Hodgkin’S Disease: Discovery, Development And Epidemiology
In 1865 Thomas Hodgkin was immortalized by his peer, Samuel Wilks, in the annals of medical literature through the eponymous use of the term ‘Hodgkin’s disease’. At that time there is more heterogeneous group of neoplastic lymph node enlargement which is non-Hodgkin lymphoma (NHL). A century and a half later, NHL has emerged and now considered as the leading hematological malignancy worldwide. In 1864 and 1865, Virchow and Cohnheim had recognized the diseased enlargement of lymph nodes as lymphosarcoma and pseudoleukaemia, respectively, although the term ‘malignant lymphoma’ was first used by Bilroth in 1871.
It was obvious that the disease had resulted from a mix of neoplastic, infective and miscellaneous causes of lymph node enlargement. Between the end of the 19th century and the middle of the 20th century, little headway was made in identifying NHL. The first organized classification appeared through the efforts of Rappaport in 1956, with a modified version being published in an Armed Forces Institute of Pathology fascicle in 1966. NHL was divided into nodular, diffuse and histiocytic, each with subtypes, was based on architectural organization and cell size of the neoplastic lymphoid infiltrate. The understanding of the steps involved in lymphoid development help in the understanding of development of this diverse group of malignancies because most non-Hodgkin lymphomas (NHLs) reflect stages of lymphoid development. The application of gene expression profiling (GEP) and massively parallel high-throughput sequencing, as well as a better appreciation of the contribution of microRNAs (miRNAs) and epigenetic alterations to lymphoma pathogenesis, provide further insights on the mechanism underlying lymphomagenesis. The classification of NHL was then adopted by the World Health Organization (WHO) classification of neoplasm of the hematopoietic and lymphoid tissues, published in 2001, updated in 2008 and revised again in 2016.
Epidemiology of non-Hodgkin lymphoma
Currently, NHL represents approximately 5% of all cancer diagnoses, being the seventh most common cancer in women and the seventh in men. Estimates from the American Cancer Society indicate that in 2017 approximately 72, 240 new cases of NHL will be diagnosed in the United States and approximately 20, 140 people will die of the disease. In addition, there are approximately 600, 000 people living with NHL in the United States. - Geographic distribution.
The incidence of NHL varies throughout the world, in general being more common in developed countries, with rates in the United States of more than 15 per 100, 000 compared with 1. 2 per 100, 000 in China.
