Immunopathological basis of Hodgkin's lymphoma in young adults
Abstract
Introduction: Hodgkin lymphoma (HL) is a unique hematopoietic neoplasm characterized by Reed-Sternberg cancer cells in an inflammatory context. Although relatively rare, it is the most common cancer among young people aged 15 to 19.
Objective: To characterize the immunopathological basis of Hodgkin's lymphoma in young adults.
Development: The hallmark of this entity is the presence of sparse HRS-type neoplastic cells (Hodgkin and Reed-Sternberg), which represent between 0.1% and 10% of the total cellularity present, along with numerous immune effector cells in the tumor microenvironment. HRS cells are characterized by a large number of complex chromosomal aberrations. To evade immune eradication, tumor cells can become "invisible" through the loss or downregulation of molecules involved in antigen presentation, resistance to apoptosis signals and the expression of inhibitory receptors, paving the way for the development of an immune microenvironment characterized by the presence of HRS cells, anti-inflammatory macrophages, ineffective TCD4+ lymphocytes and immunosuppressive cytokines. In addition, interaction with the stroma provides structural and functional support to tumor cells.
Conclusions: The main histological subtypes are: nodular sclerosis, mixed cellularity, lymphocyte-rich and lymphocyte depletion; their development requires the application of evasive mechanisms that rescue tumor cells from immune effectors. The formation of an immunosuppressive microenvironment that promotes tumor proliferation is essential.
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Centro Provincial de Información de Ciencias Médicas. Universidad de Ciencias Médicas de Holguín. Cuba.
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