Hodgkin’S Lymphoma

(Morbus Hodgkin)

Hodgkin’s lymphoma is a localized or disseminated malignant proliferation of cells of the lymphoreticular system preferably involvement of lymph nodes, spleen, liver and bone marrow. Symptoms include painless lymphadenopathy, sometimes with fever, night sweats, unintentional weight loss, itching, splenomegaly and hepatomegaly. Diagnosis is based on lymph node biopsy. The treatment is curative in over 75% of cases and consists of chemotherapy with or without radiation therapy.

In the US, about 9,000 new cases of Hodgkin lymphoma are diagnosed annually. The ratio to female is male 1.4: 1st Hodgkin’s lymphoma is rare before age 10, and most often between 15 and 40 years, a second peak incidence is> 50 to 60 years of age.

Hodgkin’s lymphoma is a localized or disseminated malignant proliferation of cells of the lymphoreticular system preferably involvement of lymph nodes, spleen, liver and bone marrow. Symptoms include painless lymphadenopathy, sometimes with fever, night sweats, unintentional weight loss, itching, splenomegaly and hepatomegaly. Diagnosis is based on lymph node biopsy. The treatment is curative in over 75% of cases and consists of chemotherapy with or without radiation therapy. In the US, about 9,000 new cases of Hodgkin lymphoma are diagnosed annually. The ratio to female is male 1.4: 1st Hodgkin’s lymphoma is rare before age 10, and most often between 15 and 40 years, a second peak incidence is> 50 to 60 years of age. Pathophysiology Hodgkin lymphoma results from the clonal transformation of B cells, resulting in the pathognomonic double-core Reed-Sternberg cells develop. The cause is unknown, but playing a genetic susceptibility and external causes (eg professional activity, such as wood processing;. Treatment with phenytoin, radiation therapy or chemotherapy, infection with the Epstein-Barr virus, Mycobacterium tuberculosis, herpes virus type 6, HIV) a Role. The risk in persons with certain types of immunosuppression slightly increased (e.g., patients taking immunosuppressive drugs following transplantation.); in persons with congenital immunodeficiency syndromes (for. example, ataxia telangiectasia, Klinefelter’s syndrome, Chediak-Higashi syndrome, Wiskott-Aldrich syndrome) and in individuals with certain autoimmune diseases (rheumatoid arthritis, celiac disease, Sjogren’s syndrome, SLE). Most patients also develop a slowly progressive disorder of T cell-mediated immunity (T-cell function), which contributes in advanced stages to common bacterial and atypical fungal, viral and protozoal infections. The humoral immunity (antibody production) is suppressed in advanced stages. Cause of death is often sepsis. Symptoms and signs Most patients present with painless cervical lymphadenopathy. Although the mechanism is unclear, it may come into affected areas immediately after consumption of alcoholic drinks to pain, which provide an early clue to the diagnosis. Other manifestations occur due to spread of the disease within the reticuloendothelial system, usually at adjacent regions. Pronounced itching can occur early. Constitutional symptoms include fever, night sweats and unintended weight loss (> 10% of body weight in the previous 6 months) and can access a broad involvement of internal lymph nodes (mediastinal or retroperitoneal), point (liver) or bone marrow. Splenomegaly is often present; Hepatomegaly may occur. Pel-Epstein-fever (a few days with a high fever that regularly alternating with a few days to several weeks lasting normo- or hypothermia) occurs occasionally. Cachexia is common in disease progression. A bone involvement is often asymptomatic, but can vertebral osteoblastic lesions (ivory vertebra) and, rarely, cause pain with osteolytic lesions and compression fractures. Intracranial, gastric and cutaneous lesions are rare and suspicious for HIV-associated Hodgkin’s lymphoma. The local compression by large tumor masses often causes symptoms including jaundice due to intrahepatic or extrahepatic biliary obstruction leg edema as a result of lymphatic obstruction in the pelvis or in the groin Severe shortness of breath and wheezing as a result tracheobronchealer compression Pulmonary cavities or abscesses as a result of Lungenparenchyminfiltration that a lobar consolidation can mimic or bronchopneumonia Epidural infested with spinal cord compression can lead to paraplegia. Horner syndrome, and vocal cord paralysis can occur when enlarged lymph nodes compress the cervical sympathetic nerve and the recurrent laryngeal nerve. Neuralgic pain caused by nerve root compression. Diagnostic X-ray examination of the chest CT of the thorax, abdomen and pelvis blood count, alkaline phosphatase, LDH, liver function tests, albumin, calcium, urea and creatinine lymph node biopsy PET for staging and MRI in neurological symptoms Uncommon Bone marrow biopsy The suspicion of Hodgkin’s lymphoma is usually in patients with painless lymphadenopathy or mediastinal adenopathy, which is determined as part of a routine chest X-ray examination. A similar lymphadenopathy may be the result of infectious mononucleosis, toxoplasmosis, cytomegalovirus infection, a non-Hodgkin’s lymphoma and leukemia. Similar chest x-ray findings can also benefit from a lung cancer, sarcoidosis or tuberculosis originate (Clarification of a mediastinal mass, mediastinal masses: Diagnosis). Hodgkin’s lymphoma (Mediastinal lymphadenopathy) DR P. MARAZZI / SCIENCE PHOTO LIBRARY var model = {thumbnailUrl ‘/-/media/manual/professional/images/m1340534-hodgkin-lymphoma-science-photo-library-high_de.jpg?la = en & thn = 0 & mw = 350 ‘, imageUrl:’ /-/media/manual/professional/images/m1340534-hodgkin-lymphoma-science-photo-library-high_de.jpg?la=de&thn=0 ‘, title:’ Hodgkin lymphoma (Mediastinal lymphadenopathy) ‘, description:’ u003Ca id = “v38396006 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eRöntgenthorax a patients with Hodgkin’s lymphoma is a mediastinal lymphadenopathy u003c / p u003e u003c / div u003e ‘credits’. DR P. MARAZZI / SCIENCE PHOTO LIBRARY’

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