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Historical review of lymphomas

Introduction While lymphoma history begins with the description of Hodgkin's disease in 1832, almost all the significant events in the field have occurred in the past 60 years. Lymphoma (together with acute leukaemia) played an essential role in the birth of medical oncology and contributed greatly to our understanding of the malignant transformation. The clinical discipline profited from the explosive growth of immunology after World War II and the clinic, in turn, provided the scientist with many insights. Curiously, Hodgkin's disease, a therapeutic triumph, only reluctantly yielded its pathogenetic secrets, while the much less therapeutically tractable non-Hodgkin's lymphomas readily disclosed a spectrum of detailed pathogenetic mechanisms of malignancy. Except for those with symptomatic advanced disease or the elderly, most patients with Hodgkin's disease are now cured by fastidious irradiation and/or combination chemotherapy, based on an accurate knowledge of disease distribution obtained from sophisticated diagnostic study; the major challenge today is reduction of late lethal second neoplasms and cardiac complications of therapy. A variety of different misadventures in immunoglobulin (Ig) gene assembly, involving oncogene regulators of mitosis, programmed cell death and differentiation, have been defined at the molecular level and probably determine the specific nonHodgkin's lymphoma subtype.