Causes of lymph node cancer

Hodgkin’s lymphoma is a degeneration of the B cells of the lymphocytes, whereby the underlying cause is unknown in most cases. A connection with an existing infection with the Epstein-Barr virus (EBV) is suspected. An existing immunodeficiency is a possible risk factor (e.g. in immunosuppressive therapy or HIV infection).

More men than women are affected by Hodgkin’s lymphoma, whereby the 3rd and 5th decade of life are considered the main age of manifestation. Non-Hodgkin’s lymphomas, on the other hand, are degenerative diseases that can originate from both the B and T cells of the lymphocytes. Here, too, more men are affected, although the probability of contracting the disease increases with age.

The trigger for non-Hodgkin’s lymphomas is just as often unknown, only various risk factors are clearly known: in addition to a family history and an existing genetic change (chromosomal aberration), ionizing radiation (e.g. X-rays), chemical toxins, immune system disorders (e.g. HIV) and certain infections (e.g. EBV, HTLV-1) are among the factors that can promote non-Hodgkin’s lymph node cancer.

Already at the beginning of a lymph node cancer illness, the affected lymph nodes are noticeable in both Hodgkin’s disease and non-Hodgkin’s lymphoma: they are usually enlarged but not painful to the touch and cannot be moved relative to the ground (enlarged lymph nodes in the context of a cold or infection, on the other hand, are usually painful and moveable!) In Hodgkin’s disease, lymph nodes in the head and neck area are most frequently affected (60% in the neck), but lymph nodes in the armpit area (20%) or groin area (10%) are less frequently affected. The region affected in non-Hodgkin’s lymphoma is somewhat less specific.

Both types of lymph node cancer are in most cases accompanied by a so-called B-symptom, which is characterized by an unexplained fever above 38°C, heavy sweating during sleep and an unintentional weight loss of more than 10% of the body weight in the last 6 months. It can also be accompanied by a strong feeling of exhaustion and tiredness and in 25% of cases itching of the skin all over the body.Rare, but groundbreaking specifically for Hodgkin’s disease, are the pain in the affected lymph node region after alcohol consumption and the so-called Pel-Ebstein fever (fever persisting for 3-7 days, alternating with fever-free intervals). In addition, both types are more susceptible to infections due to the attacked immune system.

In advanced stages, organ systems outside the lymph nodes may also be affected, resulting in an enlargement of the liver and spleen and involvement of the bone marrow with changes in blood formation and neurological symptoms. In both types of lymphoma, a physical examination can provide initial indications, as the affected lymph nodes are often enlarged and hardened when palpated. For further clarification, an exact blood test is then indispensable.

In many cases, anemia, a deficiency of lymphocytes (lymphopenia; attention: from case to case, however, an excess of lymphocytes may also be present!) and a deficiency of blood platelets (thrombocytopenia) can be detected. Furthermore, the blood sedimentation rate (BSG) and the LDH value are often increased, but the value of the blood protein (serum albumin) is reduced.

If the physical examination and blood count suggest that lymph node cancer may be present, a lymph node biopsy is usually performed on the affected lymph node region in order to examine the degenerated lymph node tissue histologically and confirm the diagnosis. In this procedure, either a sample is taken from the lymph node tissue (using a biopsy needle or punch) or even the entire lymph node is removed through a skin incision under local or general anesthesia. Once the diagnosis has been definitively confirmed, the complete extent of the tumor in the body must be determined in order to determine the stage of the tumor, the best treatment option and the prognosis. For this purpose, so-called staging examinations are used, which include an ultrasound examination of the abdomen and the lymph nodes in the armpit, neck and groin area, as well as an X-ray and a CT of the thorax, a skeletal scintigraphy and a bone marrow and liver biopsy.