorigins,
have B-cell Lymphwhich
node
7. Skin irritations and
make it not a threat to other immune cells. It
Lesions may occur as a
attracts the immune micro-environment and
result of decreased
infiltrates local immune response
immune response to
any bacteria that may
be lodged or Different CD molecules such as CD30 and CD
penetrate the skin or 45 which are confirmatory for HL are also
possible found in the RS since it is a B-cell in origin,
hypersensitivity many CD molecules are found in it and they
reaction serve as receptors which make them unable to
be attacked and are sometimes not recognized
as threats

Further proliferation of RS cells and Abnormal

B-cells that are oncogenic in nature

 Stage I. The cancer is limited to one lymph node region or

a single organ.

Stage II. In this stage, the cancer is in two different lymph nodes or
the cancer is in a portion of tissue or an organ and nearby lymph
nodes. But the cancer is still limited to a section of the body either
above or below the diaphragm.
  Stage III. When the cancer moves to lymph nodes both
above and below the diaphragm, it's considered stage III. Cancer
may also be in one portion of tissue or an organ near the lymph
node groups or in the spleen.

 Stage IV. This is the most advanced stage of Hodgkin's

lymphoma. Cancer cells are in several portions of one or more
organs and tissues. Stage IV Hodgkin's lymphoma affects not only
the lymph nodes but also other parts of your body, such as the
liver, lungs or bones.

Hodgkins Lymphoma can be classified in either A or B type.

 A. No significant signs and symptoms of cancer

 B. With significant signs and symptoms of cancer such as

persistent fever, weight loss, night sweats

Complications of HL varies from it’s different stages however

common complications are:

 Metastasis of cancer through several parts of the body

that can be very fatal if it occurs on vital organs such as
Brain, Lungs and Liver
 Sepsis or Viremia
 Severe airway compression especially if the Tumor affects
the cervical lymph nodes
 Superior Vena cava syndrome
 Fatigue experience upon moving or because of heavy
tumor

References:

1. Seeleys Principles of Anatomy and Physiology

2. http://www.nlm.nih.gov
3. Hodgkins and Non-Hodgkins Lymphoma (John P. Leonard, Morton Coleman)
4. http://www.ncbi.nlm.nih.gov/pubmed/16304386