Hodgkin’s disease

Abstract

The debate as to whether Hodgkin’s disease is an inflammatory or neoplastic disease appears to have been settled in favour of the latter. The main evidence supporting a neoplastic proliferation is the relentless progression of the disease when untreated, the morphological atypia of some of the component cells and the finding of aneuploidy in cytogenetic preparations made from Hodgkin’s tissue (Kaplan, 1980). The Reed-Sternberg (RS) cell and its mononuclear counterpart (often referred to as the Hodgkin cell) are regarded as the neoplastic cells whereas the other components of Hodgkin’s disease tissue are thought to be reactive. The presence of RS cells is mandatory for a diagnosis of Hodgkin’s disease, but since morphologically identical or closely similar cells may be seen in other lymphoproliferative or neoplastic diseases the diagnosis of Hodgkin’s disease should be made only when RS cells are seen in a cellular setting appropriate for one of the morphological subtypes of that disease. The composition of the reactive cells forming that setting, the numerical relationship of those cells to the RS cells and variations in the morphology of the RS cells are used to define the histological subtypes of Hodgkin’s disease (Table 4.1) (Lukes and Butler, 1966).