Hodgkin lymphoma, formerly known as Hodgkin's disease, is a type of cancer that originates in the lymphatic system, specifically in the white blood cells called lymphocytes. It is characterized by the presence of Reed-Sternberg cells, large abnormal cells that are typically found in affected lymph nodes. Hodgkin lymphoma is one of the two main types of lymphoma, with the other being non-Hodgkin lymphoma.
Symptoms
Symptoms of Hodgkin lymphoma may include:
- Swollen Lymph Nodes: Painless swelling of lymph nodes, typically in the neck, armpits, or groin.
- Fatigue: Persistent fatigue or weakness, often unrelated to activity levels.
- Fever: Recurrent or persistent fever without an obvious cause.
- Night Sweats: Profuse sweating, particularly at night, which may soak through clothing and bedding.
- Unexplained Weight Loss: Significant weight loss without dieting or intentional efforts to lose weight.
- Itchy Skin: Pruritus (itchy skin) without an apparent rash or other skin changes.
- Loss of Appetite: Decreased appetite and early satiety (feeling full after eating small amounts).
- Enlarged Spleen: Swelling or discomfort in the left upper abdomen due to an enlarged spleen.
- Cough or Shortness of Breath: Symptoms may occur if Hodgkin lymphoma affects the chest or mediastinum, leading to compression of the airways or lungs.
Risk Factors
Risk factors for Hodgkin lymphoma may include:
- Age: The risk of Hodgkin lymphoma peaks in young adulthood (between ages 15 and 40) and again in older adults (after age 55).
- Gender: Men are slightly more likely to develop Hodgkin lymphoma than women.
- Family History: Individuals with a family history of Hodgkin lymphoma or certain other lymphomas may have an increased risk.
- Epstein-Barr Virus (EBV): Infection with the Epstein-Barr virus, particularly during adolescence or young adulthood, may increase the risk of developing Hodgkin lymphoma.
- Weakened Immune System: Conditions or medications that suppress the immune system, such as HIV/AIDS or organ transplantation, may increase the risk.
Diagnosis
Diagnosis of Hodgkin lymphoma involves a combination of medical history, physical examination, and diagnostic tests:
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Medical History: The healthcare provider will inquire about symptoms, medical history, family history of cancer, and other relevant factors.
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Physical Examination: Palpation of lymph nodes, spleen, and other areas of the body to assess for swelling or enlargement.
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Blood Tests: Complete blood count (CBC) and blood chemistry tests to evaluate overall health and detect abnormalities such as anemia or elevated markers of inflammation.
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Imaging Studies:
- CT Scan: Computed tomography (CT) imaging of the chest, abdomen, and pelvis to assess the extent of lymph node involvement and identify any other abnormalities.
- PET Scan: Positron emission tomography (PET) scan may be performed to evaluate metabolic activity and identify areas of increased uptake suggestive of cancer.
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Biopsy: The definitive diagnosis of Hodgkin lymphoma is established by examining a tissue sample (biopsy) of an enlarged lymph node or other affected tissue under a microscope. The presence of characteristic Reed-Sternberg cells confirms the diagnosis.
Types
Hodgkin lymphoma is classified into several subtypes based on the characteristics of the Reed-Sternberg cells and other features observed under the microscope. These subtypes include:
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Classical Hodgkin Lymphoma:
- Nodular Sclerosis Hodgkin Lymphoma
- Mixed Cellularity Hodgkin Lymphoma
- Lymphocyte-Rich Hodgkin Lymphoma
- Lymphocyte-Depleted Hodgkin Lymphoma
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Nodular Lymphocyte-Predominant Hodgkin Lymphoma: This subtype is characterized by the presence of popcorn cells and has distinct clinical and pathological features compared to classical Hodgkin lymphoma.
Treatment
Treatment of Hodgkin lymphoma depends on various factors, including the stage of the disease, subtype, overall health, and individual preferences. Treatment modalities may include:
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Chemotherapy: Combination chemotherapy regimens, typically including drugs such as doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD regimen), are commonly used as first-line treatment for Hodgkin lymphoma.
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Radiation Therapy: External beam radiation therapy may be used to target affected lymph nodes or areas of residual disease after chemotherapy.
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Immunotherapy: Monoclonal antibodies such as rituximab or brentuximab vedotin may be used in combination with chemotherapy