The Reed-Sternberg cell in classical Hodgkin's disease.

There has been substantial advances in our understanding of the nature of the Hodgkin/Reed-Sternberg (H/RS) cell in recent years. There is now compelling evidence that the H/RS cells in the vast majority of cases of classical Hodgkin's disease (CHD) are derived from the B-cell lineage and a major clonal population is present. The immunoglobulin heavy chain variable region gene generally has a high load of somatic mutations suggesting that the H/RS cells are derived from germinal center (GC) (GC) or post-GC cells. The cellular milieu in the tumour is largely determined by the cytokines and chemokines secreted by the H/RS cells and the surrounding reactive elements. The pattern of secretion is partially determined by signals transduced through direct surface interactions between H/RS cells and infiltrating T-cells. Immunosuppressive cytokines and cytokines that preferentially induce a TH2 type of immune response may be partially responsible for the escape of the H/RS cells from immune surveillance. Multiple genes that have been shown to be involved in neoplastic transformation have been studied in HD. The significance of the data generated has been difficult to interpret. Efforts have been made to study the global gene expression pattern of the H/RS cells. There are many difficulties inherent in this approach, but new insight into the pathogenesis and evolution of HD would be expected from the studies.