by Gloria S. Akande

Created on: July 18, 2009   Last Updated: July 19, 2009

Non-Hodgkin's Disease (Non-Hodgkin's Lymphoma) and Hodgkin's Disease (Hodgkin's Lymphoma) are the two major categories of malignant lymphoma that are malignant neoplasms of the bone marrow and the lymphoid system. Lymphomas are neoplasms of lymphocytes, lymphoid white blood cells. The tumors may start as small nodules or aggregates of lymphoid cells and later develop into a more diffuse process, which may involve lymph nodes, spleen, liver, bone marrow and other organs of the body. The highest incidence of both diseases is in developed countries. Non-Hodgkin's Lymphoma makes up 70% of malignant lymphomas in the United States and some 65,000 new cases yearly. It can occur at any age, but is seen more prominently in adults. It is more common in males and Caucasians. Non-Hodgkin's Lymphomas are classified as B-Cell and T-Cell neoplasms and proliferations which involve lymph nodes, the liver, spleen and organs outside the lymphatic system and the bone marrow to a greater degree than that of Hodgkin's Lymphoma.

There are and have been several classification schemes of Non-Hodgkin's Lymphomas based on morphology and clinical pathology studies and clinical relevance of the categorization and whether the lymphoma is aggressive and fast growing or indolent and slow growing. The International Working Formulation of lymphomas is based on microscopic differences and correlation with patient survival. The lymphomas are divided into the following categories:

*Low Grade

*Intermediate

*High Grade

*Miscellaneous

The Revised European American Lymphoma (REAL) Classification has been found to be clinically applicable and is based upon cell morphology and the types of lymphoid cells. The World Health Organization classification that is used predominantly is based on the types of hematopoietic or blood cells present and the lymphoid tissue, whether they are B or T or NK cells. Hodgkin's Lymphoma makes up about 25% of the malignant lymphomas in the United States. There is a bimodal peak age incidence of the disease is at 15 to 40 years and at 70 years. The disease occurs slightly more in males than in females. The most common clinical presentation of the disease is that of a painless enlargement of lymph nodes in the neck. The associated B symptoms are present in 25% of patients with Hodgkin's, they include weight loss, itching, fever and night sweats. The B symptoms are used in the clinical Arbor staging of Hodgkin's Disease.

Hodgkin's Lymphoma is classified into the following

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