Children with Hodgkin's disease?

summary

Children with Hodgkin's disease? Hodgkin's disease is a malignant tumor of lymphatic reticular tissue, which often occurs in a group of lymph nodes and spreads to other lymph nodes and / or extranodal organs or tissues. Different pathological changes of Hodgkin's disease are closely related to the prognosis. In order to take different effective treatment, it can be divided into four types according to the prognosis.

Children with Hodgkin's disease?

Lymphocytic dominant type: this type accounts for about 10% - 20% of the disease. It has the best prognosis and differentiation. It can also be considered as the early stage of Hodgkin's disease. Its malignant degree is relatively low, and the focus is often limited to one or a group of lymph nodes. The clinical symptoms are mild or no discomfort. Microscopically, lymphocytes and histiocytes proliferated in different proportions in the area where the normal lymphoid tissue structure disappeared, and small lymphocytes usually proliferated; Strehl cells are rare and atypical. There was no necrotic change in lymph nodes. This kind of lymph node is the most difficult to distinguish from inflammatory lesions and is easy to be missed.

Tuberous sclerosis type: is the most common type in children, accounting for about half of the disease, the prognosis is second only to lymphocyte dominant type. This type often occurs in mediastinal lymph nodes, but also can involve supraclavicular lymph nodes, rarely in abdominal lymph nodes, clinical development is slow. There were more collagen fiber bundles in the lesions, which divided the tumor cells into nodules. Streptavidin cells are commonly seen in the fissure like blank, also known as fissure cells.

Mixed type: this type accounts for more than 10% of the disease. Extranodal invasion was common at the time of diagnosis, and the prognosis was poor. It can be evolved from lymphocyte dominant type. Most of them have obvious clinical symptoms. The structure of the lymph node was diffusely disappeared, but only part of the structure was destroyed when the lymph node was initially involved. There were various cells in the lesion, including lymphocytes, histiocytes, eosinophils and plasma cells, and there were typical binuclear, lobulated nuclei or polynuclear Strehl cells with large nucleoli. This type of change is diverse, typical is easy to diagnose, atypical and inflammatory granuloma, tuberculosis, reactive hyperplasia is easy to confuse.

matters needing attention

Lymphocytopenia type: this type accounts for about 10%, and the prognosis is the worst. It can be directly evolved from lymphocytic dominant type or from mixed type. It is the late stage of lymphoma and the most poorly differentiated type. There are few lymphocytes in the lesions, which can be divided into two forms. One is diffuse sclerosis composed of clear collagen fibers, with few lymphocytes and reduced lymph node volume; One is mainly composed of a large number of heterotypic reticular cells, which are easy to find. Nodular sclerosis and lymphocytic predominance are more common in children, which is the reason for the long survival of children with Hodgkin's disease.