Hodgkin's lymphoma

• What is Hodgkin’s Lymphoma
• Statistics on Hodgkins Lymphoma
• Risk Factors for Hodgkins Lymphoma
• Progression of Hodgkins Lymphoma
• Symptoms of Hodgkins Lymphoma
• Clinical Examination of Hodgkins Lymphoma
• How is Hodgkins Lymphoma Diagnosed?
• Prognosis of Hodgkins Lymphoma
• How is Hodgkins Lymphoma Treated?
• Hodgkins Lymphoma References

What is Hodgkins Lymphoma

Hodgkin’s Lymphoma is a type of lymphoma that usually arises from the lymphocytes found within the lymph nodes.
Lymph nodes are groups of lymphatic cells held together by connective tissue, distributed throughout the body. Lymph fluid is produced when the blood passes through the tissues. Most of the cellular content of the blood (white cells, red cells and platelets) stays within the blood vessels, some of the liquid content (water, proteins, antibodies, fats) and some white cells pass through and bathe the tissues in nutrients.
The lymphatic fluid is collected by the lymphatic vessels and channeled to the local lymph nodes, where it is filtered and passed onwards to the next set of lymphatic vessels. The direction of drainage is from the periphery to central, with the lymph ultimately emptying into the subclavian vein via the thoracic duct in the chest. The lymph nodes produce lymphocytes which are mainly responsible for producing antibodies.

Statistics on Hodgkins Lymphoma

Hodgkin’s Lymphoma is relatively uncommon, occurring in approximately 3 per 100 000 and occurs usually in early adulthood. There can be a second peak with Hodgkin’s Lymphoma occurring in older adults, with sex incidence being slightly more common in men.
Geographically, Hodgkin’s Lymphoma tumour is found worldwide, with some mild geographical variation.

Risk Factors for Hodgkins Lymphoma

The cause of most cases of Hodgkin’s lymphoma is unknown.
There may be a genetic predisposition as first degree relatives of people with Hodgkin’s Lymphoma are at a slightly higher risk (9 per 100 000) of developing this disease.

Progression of Hodgkins Lymphoma

Hodgkin’s Lymphoma tumour spreads by passage through the lymphatic channels to adjacent lymph nodes. As the spleen is an important organ of the lymphatic system, it may also be involved. Later in Hodgkin’s Lymphoma may spread via the bloodstream to the liver, other organs and bone.

How is Hodgkins Lymphoma Diagnosed?

General investigations into Hodgkin’s Lymphoma may show anaemia or abnormal liver function. If haemolysis is present the serum haptoglobin level may be lowered.

Prognosis of Hodgkins Lymphoma

Early Hodgkin’s disease has an extremely good prognosis. Stage 1A disease can be cured in more than 90% of cases.

How is Hodgkins Lymphoma Treated?

If Hodgkin’s Lymphoma is very localised, e.g. Stage 1 disease, involving only the neck lymph nodes, the usual treatment is localised radiotherapy which is very effective. This mode of treatment may also be used to treat groin lymph nodes (using the “inverted Y field”). Otherwise, radiotherapy is reserved for treating specific problems that require focal therapy, such as bone pain from bone involvement or treating an obstruction of the Superior Vena Cava (the large vein that drains the face and upper body).
Stage 2 Hodgkin’s Lymphoma (and some types of Stage 1 disease) are treated with chemotherapy. There are a variety of treatments which are exceptionally effective for Hodgkin’s disease. Some involve both chemotherapy and radiotherapy. As every Hodgkin’s Lymphoma patient is different, your treating specialist will be able to advise you on which treatment is best for you.
The Hodgkin’s Lymphoma symptoms that may require attention are fatigue from anaemia, appetite loss and weight loss, shortness of breath and coughing in chest involvement and in rare occasions pain from organ or bone involvement.
Improvement in Hodgkin’s Lymphoma symptoms is an important measurement. Specific monitoring may be by measurement of the size of the involved lymph nodes. This may often be done with a simple ruler of tape measure if the nodes are easily felt e.g. in the neck. If the lymph nodes are deep inside, e.g. in the chest or abdomen, then imaging such as CT can show the response to Hodgkin’s Lymphoma treatment.

Hodgkins Lymphoma References

1. MEDLINE Plus
2. Sidney Kimmel Cancer Center John Hopkins University
3. USA National Cancer institute