[What is actually Hodgkin disease?]

For long, there has been controversy over the very nature of Hodgkin's disease: Is it a true neoplasm, an inflammatory, even infectious disease, an unusual immunologic reaction, or a combination of these pathogeneses? New information has been obtained during the last few years from immunohistology, immunohistochemistry, and molecular genetics. Epidemiologic, serologic and and direct detection studies all independently point to Epstein-Barr-virus as a potential aetiologic cofactor. Clonality studies show that viral infection precedes clonal expansion of tumour cells. Single cell analysis of rearrangement of immunoglobulin genes published 1996-98 proves the B cell nature of Reed-Sternberg and Hodgkin cells, and indicates their origin from a single transformed B cell and subsequent monoclonal expansion. Hodgkin's disease is a tumour of cytokine-producing and cytokine-responding cells. Different quantities of a series of cytokines may explain differences in prognosis, clinical symptoms and histopathological features.