Hodgkin lymphoma

What histological variants of lymphogranulomatosis are distinguished in the modern morphological classification?

The modern WHO classification distinguishes two main types of Hodgkin's lymphoma: classical and nodular lymphocyte-predominant.

Histological variants of classical Hodgkin's lymphoma:

• Nodular sclerosis variant — includes types I and II.
• Mixed cellularity variant.
• Lymphocyte-rich classical variant (lymphocyte-rich) — corresponds to the outdated term "lymphocytic predominance".
• Lymphocyte-depleted variant — is rare.

Nodular lymphocyte-predominant Hodgkin's lymphoma is distinguished as a separate type with a different pathogenesis and immunophenotype.

What does the spleen look like macroscopically in lymphogranulomatosis?

Macroscopically, lymphogranulomatosis forms the so-called "porphyry spleen". The spleen is enlarged and firm. On cross-section, red pulp is seen with white-yellow foci and streaks.

In which organs are extranodal lesions and metastases most frequently detected during the generalization of lymphogranulomatosis?

During the generalization of lymphogranulomatosis, the spleen, liver, lungs, bone marrow, stomach and other parts of the gastrointestinal tract, skin, and kidneys may be involved. Sources also indicate that primary extranodal localization in the spleen, liver, lungs, stomach, skin, and bone marrow is rare.

What pathological processes and complications are most often the direct cause of death in patients with lymphogranulomatosis?

The direct causes of death in patients with lymphogranulomatosis are most often progression of the underlying disease and complications of ongoing therapy.

Main pathological processes and complications:

• Disease progression — generalization of the process with involvement of internal organs, development of cachexia, and multiple organ failure.
• Chemotherapy and radiotherapy complications — toxic effects on organs, development of secondary tumors.
• Infectious complications — sepsis, septic shock, and pneumonia against the background of secondary immunodeficiency.
• Critical conditions — acute respiratory failure, acute kidney injury, cerebrovascular accidents, gastrointestinal bleeding, and tumor lysis syndrome.