2. The Stealthy Siblings: Subtypes of Hodgkin Lymphoma
When most people think of Hodgkin Lymphoma, they might be under the misconception that it’s a singular disease. However, HL is more like a family, with different members showcasing unique characteristics. HL is broadly categorized into various subtypes, and each of these has its distinctive features and behavior.
Classical Hodgkin Lymphoma (cHL) is the most common type, accounting for about 95% of all HL cases. The hallmark of cHL is the presence of Reed-Sternberg cells, which we’ve discussed before. But cHL itself is further categorized into four subtypes: Nodular sclerosis, Mixed cellularity, Lymphocyte-rich, and Lymphocyte-depleted.
Then, there’s the lesser-known sibling: Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). This type is rarer, accounting for the remaining 5% of cases. It’s distinct because it involves large cells known as LP cells, which are different from Reed-Sternberg cells. NLPHL tends to grow slowly and can be tricky to diagnose because of its rarity and the absence of the typical Reed-Sternberg cells.
Interestingly, the treatment and prognosis can vary between these subtypes. While cHL is typically treated with chemotherapy and possibly radiation, NLPHL may be approached differently due to its slow growth. Sometimes, merely keeping an eye on it, a strategy known as ‘watchful waiting’, might be the initial approach. (2)
