Hodgkin’s disease is usually detected when a person has an enlarged lymph node, usually in the neck, but sometimes in the armpit or groin. Although usually painless, an enlarged node can be a painful few hours after a person drinks a lot of alcohol.
Pioneer of preventive medicine
Thomas Hodgkin (17th August 1798 with – April 5, 1866) was a British physician and is considered one of the most respected pathologists of his time and a pioneer of preventive medicine. It is 1832 first described lymphoma, specifically one type now known by his name Hodgkin’s lymphoma (HL) or Hodgkin’s disease. Other lymphomas are grouped under the name of non-Hodgkin’s lymphoma (NHL), and technology development laboratory revealed that the group has 43 (WHO) various forms of lymphomas, however, the name NHL is moving away.
Hodgkin’s lymphoma, also known as Hodgkin’s disease is a cancer of the lymphatic system, which is part of the immune system. Lymph is one of the body fluid which is produced initially as the extracellular liquid and then enters the lymph vessels by filtration. After entering the lymphatic vessel, lymph travels to the lymph nodes and eventually goes to the left or right podključnu vein and there is mixed with blood. Lymphoma is the name for the primary tumor whose tumor cells derived from lymphocytes, cells of the immune system. These new creation usually occur in the lymph nodes, which is presented as an increase in the (tumor) node. Lymphomas are, in simple terms, is closely associated with lymphocytic leukemia, whose tumor cells also originate from lymphocytes, but usually, affect the circulating blood and bone marrow. Lymphoma can be derived from cells at different stages of development (differentiation), so there are many different types of lymphoma, and are classified depending on their characteristics (genetic, immunological, morphological).
For Hodgkin lymphoma cells in the lymphatic system grow abnormally fast and may spread beyond the lymphatic system. As Hodgkin’s lymphoma progresses disables the body’s ability to fight off infection. NHL is one of two common types of cancer of the lymphatic system. The second type, non-Hodgkin’s lymphoma, it is far more common. Hodgkin’s lymphoma is a type of lymphoma that is different from the other finding specific types of cancer cells called ReedSternbergovim cells under a microscope have a distinctive look. Reed-Sternberg cells are large malignant cells that have more than one core. They can be seen when viewing under a microscope tissue sample lymph node. Hodgkin’s disease is classified into four types based on features of the tissue that can be seen under the microscope.
The causes and symptoms of Hodgkin lymphoma
It is not clear what causes Hodgkin’s lymphoma. Doctors know that usually occurs when the cells that fight infection, and which are called B cells develop mutations in the DNA. The mutation causes the cells divide rapidly and continue living when healthy cells would have to die. This allows a large number of abnormal B-cells, which accumulate in the lymphatic system and cause the signs and symptoms of Hodgkin lymphoma.
Hodgkin’s disease is usually discovered when a person has an enlarged lymph node, usually in the neck, but sometimes in the armpit or groin. Although usually painless, an enlarged node can be a painful few hours after a person drinks a lot of alcohol. Sometimes the enlarged lymph nodes, which are usually painless, unexpectedly find themselves deep inside the chest or abdomen and are detected by X-rays or computed tomography when that is done for other reasons.
In Hodgkin’s disease with enlarged lymph nodes are sometimes present additional symptoms such as fever, night sweats, and weight loss. For unknown reasons, the skin can be very itchy. Some people have PelEbsteinovu fever, an unusual form of high temperature for several days, which alternates with the normal temperature or the one below normal for days or weeks. May develop other symptoms depending on where the lymphoma cells grow. A person may be no symptoms or have only some of these symptoms.
Symptoms of Hodgkin lymphoma may include the following:
- Swollen lymph in the neck, armpit or groin
- Chronic fatigue
- night sweats
- Unexplained weight loss – up to 10% or more of total body weight
- A cough, shortness of breath or chest pain
- loss of appetite
Increased sensitivity to the effects of alcohol and pain in the lymph nodes after drinking alcohol
Visit your doctor if you have any signs or symptoms that worry you.
