Hodgkin’s Lymphoma

Hodgkin's Lymphoma

Hodgkin's Lymphoma, also known as Hodgkin's disease, is a type of lymphoma, which is a cancer that originates from a type of white blood cells called lymphocytes. It is characterized by the presence of Reed-Sternberg cells, which are large, abnormal lymphocytes that can be identified under a microscope. This disease was first described by Thomas Hodgkin in 1832.

Epidemiology

Hodgkin's Lymphoma is relatively rare, accounting for about 10% of all lymphomas. It has a bimodal age distribution, with peaks in young adults (ages 15-35) and in older adults (over 55 years). The disease is slightly more common in males than in females.

Etiology

The exact cause of Hodgkin's Lymphoma is not well understood, but several risk factors have been identified:

• Epstein-Barr Virus (EBV): There is a strong association between EBV infection and Hodgkin's Lymphoma.
• Family History: A family history of lymphoma increases the risk.
• Immunosuppression: Individuals with weakened immune systems, such as those with HIV/AIDS or those taking immunosuppressive drugs, are at higher risk.

Pathophysiology

Hodgkin's Lymphoma is characterized by the presence of Reed-Sternberg cells, which are derived from B lymphocytes. These cells are typically found in the lymph nodes, but can also be present in other lymphoid tissues. The disease often spreads in a predictable manner from one group of lymph nodes to another.

Clinical Presentation

Patients with Hodgkin's Lymphoma may present with:

• Lymphadenopathy: Painless swelling of the lymph nodes, often in the neck, armpits, or groin.
• B Symptoms: Fever, night sweats, and weight loss.
• Pruritus: Itching of the skin.
• Fatigue: Generalized tiredness and weakness.

Diagnosis

The diagnosis of Hodgkin's Lymphoma is confirmed through a biopsy of the affected lymph node, which reveals the characteristic Reed-Sternberg cells. Additional tests may include:

• Imaging Studies: CT scan or PET scan to assess the extent of the disease.
• Blood Tests: To evaluate overall health and organ function.

Staging

Hodgkin's Lymphoma is staged using the Ann Arbor Staging System:

• Stage I: Involvement of a single lymph node region or a single extralymphatic site.
• Stage II: Involvement of two or more lymph node regions on the same side of the diaphragm.
• Stage III: Involvement of lymph node regions on both sides of the diaphragm.
• Stage IV: Disseminated involvement of one or more extralymphatic organs.

Treatment

The treatment of Hodgkin's Lymphoma typically involves a combination of chemotherapy and radiation therapy. The specific regimen depends on the stage and other factors:

• Chemotherapy: Common regimens include ABVD (Adriamycin, Bleomycin, Vinblastine, Dacarbazine).
• Radiation Therapy: Often used in early-stage disease or to treat bulky disease.
• Stem Cell Transplant: May be considered in relapsed or refractory cases.

Prognosis

The prognosis for Hodgkin's Lymphoma is generally favorable, with high cure rates, especially in early-stage disease. The 5-year survival rate is approximately 85%.

Also see

• Non-Hodgkin Lymphoma
• Leukemia
• Multiple Myeloma
• Epstein-Barr Virus