Medical history (history of illness) represents an important component in the diagnosis of Hodgkin’s disease. Family history Is there a history of frequent tumors in your family? Social history What is your profession? Are you exposed to harmful working substances in your profession? Current medical history/systemic medical history (somatic and psychological complaints). Have you noticed … Hodgkin’s Disease: Medical History
Blood, blood-forming organs-immune system (D50-D90). Sarcoidosis (synonyms: Boeck’s disease; Schaumann-Besnier’s disease) – systemic disease of connective tissue with granuloma formation (skin, lungs, and lymph nodes). Infectious and parasitic diseases (A00-B99). Local infections, unspecified Infectious diseases such as infectious mononucleosis (glandular fever), HIV infection, rubella (rubella). Tuberculosis (consumption) Neoplasms – tumor diseases (C00-D48) Non-Hodgkin’s lymphoma (NHL) … Hodgkin’s Disease: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by Hodgkin’s disease: Respiratory system (J00-J99) Pulmonary disease secondary to radiation and/or chemotherapy. Blood, blood-forming organs – immune system (D50-D90). Anemia (anemia) Thrombocytopenia – deficiency of platelets (blood platelets). Endocrine, nutritional and metabolic diseases (E00-E90). Hypercalcemia (calcium excess) due to tumor … Hodgkin’s Disease: Complications
The following histological types of Hodgkin’s disease are distinguished: Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) 5 %. Classical Hodgkin lymphoma with Nodular sclerosing type (NSHL) (circa 60%). Mixed type (MCHL) (circa 30 %) Lymphocyte-rich type (circa 4 %) Lymphocyte-poor type (< 1%) Based on the findings of clinical staging, but independent of histologic type, Hodgkin lymphoma … Hodgkin’s Disease: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye) [accompanying symptoms: night sweats; pruritus (itching); pallor; erythema nodosum (nodular erythema), localization: both extensor sides of … Hodgkin’s Disease: Examination
To prevent Hodgkin’s disease, attention must be paid to reducing risk factors. Disease-related risk factors HIV infection EBV infection Immunosuppressive therapy Other risk factors Wood preservatives Hair dye Fertility-protective measures (fertility-preserving measures) In female patients, medicinal measures: Gonadotropin releasing hormone (GnRH) analogues together with hormonal combined contraceptives (contraceptives) or estrogen transdermally (“through the skin“). Cryopreservation … Hodgkin’s Disease: Prevention
First-line therapy for Hodgkin lymphoma (HL) is essentially based on polychemotherapies plus radiotherapy (radiotherapy, radiatio). Radiotherapeutic measures in Hodgkin’s disease [according to S3 guideline]: Early stage (localized involvement in stage I-II without risk factors): patients with classic HL: after two cycles of ABVD chemotherapy (adriamycin=doxorubicin, bleomycin, vinblastine, and DTIC=dacarbzine), patients receive radiotherapy: conventional “involved-field” irradiation … Hodgkin’s Disease: Radiotherapy
The following symptoms and complaints may indicate Hodgkin’s disease: Leading symptoms Hard, indolent (painless) lymphadenopathy (lymph node enlargement) – lymph nodes caked into packets (DD/disease with similar or nearly identical symptomsTuberculosis) present in 80-90% of patients at the time of diagnosis; occur primarily in the neck (cervical), under the axilla (axillary), or in the inguinal … Hodgkin’s Disease: Symptoms, Complaints, Signs
Pathogenesis (disease development) The pathogenesis of Hodgkin’s disease involves malignant degeneration in the lymphatic system. A connection with EBV infection (EBV: Epstein-Barr virus) is discussed in the development of Hodgkin’s lymhpoma: The Epstein-Barr virus is detected in the tower cell clones in approximately 50% of cases. However, this is very unlikely as the sole cause, … Hodgkin’s Disease: Causes
General measures Nicotine restriction (refraining from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Aim to maintain a normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis. Falling below the BMI lower limit … Hodgkin’s Disease: Therapy
1st order laboratory parameters – obligatory laboratory tests. Small blood count [leukocytosis; thrombocytopenia] Differential blood count [absolute lymphopenia; eosinophilia in one-third of cases] Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT). Renal parameters … Hodgkin’s Disease: Test and Diagnosis
Therapeutic targets Complete remission (complete tumor regression). Healing Therapy recommendations The main component of therapy for Hodgkin’s disease is polychemotherapy. Combined chemoradiation therapy should be given as primary therapy in patients with early-stage Hodgkin lymphoma. See also under “Other therapy.” Primary therapy is carried out with [S3 guideline]: Early stage: Age < 60 years: ABVD … Hodgkin’s Disease: Drug Therapy
