The current classification of Hodgkin lymphoma (HL) is the result of an integrated approach that combines the evaluation of morphological patterns, immunophenotypic characteristics, molecular features, and clinical presentation. Evolving from its origins based solely on histological observation to the latest updates in the WHO 5th Edition, this system has become an essential tool for accurate diagnosis and personalized therapeutic strategies. Each subtype of classic HL (cHL)—nodular sclerosis, mixed cellularity, lymphocyte-rich, and lymphocyte-depleted—exhibits distinctive pathological and clinical features, now better understood through multidisciplinary studies and international collaborations. HL also includes nodular lymphocyte-predominant HL (NLPHL), a distinct entity with unique morphologic, immunophenotypic, and clinical features. A hallmark morphological feature of cHL is the presence of Hodgkin and Reed-Sternberg (HRS) cells, large and often multinucleated cells derived from B lymphocytes that have lost their typical B-cell phenotype. Identifying these cells is critical for diagnosis and for differentiating HL from other hematologic malignancies. HL is characterized by the rarity of malignant cells, a high curability rate, and a rich immune cell microenvironment that is both shaped and exploited by the tumor. Understanding these core aspects paves the way for exploring the role of immunologic and genetic biomarkers in refining classification, enhancing diagnosis, improving prognostic assessment, and guiding therapy for patients with cHL.
霍奇金淋巴瘤（HL）的现行分类体系是整合形态学模式、免疫表型特征、分子学标志及临床表现的综合评估结果。从最初单纯依赖组织学观察到世界卫生组织第五版的最新修订，这一分类系统已发展为精准诊断和个体化治疗策略的重要工具。经典霍奇金淋巴瘤（cHL）各亚型——结节硬化型、混合细胞型、富于淋巴细胞型和淋巴细胞消减型——均呈现独特的病理与临床特征，这些特征通过多学科研究和国际合作得到了更深入的理解。HL还包括结节性淋巴细胞为主型HL（NLPHL），这是一种具有独特形态学、免疫表型和临床特征的独立类型。cHL的标志性形态学特征在于霍奇金与里-施（HRS）细胞的存在，这些源自B淋巴细胞的大型多核细胞已丧失典型B细胞表型。识别这些细胞对HL的诊断及其与其他血液系统恶性肿瘤的鉴别至关重要。HL的典型特征包括恶性细胞稀少、治愈率高以及富含免疫细胞的微环境——这种微环境既受肿瘤塑造又被其利用。理解这些核心要素为探索免疫与遗传生物标志物在cHL分类细化、诊断优化、预后评估提升及治疗指导中的作用奠定了基础。
Hodgkin Lymphoma Classification—From Historical Concepts to Current Refinements
肿瘤(癌症)患者之家