What is Non-Hodgkin’s Disease and Hodgkin’s Disease?

Lymphoma is defined as the cancer of the lymphatic system.

Classification of Lymphomas is given below;

1. Hodgkin lymphoma

2. Non-Hodgkin lymphoma ¨ B-cell lymphoma ¨ T-cell lymphoma

Both HL (Hodgkin’s lymphoma) and NHL (non-Hodgkin’s lymphoma disease) are lymphomas — types of malignancy or cancer that begin in a subset of WBCs (white blood cells) termed as lymphocytes.

The major difference between HL and NHL is in terms of presence of Reed-Sternberg cells and the specific lymphocyte each involves.

Reed-Sternberg cells – also termed as lacunar histiocytes, are giant and distinctive cells present in the lymph fluid. They can be easily identified under the microscope because they are large in size and often contain more than 1 nucleus.

Non-Hodgkin’s Disease

Characterized by

• Neoplastic transformation of either B or T cell lineages of lymphatic cells
• Absent reed-Sternberg cells
• NHL causes the accumulation of neoplastic cells in both the lymph nodes as well as in extra lymphatic organs and the bloodstream.

Hodgkin’s Disease

Characterized by:

• The presence of Reed-Sternberg cells on histology
• Spreading in an orderly fashion to contagious lymph nodes (For example, HL that starts in the cervical lymph nodes may spread first to the supraclavicular nodes then to the axillary nodes)

Difference between Non-Hodgkin’s disease and Hodgkin’s disease

Definition

Non-Hodgkin’s disease

The lymphoma is Non-Hodgkin’s lymphoma if the abnormal cell termed as a Reed-Sternberg cell is not present.

Hodgkin’s disease

The lymphoma is Hodgkin’s lymphoma if a specific type of abnormal cell termed as a Reed-Sternberg cell is detected by the doctor.

Location

Non-Hodgkin’s disease

• Skin rash, coughing, pain in the chest, abdomen, or bones, painless and swollen lymph nodes in your groin, armpits, or neck
• Mucosa of the hard and/ or soft palate is the most common site > pharyngeal and lingual tonsils and the pharyngeal walls. Above locations are considered as Waldeyer’s ring.

Hodgkin’s disease

Cervical Lymphatic Chain (frequently involved by HL) that gives the patient a so-called

Bull-neck appearance – Due to the presence of bulky unilateral or bilateral fused lymph node masses of the lymphatic cervical chain.

Types

Non-Hodgkin’s disease

There are more than 61 types and subtypes of non-Hodgkin lymphoma. B-cell lymphomas account for eighty percent of all cases. Diffuse large B-cell lymphoma (blood cancers in the lymph nodes) is the most common form on non-Hodgkin lymphoma.

Hodgkin’s disease

There are 6 varieties of Hodgkin lymphoma. The most common forms are nodular sclerosis, classical Hodgkin lymphoma and mixed cellularity classical Hodgkin lymphoma. They account for about 90% of all cases.

Risk Factors

Non-Hodgkin’s disease

INFECTIONS

• Human immunodeficiency virus (HIV)
• Helicobacter pylori: Extra nodal tissues generating lymphoma include MALT (Mucosa associated lymphoid tissue)
• Epstein-Barr virus (EBV): linked to Burkitt lymphoma
• Hepatitis C virus
• Human T-cell leukaemia/lymphoma virus (HTLV-1)

Hodgkin’s disease

• Previous infection with or mononucleosis or Epstein-Barr virus (EBV) infection 
• Weakened immune system
• Family history: About five percent of cases have a family link
• Age: Hodgkin lymphoma occurs most often in early adulthood (between ages fifteen-forty, and especially in the twenties) or late adulthood (after age fifty-five)

Nodal Groups

Non-Hodgkin’s disease

Thoracic – 25 – 40%

Para-aortic – 45 – 55%

Mesenteric – 50 – 60%

Hodgkin’s disease

Thoracic – 65 – 85%

Para-aortic – 25 – 35%

Mesenteric – 5%

Age

Non-Hodgkin’s disease

The average age of someone who is diagnosed with non-Hodgkin’s lymphoma disease is 60,

Hodgkin’s disease

Most Hodgkin lymphomas disease occur in people in age group of 15 to 24, or over 60.

Prognosis

Non-Hodgkin’s disease

The prognosis for NHL varies in accordance with the particular type of lymphoma and the extent at which the cancer spreads (stage of the cancer). The five-year survival rate overall for all patients with NHL has been reported about seventy two percent in 2005 to 2010.

Hodgkin’s disease

Hodgkin’s Lymphoma is curable type of cancer in comparison to the NHL, with 5-year survival rates that have steadily increased to about eighty eight percent in 2005 to 2010. This rate is even higher (about ninety four percent) in people under age forty-five at the time of diagnosis.

Treatment

Non-Hodgkin’s lymphoma

Treatment for Non-Hodgkin lymphoma disease includes chemotherapy, plasmapheresis (procedure to swap unhealthy plasms with a healthy plasma), targeted therapy, stem cell transplant, immunotherapy, radiation therapy, antibiotic therapy, surgery, and watchful waiting.

Hodgkin’s lymphoma

Treatment for Hodgkin lymphoma disease includes radiation therapy, chemotherapy, and surgery.

Summary

The points of difference between Non-Hodgkin’s disease and Hodgkin’s disease have been summarized as below:

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