The cancer cell pathologists recognise by its pair of owl eyes
Under the microscope, the classic cell of Hodgkin lymphoma is huge for a cell, 20 to 50 micrometres across, with two mirror-image nuclei that each hold a prominent nucleolus. Pathologists call the look owl eyes. These Reed–Sternberg cells, scattered among ordinary immune cells in a lymph node, define the disease.
The English physician Thomas Hodgkin first described the condition in 1832. It is a lymphoma, a cancer of lymphocytes, a group of white blood cells, and the Reed–Sternberg cells usually come from B cells, although they sometimes carry markers typical of T cells. They also make interleukin-21, a signalling molecule once thought to be produced only by T cells, which may help explain why other immune cells cluster around them.
The variants have vivid names. A lacunar cell's cytoplasm shrinks away from its nucleus and leaves an empty-looking gap. Popcorn cells have a heavily lobed nucleus and mark a separate form, nodular lymphocyte-predominant disease, which makes up about a tenth of cases; the classic form accounts for the other nine tenths. A mummy cell has a compact nucleus with no nucleolus.
Some features are curious. The commonest sign is painless swelling of lymph nodes, usually in the neck, armpit or groin. In just two to three per cent of patients, affected nodes hurt within minutes of drinking alcohol, rare but so specific that it is regarded as characteristic of the disease. A cyclical fever, named Pel–Ebstein after two physicians, has been described, though whether it truly exists is debated. About half of cases are linked to the Epstein–Barr virus.
In 2015 around 574,000 people worldwide had the condition, and most are diagnosed between 20 and 34. In the United States 89 per cent of those diagnosed live at least five years, rising to 97 per cent under age 20.
Source: Hodgkin lymphoma
