MCHL is a common type of classic Hodgkin’s lymphoma, most common in people with HIV infection or children with a history of Epstein-Barr virus infection. It has a generally favorable outlook.

Mixed cellularity Hodgkin’s lymphoma (MCHL) is a type of cancer that starts in the lymphatic system. It’s the second most common type of classic Hodgkin’s lymphoma, accounting for about 4 in every 10 cases.

Hodgkin’s lymphoma usually starts in B lymphocytes, cells that make proteins called antibodies to help protect you from bacteria and viruses. These B lymphocytes reside in small lumps of tissue called lymph nodes (or lymph glands).

MCHL gets its name because the lymph nodes contain a mix of very large cells called Reed-Sternberg (RS) cells and other abnormal cells.

This article will provide an overview of MCHL, including its causes, risk factors, symptoms, diagnosis, treatment, and outlook.

Symptoms of MCHL are more common when the cancer reaches later stages. They may include:

  • unexplained weight loss
  • high fever
  • night sweats
  • enlarged lymph nodes in the upper half of the body, such as the neck and armpit

Doctors usually diagnose MCHL through a lymph node biopsy. This involves removing a small sample of tissue from the lymph node, preferably via excision or by using a fine needle if necessary. A pathologist in a lab can then examine the tissue sample under a microscope.

A doctor may also order blood tests to help them diagnose or rule out other conditions. These may include:

Imaging tests, like a PET scan, X-ray, or CT scan, can help your doctor determine the stage of the cancer and if it has spread to other parts of the body.

Treatment for MCHL depends on the stage of cancer, your overall health, and other factors. The goal of treatment is to cure the disease and may include one or more cycles of chemotherapy or radiation therapy.

If chemotherapy and radiation don’t work or the cancer relapses (comes back after treatment), treatment may include high dose chemotherapy followed by an autologous stem cell transplant or immunotherapy.

The outlook for people with Hodgkin’s lymphoma is generally favorable. It has an 80% cure rate and a 5-year relative survival rate of 89%. According to the Leukemia & Lymphoma Society, Hodgkin’s lymphoma is now one of the most curable forms of cancer.

According to the National Cancer Institute (NCI), with treatment, MCHL has the same outlook as nodular sclerosis Hodgkin’s lymphoma, which is highly curable.

Many people with MCHL enter remission after treatment. However, up to 30% of people with Hodgkin’s lymphoma will relapse after achieving an initial remission.

Researchers aren’t sure what causes MCHL but have identified certain risk factors, like infections with HIV and Epstein-Barr Virus (EBV).

Some researchers think these infections can cause DNA changes in B lymphocytes, leading to the formation of Reed-Sternberg cells.

Research also suggests that genetics may play a role in the development of Hodgkin’s lymphoma.

MCHL occurs most often in people with HIV infection. It’s also more common in children with a history of EBV infection.

Risk factors for MCHL include:

Resources for support

If you’ve received an MCHL diagnosis, organizations such as the Lymphoma Research Foundation and the Leukemia & Lymphoma Society can offer emotional support, patient resources, education, and assistance with treatment and recovery.

What does “mixed cellularity” mean?

Mixed cellularity means that the lymph nodes of people with MCHL contain a mix of Reed-Sternberg (RS) cells and other types of abnormal cells.

What is the most aggressive form of Hodgkin’s lymphoma?

Lymphocyte-depleted Hodgkin lymphoma is a rare form of Hodgkin’s lymphoma that experts consider more aggressive than other types of Hodgkin’s lymphoma.

Which type of Hodgkin’s lymphoma has the best prognosis?

Nodular sclerosis, the most common type of classical Hodgkin’s lymphoma (CHL), has a high survival rate, especially when doctors diagnose and treat it early. It generally carries a better survival rate than other types of CHL.

MCHL is the second most common subtype of Hodgkin’s lymphoma. MCHL occurs most often in people with an active HIV infection or with a history of EBV infection.

With early diagnosis and treatment, MCHL carries an excellent overall outlook.