Immunopathology of Hodgkin's disease

The past several years have seen major advances in the immunopathology of Hodgkin's disease, although the cell of origin remains unproven. Reed-Sternberg cells have been characterized with monoclonal antibodies and are found to consistently express panleukocytic antigen (T-200), HLA-DR antigens, and several activation-proliferation antigens (Tac, OKT-9, Ki-1). Reed-Sternberg cells also express a nonlineage-specific antigen defined by the antigranulocyte antibody Leu M-1. Lineage-specific B, T or monocyte-macrophage antigens are generally lacking. With the possible exception of the lymphocyte predominant form of the disease, Hodgkin's disease appears immunologically homogeneous. The possible origin of Reed-Sternberg cells by neoplastic transformation of antigen-presenting dendritic cells (interdigitating reticulum cells) appears to be an attractive albeit unproven hypothesis. Application of molecular biologic techniques in the future may yield definitive evidence as to the origin and nature of these enigmatic cells, and to the pathophysiology of the disease which they define.