Abstract

Recent histologic, immunophenotypic and genotypic data have restricted the concept of Hodgkin's disease (HD) to the type 2 and 3 of Rye classification. This classification should be revised since the lymphocyte-predominance type has been shown to include the nodular paragranuloma which is a B-cell lymphoma, cases which have been confused with T-cell-rich large B-cell non Hodgkin's lymphoma (NHL) and cases which should be reclassified among the mixed cellularity group. Further more, most types 4 are now regarded as anaplastic large cell NHL. Immunophenotypic and genotypic studies support the heterogeneous nature of Reed-Sternberg and Hodgkin's (RSH) cells since they could be derived from B, T or null lymphocytes. In 50% of cases, RSH cells harbour the Epstein-Barr virus genome and express a viral protein, the latent membrane protein, which could play an oncogenic role in HD. Finally, RSH cells produce a wide range of cytokines that could stimulate their proliferation and explain the marked cellular reaction that is observed in HD.

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