Hodgkin lymphoma: symptoms, causes, diagnosis, treatment

Hodgkin lymphoma (HL) is one of two types of cancer that develops in lymphocytes , the white blood cells of the lymphatic system, which is part of the immune system. The main symptom of HL is swollen lymph nodes in the neck, armpits, and groin, which usually prompts the doctor to perform laboratory and / or imaging tests to diagnose the disease.

Hodgkin lymphoma is relatively rare, accounting for only about 10% of all lymphoma cases, and affects fewer than 200,000 people annually in the United States, mostly adolescents and young adults ages 15 to 40 and adults older than 55. years. Another type of lymphoma, non-Hodgkin lymphoma, is significantly more common.

Types

There are five main types of LH. Four of them represent what was once called classical Hodgkin lymphoma and account for more than 95% of all LH cases in developed countries .

Types of Hodgkin lymphoma
Kind of Incidence (percentage of LH diagnoses) Who is affected specs
Nodal sclerosing Hodgkin lymphoma (NSHL) 60% to 70% Women, youth Lumps on the neck, armpits and chest are mainly affected.
Mixed cellularity Hodgkin lymphoma (MCHL) P 15% to 30% People of all ages, mainly in developing countries Lumps in the abdomen are more likely than in the chest.
High lymphocyte count classical Hodgkin lymphoma (LRCHL) 5% to 6% People from 30 to 40 years old It is rarely found in more than a few lymph nodes, mainly in the upper half of the body.
Hodgkin lymphocytic lymphoma (LDL) 1% HIV-infected older people It is usually diagnosed at a late stage.
Nodular lymphocyte-dominated Hodgkin lymphoma (NLPHL) 4% to 5% Without details Under the microscope, the affected cells look more like NHL cells; growing very slowly

Symptoms

The lymphatic system is made up of small bean-like organs called nodes, which are strategically located along a network of ducts filled with lymphatic fluid, where they serve as checkpoints for the immune system.

The most common and often the only symptom of Hodgkin lymphoma is a painless swelling felt in the neck, armpit, or groin, indicating an enlarged lymph node . Sometimes more than one node is affected.

HL can also affect the deep lymph nodes in the chest, which are difficult to detect without imaging.

If other symptoms develop as a result of Hodgkin lymphoma, they are collectively called B symptoms. They may include :

  • Loss of appetite
  • Weightloss
  • Fever and chills
  • Skin itch
  • Night sweats

A rare symptom of Hodgkin lymphoma is pain that occurs after drinking alcohol. It is not known why this pain occurs, which is concentrated in the lymph nodes. One theory is that this is due to the dilation of the glands' blood vessels in response to alcohol.

Causes

Little is known about the causes of Hodgkin lymphoma other than that it occurs in a specific type of lymph cell: B lymphocytes or B cells. These are cells of the immune system that produce proteins called antibodies that help protect the body from bacteria and viruses.

According to the National Cancer Institute (NCI), changes in the DNA of B lymphocytes transform them from normal cells into large abnormal cells called Reed-Sternberg cells, which often contain more than one nucleus.

If Hodgkin lymphoma spreads, it tends to travel from one lymph node to another; Only occasionally and in later stages of the disease does HL enter the bloodstream, allowing it to travel to other parts of the body.

Risk factor's

There are several recognized risk factors for the disease. The presence of these risk factors does not mean that a person is destined to develop Hodgkin lymphoma, it is just that they are more likely to get sick than others:

  • Epstein-Barr virus: This is the same microbe that causes mononucleosis and can also be associated with chronic fatigue syndrome (ME / CFS) . According to the American Cancer Society (ACA), some researchers speculate that infection with this virus could cause changes in the DNA of B cells that cause them to turn into Reed-Sternberg cells .
  • Family history: It is not clear why this could be the case. There may be an as yet unidentified gene that increases susceptibility to Hodgkin lymphoma, or that family members in whom multiple people developed HL had similar childhood illnesses that increased their risk.
  • A weakened immune system (for example, as a result of HIV infection or other medical conditions, or from taking medications used to suppress the immune response )

Diagnostics

The first sign of Hodgkin lymphoma is enlarged lymph nodes, but this is hardly enough to diagnose the disease. There are many causes of swollen lymph nodes, and most of them are not related to cancer. In fact, enlarged lymph nodes are often a symptom of an infection; As soon as the infection is cleared from the body, the tumor shrinks.

