Hodgkin has Reed-Sternberg cells and spreads contiguously; non-Hodgkin does not
Expansion
| Feature | Hodgkin | Non-Hodgkin |
|---|---|---|
| Diagnostic cell | Reed-Sternberg (“owl eye”) | Varies by subtype |
| Age | Bimodal: young adults and over 55 | Rises with age |
| Spread | Contiguous, node group to adjacent group | Non-contiguous, often widespread at diagnosis |
| Extranodal | Uncommon | Common |
| B symptoms | Common | Variable |
| Prognosis | Generally better | Depends on grade |
B symptoms: fever, drenching night sweats and weight loss over 10 per cent in 6 months. They upstage the disease and worsen prognosis.
Alcohol-induced nodal pain and Pel-Ebstein cyclical fever are classic though uncommon features of Hodgkin lymphoma.
Non-Hodgkin subtypes worth knowing: diffuse large B cell (commonest, aggressive but curable), follicular (indolent, t(14;18) with BCL-2, largely incurable), Burkitt (t(8;14) with MYC, starry sky appearance, the fastest growing human tumour, associated with EBV and with jaw or abdominal masses), MALT (associated with H pylori, may regress with eradication), and mantle cell (t(11;14), poor prognosis).
Both are staged by the Ann Arbor system.