Hodgkin's lymphoma, previously known as Hodgkin's disease, is a type of lymphoma, whichis a type of canceroriginating from white blood cells called lymphocytes.Hodgkin's lymphoma is characterized by the orderly spread of disease from one lymph nodegroup to another and by the development of systemicsymptoms with advanced disease. When Hodgkin’s cells are examinedmicroscopically, multinucleated Reed-Sternberg cells (RS cells) are thecharacteristic histopathologic finding.
The disease occurrence shows two peaks: the first in young adulthood (age15–35) and the second in those over 55 years old.
The survival rate is generally 90% or higher whenthe disease is detected during early stages, making it one of the more curableforms of cancer. Hodgkin's lymphoma is one of the handfuls of cancers that,even in its later stages, have a very high cure rate, in the 90s. Most patientswho are able to be successfully treated and thus enter remission generally goon to live long lives.
Patients with a history of infectious mononucleosis due to EBV may have an increasedrisk of Hodgkin's lymphoma.
Signs and symptoms
Patients with Hodgkin's lymphoma may present with the following symptoms:
- Night Sweats
- Unexplained weight loss
- Lymph nodes: the most common symptom of Hodgkin's is the painless enlargement of one or more lymph nodes. The nodes may also feel rubbery and swollen when examined. The nodes of the neck and shoulders (cervical and supraclavicular) are most frequently involved (80–90% of the time, on average). The lymph nodes of the chest are often affected, and these may be noticed on a chest radiograph.
- Splenomegaly: enlargement of the spleen occurs in about 30% of people with Hodgkin's lymphoma. The enlargement, however, is seldom massive and the size of the spleen may fluctuate during the course of treatment.
- Hepatomegaly: enlargement of the liver, due to liver involvement, is present in about 5% of cases.
- Hepatosplenomegaly: the enlargement of both the liver and spleen caused by the same disease.
- Pain following alcohol consumption: classically, involved nodes are painful after alcohol consumption, though this phenomenon is very uncommon.
- Back pain: nonspecific back pain (pain that cannot be localized or its cause determined by examination or scanning techniques) has been reported in some cases of Hodgkin's lymphoma. The lower back is most often affected.
- Red-coloured patches on the skin, easy bleeding and petechiae due to low platelet count (as a result of bone marrow infiltration, increased trapping in the spleen etc i.e. decreased production, increased removal)
- Systemic symptoms: about one-third of patients with Hodgkin's disease may also present with systemic symptoms, including low-grade fever; night sweats; unexplained weight loss of at least 10% of the patient's total body mass in six months or less, itchy skin (pruritus) due to increased levels of eosinophils in the bloodstream; or fatigue (lassitude). Systemic symptoms such as fever, night sweats, and weight loss are known as B symptoms; thus, presence of fever, weight loss, and night sweats indicate that the patient's stage is, for example, 2B instead of 2A.
- Cyclical fever: patients may also present with a cyclical high-grade fever known as the Pel-Ebstein fever, or more simply "P-E fever". However, there is debate as to whether or not the P-E fever truly exists.