Hodgkin’s Lymphoma

Overview

Hodkin lymphoma is a type of cancer that arises from white blood cells (lymphocytes). Typical symptoms of this cancer is swelling of the lymph node that is present in the neck, armpits, and groin region that would want health care providers to conduct lab test and imaging studies.
Hodgkin lymphoma is a rare type of cancer that accounts for only 10% of lymphoma cases. It is diagnosed among people between the age of 15 and 40 years old as well as adults over the age of 55. Otherwise, non-Hodkin lymphoma is more common.
Stages of Hodkin lymphoma:
1.    Localized stage: This is the stage in which cancer is limited to only one lymph node or only one organ that is outside the lymph system.
2.    Regional stage: This is a stage where cancer would extend from one lymph node to nearby organs in the body. This might occur in two or more lymph nodes which might be present in the same side of the diaphragm.
3.    Distant stage: In this cancer has spread to distant parts of the body including the lungs, liver, and bone marrow or in the lymph node area that is present above or below the diaphragm level.



Consulting Doctor

Oncologist.



Symptoms

Small bean-shaped organs are present in the lymphatic system which are known as nodes. They are present as a network of lymph-filled channels and act as checkpoints for the immune system. The frequent and most common symptom of this lymphoma is a lump formation that is painless which might appear in the armpits, neck, or groin region. At times, more than one node is affected by this disease. The lymphoma that is present deep into the chest is difficult o diagnose without imaging studies. The usual symptoms include the following:
-Loss of hunger (appetite)
-Losing weight without any obvious cause: One might lose more than 10% of the body weight.
-Increase in body temperature or feeling of chills that is often unexplained: A temperature of 39.5 degrees Celsius for two or more hours that occurs several days is a sign of a serious problem.
-Intense night sweats: Night sweats that might be so intense that would make your bed sheets wet.
-Pruritus: Skin that easily becomes itchy especially after drinking alcohol and taking a shower.
-Abdominal pain or swelling: Mild belly pain might not be a sign of a serious issue, however, if it is severe one should contact a healthcare provider.
-Pain in the chest: Hodgkin lymphoma might be present in lung tissue or in lymph nodes inside your chest cavity.
-Feeling itchy 
-Intense night sweats.
-Feeling constant fatigue: Feeling tired more than usual for several days. 
Symptomatic pain of Hodgkin lymphoma might arise after drinking alcoholic beverages.



Causes

We do not have enough information about what is the cause of Hodkin lymphoma except the fact that it does arise from a particular type of cells known as B lymphocytes. B cells are the immune cells that would make proteins known as antibodies that would help to protect from bacteria and viruses. As per National Cancer Institute, changes in the DNA of B lymphocytes would transform them from normal to large cells, and abnormal ones are knowns as Reed Sternberg cells that contain more than one nucleus.
If lymphoma spreads, it would travel from one node to another and as the disease progresses lymphoma would move to the bloodstream which would let them to travel other parts of the body.
1.    Epstein Barr virus: This virus causes mononucleosis and would lead to fatigue syndrome. Research states that infection in viruses would change the DNA of B cells and would cause them to become Reed Sternberg cells.
2.    Family history: It is unclear why family history might be linked to this disease and it increases susceptibility to Hodgkin lymphoma, In family members several people who developed HL had some form of childhood disease that increases the risk of Hodkin lymphoma.
3.    Weak immune system: This might occur as a result of HIV medication that might increase the risk of Hodkin lymphoma.



Prevention

Not many risk factors are known that would help to prevent Hodkin's Lymphoma. However, one can avoid getting infected with HIV, by refraining from involving in unprotected sex and by avoiding sharing needles or syringes.
Treatment: 
If Hodgkin's lymphoma is diagnosed in the early stages, it is considered treatable and can be cured. Four approaches are used to treat lymphoma:
1.    Chemotherapy: Several medications are approved in the market to treat Hodgkin lymphoma. 
2.    Radiation: This therapy is used after the execution of chemotherapy that would target cancerous cells that might have survived initial treatment.
3.    Immunotherapy: In this medications are used to make the immune system function better and to recognize and destroy cancerous cells.
4.    Transplant of stem cells or bone cells: This might become mandatory in rare situations.



Treatment

If Hodgkin's lymphoma is diagnosed in the early stages, it is considered treatable and can be cured. Four approaches are used to treat lymphoma:
1.    Chemotherapy: Several medications are approved in the market to treat Hodgkin lymphoma. 
2.    Radiation: This therapy is used after the execution of chemotherapy that would target cancerous cells that might have survived initial treatment.
3.    Immunotherapy: In this medications are used to make the immune system function better and to recognize and destroy cancerous cells.
4.    Transplant of stem cells or bone cells: This might become mandatory in rare situations.



Tests Required for Diagnosis

Diagnostic tests include tissue sampling, imaging as well as a blood test.
Tissue sampling:
Biopsy of lymph node (full node or a portion of it).
Fine needle aspiration (FNAC).
Imaging: 
Positron Emission Tomography (PET scan): Radioactive tracers are used that helps to detect the sign of cancer. 
Computerized tomography scan (CT scan): This presents a series of detailed pictures of the body.
Blood test: Specific blood tests do not exist to diagnose Hodkin lymphoma. However, blood results can be a sign of the possibility of HL.
Complete Blood Count (CBC): This is used for the assessment of cells in the body. It measures the amount of blood cells in your body.
Erythrocyte sedimentation rate (ESR): Sedimentation of erythrocytes is used to measure inflammatory response. It takes the erythrocyte in the test tube and would measure the amount of time it takes for cells to settle in the bottom of the tube. A high sedimentation rate might point to a diagnosis of lymphoma.
Blood chemistry test: This measures the substance that is released in your bloodstream by organs or by body tissues.
Magnetic Resonance Imaging: In this radio waves or computerized waves are used to take detailed images inside the body.
Ultrasound: This is a procedure in which sound waves that are high in energy would bounce against internal tissue or organs of the body that make echoes. Echoes that are created from this ultrasound are called sonograms.



References

Jerroci, T. (2022, October 4). An Overview of Hodgkin Lymphoma. Verywell Health. Retrieved May 26, 2023, from https://www.verywellhealth.com/hodgkin-lymphoma-4013744 
2.    Cleaveland Clinic (2023, January 1). Hodgkin Lymphoma. Retrieved May 26, 2023, from https://my.clevelandclinic.org/health/diseases/6206-hodgkin-lymphoma 
3.    American Cancer Society (1, January 1). Can Hodgkin Lymphoma Be Prevented? Cancer.org. Retrieved May 26, 2023, from https://www.cancer.org/cancer/types/hodgkin-lymphoma/causes-risks-prevention/prevention.html 
 



Disclaimer

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