In Hodgkin, the disease lymph nodes normally increase slowly and painlessly without obvious infection. A sudden increase in the lymph nodes – which can occur when a person has a cold or infection – not typical for Hodgkin’s disease. If the lymph nodes increased more than a week, the doctor should suspect Hodgkin’s disease, especially if a person has a fever, night sweats, and weight loss.
Abnormalities with regard to the number of blood cells and other blood tests can provide supporting evidence, or for the diagnosis, the doctor has to do a biopsy of the affected lymph node to see if the present Reed-Sternberg cells. Type of biopsy depends on which node is increased and how much tissue needs to be the safe diagnosis. The doctor has to take a lot of tissue that can differentiate Hodgkin’s disease from other diseases that can cause an increase in lymph node – including non-Hodgkin’s lymphoma, other cancers with similar symptoms, infectious mononucleosis, toxoplasmosis, CMV disease, leukemia, sarcoidosis, tuberculosis, and AIDS.
When the enlarged lymph node near the surface of the door, can do a needle biopsy. In this process anesthetize skin area, and needle and syringe to take a small piece of fixtures. If this type of biopsy does not provide enough tissue for diagnosis and classification of Hodgkin’s disease, one must make a small incision and take a bigger piece of the lymph node. When a lymph node is not close to the surface for example, when a deep chest-surgery needs to be more complex.
Treatment / Forecast
Treatment and prognosis depend on the stage and cell type of the disease. Hodgkin’s disease is curable with radiotherapy, combined chemotherapy, or a combination of both in 50-80% of cases. Generally, the stages I and II are treated with radiotherapy and stages III and IV chemotherapy, but depending on the case can be applied to a combination of radio- and chemotherapy.
Two effective treatments are radiotherapy (radiation) and chemotherapy. One or both, the treatment can cure most people who have Hodgkin’s disease.
Sam radiation therapy cures about 90% of people with stage I or II disease. The treatment is usually given to an ambulatory cycle of about 4 or 5 weeks. The radiation is directed at the affected area and the surrounding lymph nodes. Very enlarged lymph nodes in the chest are treated with radiation which is usually preceded or followed by chemotherapy. With this dual approach healed 85% of people.
Treatment III. different stages of the disease are due to the situation. When a person has no symptoms, sometimes it is enough just to radiation therapy. However, the only cure 65% to 75% of such people. Turning chemotherapy increases the likelihood of cure of 75% to 80% of people. When a person has symptoms other than enlarged lymph nodes, the use of chemotherapy with or without radiation. For such people, cure rates range from 70% to 80%.
In IV. stage of disease, the combination use of chemotherapeutic drugs. Two common (traditional) prescribed chemotherapy protocols are MOPP (mechlorethamine, vincristine [Onkovin], procarbazine and prednisone) and ABVD (doxorubicin [Adriamycin], bleomycin, vinblastine, and dacarbazine). The time interval between each cycle of chemotherapy is one month with a total treatment time of 6 months or more (cycle). Other treatments include a combination of other chemotherapeutic drugs. Even in this advanced stage of the disease cured over 50% of people.
The decision on the application of chemotherapy in the treatment of Hodgkin’s disease is difficult for patients and for doctors. Although chemotherapy significantly increases the probability of cure, the side effects can be severe. Drugs can cause transient or permanent infertility, increased risk of infection and the transient loss of hair. In some people develop leukemia and other forms of cancer 5 to 10 or even more years after treatment with either chemotherapy or radiation, and this number is higher in men who were treated with either therapy.
The person was not getting better after radiation or chemotherapy, or which improve the situation, but then within 6-9 months gain relapse, is less likely to cause long-term survival than a person who has a relapse one year or more after initial treatment. Further chemotherapy combined with high doses of radiation and a bone marrow or stem cells can still be used for some people. Large doses of chemotherapy combined with bone marrow transplant carry great risk of a very