Pathophysiological aspects of Hodgkin's disease.

Hodgkin's disease is characterized by unique features setting it apart from other malignancies. Clinically, systemic symptoms are often prominent and spontaneous remissions may be seen. As major immunological aberrations, a reactive humoral response with hypergammaglobulinemia and a depression of cell-mediated immunity are observed. Pathologically, the diagnosis is based on the presence of pleomorphic morphology; this consists of an infiltrate of reactive inflammatory cells sometimes forming granulomatous lesions with or without varying numbers of the cells presumed to be malignant. The nature of these malignant cells remains undefined, with data supporting mainly B-cell, but also macrophage origin. Clear-cut evidence for monoclonality is available only in prognostically unfavourable histological forms.