However, an enlarged lymph node cannot be ignored. If you find this yourself, see your doctor.

If, after talking with you about your medical history and undergoing a physical exam, you are concerned about the possibility of lymphoma, there are several diagnostic steps you can take.

Close up of fabric:

  • Lymph node biopsy (whole or part of a lymph node)
  • Fine needle aspiration (FNAC)

Display:

According to the recommendations of the National Comprehensive Cancer Network, PET scans and computed tomography ( PET / CT ) are often done together to diagnose and evaluate Hodgkin lymphoma.

Blood tests: There are no specific blood tests for Hodgkin lymphoma. However, the results of some of them may indicate the possibility of HL (or be used to monitor it).

  • Complete blood count (CBC) to evaluate the levels of various cells in your blood.
  • Erythrocyte sedimentation rate (ESR) to measure inflammation

Watch out

When found early, Hodgkin lymphoma is one of the most treatable and curable forms of blood cancer. There are four standard approaches to treating lymphoma.

In most cases, chemotherapy is the first and only form of treatment for Hodgkin lymphoma.

Front facing

From diagnosis to the last day of treatment and beyond (survival), managing Hodgkin lymphoma will be challenging in a number of ways. Inevitably, you will have to deal with a variety of emotions.

Among the ways of coping with the intense and ever-changing ebb and flow of feelings, accepting them as normal (rather than a sign of weakness), educating yourself in the unknown, and seeking support from others are the safe first steps.

Coping with the side effects of treatment will also be of the utmost importance during your journey through Hodgkin lymphoma. Your healthcare provider can help you find ways to alleviate and even prevent many of these physical consequences from both the disease itself and the treatments used to correct it.

Since the experience of diagnosing and treating a condition like Hodgkin lymphoma lasts for weeks, if not months, your daily life will also be affected in many ways (daily routine, work, finances, etc.). It is important that you seek help. from both support programs and those around you to cope with and focus on your health.

Forecast

Many factors contribute to the inaccurate measurement of cancer survival. According to the American Cancer Society , specific variables associated with Hodgkin lymphoma include age, whether it is first onset or relapse, general health, response to treatment, and numerous factors related to various blood components and specific symptoms.

With these considerations in mind, the 5-year survival rate for Hodgkin lymphoma, based on the NCI SEER database of survival statistics for many cancers, is grouped into three stages: localized, regional, and distant.

Five-year survival rate for Hodgkin lymphoma
Stage Description Survival percentage
Located Limited to an area of the lymph node, a lymphoid organ, or an organ outside the lymphatic system 92%
Regional Has spread from one lymph node to an adjacent organ, occurs in two or more lymph node areas on one side of the diaphragm, or is considered a volumetric disorder * 93%
Far It has spread to distant parts of the body, such as the lungs, liver, or bone marrow, or to areas of the lymph nodes above and below the diaphragm. 78%
All stages together 87%

* Tumors in the chest that are at least one-third the width of the chest, or tumors in other areas that are at least 10 centimeters (about 4 inches) wide.

Get the word of drug information

Diagnosing Hodgkin lymphoma can be overwhelming, and trying to understand the disease and treatment options can be challenging. Ask your doctor as many questions as necessary, even if it means that you will have to ask the same questions over and over again. Sometimes it can be helpful to talk to someone who has had Hodgkin lymphoma and any associated diagnoses and treatment. Survival workshops, conferences, and even social media are great ways to connect with other people who might share your challenges or have similar experiences and ideas.

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