Hodgkin's Disease

Hodgkin's disease is a type of lymphoma in which antibody producing cells of the lymphatic system begin to grow abnormally. It usually begins in a lymph nodes and progresses slowly, in a fairly predictable way, spreading via the lymphatic vessels from one group of lymph nodes to the next.

If the cancer cells spread to the blood, the disease can reach almost any site in the body. Advanced cases of Hodgkin's disease may involve the spleen, liver, bone marrow and lungs.


There are different subtypes:
- nodular sclerosis (30-60% of cases)
- mixed cellularity (20-40% of cases)
- lymphocyte predominant (5-10% of cases)
- lymphocyte depleted (less than 5 % of cases)
- unclassified

Hodgkin's Disease

Hodgkin's disease can occur at any age. However, the majority of cases develop in early adulthood (ages 15-40) and late adulthood (after age 55). Approximately 10-15% of cases are in children under age 17. It is more common in boys than in girls under the age of 10. The disease is very rare in children under five.


The cause of Hodgkin's disease is not known. It is suspected that some interaction between an individual's genetic makeup, environmental exposures, and infectious agents may be responsible. Immune system deficiencies also may be involved.

Risk Factor

Age - People between the ages of 15 and 40, as well as those older than 55.
Family history - Anyone with a brother or a sister who has the disease faces an increased risk of developing Hodgkin's.
Sex - Males are slightly more likely to develop Hodgkin's.
Past Epstein-Barr infection - People who had illness caused by the Epstein-Barr virus, such as infectious mononucleosis, are more likely to develop Hodgkin's disease.
Compromised immune system - Having a compromised immune system, such as from HIV/AIDS


Early symptoms of Hodgkin's disease may be similar to those of the flu:
- fever, night sweat, chill
- fatigue
- loss of appetite
- weight loss
- itching

Pain after drinking alcoholic beverages
Swelling of one or more lymph nodes

Sudden or emergency symptoms of Hodgkin's disease include:
- sudden high fever
- loss of bladder and/or bowel control
- numbness in the arms and legs and a loss of strength

As lymph nodes swell, they may push on other structures, causing a variety of symptoms:
- pain due to pressure on nerve roots
- coughing or shortness of breath due to compression of the trachea
- kidney failure from compression of the ureters

As Hodgkin's disease progresses, the immune system becomes less effective at fighting infection. Thus, patients with Hodgkin's lymphoma become more susceptible to both common infections caused by bacteria and unusual (opportunistic) infections. Later symptoms of Hodgkin;s disease include the formation of tumors.

Chronic Hodgkin's Disease


The initial diagnosis of Hodgkin's disease often results from abnormalities in a chest x ray that was performed because of nonspecific symptoms. The physician then takes a medical history to check for the presence of symptoms and conducts a complete physical examination.

Lymph Node Biopsy

Diagnosis of Hodgkin's disease requires either the removal of an entire enlarged lymph node (an excisional biopsy) or an incisional biopsy, in which only a small part of a large tumor is removed.

The sample of biopsied tissue is examined under a microscope.

Giant cells called Reed-Sternberg cells must be present to confirm a diagnosis of Hodgkin's disease. These cells usually contain two or more nuclei. Normal cells have only one nucleus. Affected lymph nodes may contain only a few Reed-Sternberg cells and they may be difficult to recognize.

Clinical Staging, Treatments And Prognosis

All of the available treatments for Hodgkin's disease have serious side effects, both short and long term. However with accurate staging physicians and patients often can choose the minimum treatment that will cure the disease. The staging system for Hodgkin's disease is the Ann Arbor

Staging Classification

Stage I: The disease is confined to one lymph node area
Stage II: The disease is in two or more lymph nodes areas on one side of the diaphragm
Stage III: The disease is in lymph node areas on both sides of the diaphragm
Stage IV: The disease has spread from the lymphatic system to one or more other organs, such as the bone marrow or liver


Treatment for Hodgkin's disease depends both on the stage of the disease and whether or not symptoms are present.

Radiation therapy and/or chemotherapy (drug therapy) are the standard treatments for Hodgkin's disease.

No comments:

Post a Comment