Histopathological Spectrum of Paediatric Hodgkin´s Lymphoma
Payal K. Dept. of Pathology, St Johnâ€™s Medical College, Bangalore, India. Tel:080-25634854,
Background: Hodgkinâ€™s lymphoma (HL) accounts for 5 per cent of the malignancies in the pediatric age group and is potentially curable. However, early diagnosis is essential for timely management. The diagnosis and classification of Hodgkinâ€™s lymphoma was considered to be relatively simple and straightforward earlier, but the characteristic Reed-Sternberg cells (R-S cell) that occur within an inflammatory milieu and are required for the diagnosis can also be seen in other reactive conditions, such as infectious mononucleosis and other malignant lesions, such as nonHodgkinâ€™s lymphomas. The advances in phenotyping, molecular characteristics, histogenesis and possible mechanisms of lymphoma genesis, have led to a change in the classification into the Revised European American Lymphoma (R.E.A.L) classification followed by the World Health Organization (WHO) scheme. This has been done with a view to reflect the differences in clinical presentation, prognosis, and management. In the process, while the borders between some histological types of lymphoma became sharper, others continue to remain ill defined.
Material and Methods: Paraffin sections and medical records of the diagnosed cases of HL were retrospectively studied during the period between Jan 1992 and Dec 2003. The sections were studied to assess the architecture, the presence of R-S cells and its variants, background infiltrate, and fibrosis.
Results: 29 cases of pediatric HL were encountered out of a total of 106 cases of Hodgkinâ€™s lymphoma. The age range was 3-14 years with an M: F ratio of 24:5. The most common clinical presentation was lymphadenopathy in 18 cases. Histologic sub typing of 29 cases revealed mixed cellularity to be the predominant subtype.
Conclusions: Pediatric HL accounts for 27.3 % of all cases of Hodgkinâ€™s Lymphoma in our study. The mean age at presentation was 8.5 years with a male predominance. Mixed cellularity was found to be the most common subtype.