Hodgkin lymphoma is one of the most unique types of cancer known to oncology. When looking at the cells from virtually any kind of cancer under the microscope, one would see that for every 100 cells counted, 90 to 95 of those cells counted would be malignant, with about 10 to 5 of those cells being normal infiltrating cells. This is because malignant cells grow and divide at a pace that allows for the rapid accumulation of those cells in large masses, called tumors. Examination of a tumor from a patient with Hodgkin Lymphoma would reveal that for every 100 cells counted, only 1 to 2 of the cells counted would be malignant, and 98 to 99 would be normal! The malignant cells are called the Reed-Sternberg cells, named for the pathologists who first described them. This interesting and unique feature of the disease implies that the surrounding environment can play an important role in influencing the behavior of the malignant cells. And, unlike non-Hodgkin lymphoma, Hodgkin lymphoma spreads in a very predictable manner, and is not considered a systemic disease at diagnosis.
The disease is known to spread by the lymphatic vessels, spreading from one lymph node to the next by contiguous spread. While our progress with Hodgkin Lymphoma over the years is often heralded as one of the great accomplishments in all of cancer medicine, still only about 70% of patients can expect to be cured. For those not cured with conventional chemotherapy, the disease can be managed, and sometimes becomes more indolent and chronic in nature.