Definition
Hodgkin lymphoma, also known as Hodgkin’s disease, is a malignant disease of the human lymphatic system. By definition, certain cells of the immune system, the B cells, are degenerated and form malignant tumors that originate from the lymph nodes. Hodgkin’s lymphoma is one of the two major subgroups of lymphomas, the other group is made up of the diverse non-Hodgkin lymphomas.
By definition, Hodgkin’s lymphoma includes the presence of specific cells, the Sternberg-Reed giant cells and the eponymous Hodgkin cells. Hodgkin’s lymphoma is characterized by swollen, externally palpable lymph nodes as well as the so-called B-symptoms of night sweats, weight loss and fever. Hodgkin’s lymphoma can theoretically develop in any lymph node, but it often occurs in the neck or armpit or in the groin region. Compared to non-Hodgkin’s lymphomas, Hodgkin’s lymphoma has a relatively good prognosis, so that a curative, i.e. curative therapy is always initiated. Hodgkin’s lymphoma mostly affects young men between 25 and 30 years of age, with a second peak of frequency between 50 and 70 years of age.
Cause of Hodgkin’s lymphoma
So far, no clear cause for Hodgkin’s lymphoma has been identified. However, some factors are known that are associated with Hodgkin’s lymphoma and thus may be a possible cause. In particular, the Epstein-Barr virus (EBV), the pathogen causing, among others, Pfeiffer’s glandular fever, is associated with Hodgkin’s lymphoma.
In about 50% of the cases EBV could be detected in this type of lymphoma. HIV infection is also a risk factor for Hodgkin’s lymphoma, and smoking is discussed as a possible cause. In addition, Hodgkin’s lymphoma can occur after aggressive, immunosuppressive therapy such as organ transplantation.
Symptoms of Hodgkin’s lymphoma
If a patient shows the above mentioned symptoms over a longer period of time, Hodgkin’s lymphoma must be considered and the appropriate diagnostic procedure must be initiated. The most important step is a lymph node biopsy (sample collection) from an affected lymph node, after which the material is examined under the microscope. Here, the Sternberg-Reed cells and Hodgkin cells typical for Hodgkin lymphoma can be detected.
This diagnosis must be made before initiating therapy in order to confirm the diagnosis. However, the subsequent staging examinations are no less important in order to correctly classify Hodgkin’s lymphoma and thus to be able to choose the appropriate therapy. In addition to a thorough clinical examination in which all lymph node stations are scanned as far as possible, a number of other diagnostic tests are used.
Blood parameters such as signs of inflammation and cell counts are examined and, if necessary, the bone marrow is punctured. In Hodgkin’s lymphoma, diagnostic equipment is indispensable. An X-ray of the chest provides information about any lymph nodes in and around the lungs and in the mediastinum, the space behind the breastbone between the lungs and the heart.
In Hodgkin’s lymphoma, computed tomography of the neck and upper body is of great importance. In addition, a skeletal scintigraphy may be useful to exclude bone involvement. Once the diagnosis has been confirmed and the final diagnosis for staging has been made, Hodgkin’s lymphoma is classified according to the Ann-Arbor classification.
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