Hodgkin's Disease

Hodgkin's lymphoma (or Hodgkin's disease, lymphogranulomatosis) is a malignant tumour of the lymphatic system. The disease was named after the English physician Thomas Hodgkin (1798-1866), who first described it in 1832.

The annual incidence of Hodgkin's lymphoma is two to four new cases per 100,000 people; the male to female ratio is 3:2. Hodgkin's disease mainly affects young to middle-aged adults. In industrialized countries, there are two disease peaks in the age distribution, a larger one in the third and a slightly smaller one in the seventh decade of life.

Symptoms

The disease becomes evident through a painless swelling of lymph nodes, which patients typically notice by chance. The most frequently affected lymph nodes are in the neck, armpit, abdomen and groin area. Patients report fatigue, a drop in energy or itching. If fever and night sweats occur, these are called B symptoms. An enlargement of the liver and/or spleen can be signs of the disease.

Characteristic for the fine tissue diagnosis of Hodgkin's lymphoma are the mononuclear Hodgkin's cells as well as the multi-nucleated Sternberg Reed giant cells, often also referred to as Hodgkin Reed Sternberg cells (HRS cells). These cells originate from the B lymphocytes (white blood cells) in the germ centres of the lymph nodes. They are the actual malignantly growing cells of Hodgkin's lymphoma and multiply from a single cell (monoclonal). Sternberg Reed cells are typically larger than 20 µm with several bright nuclei.

The blood count often shows lymphocytopenia. The erythrocyte sedimentation rate is greatly increased. A tissue examination of an affected lymph node is essential for diagnosis. Further examinations are performed using ultrasound, chest x-ray, computer tomography and bone marrow puncture. The chances of recovery are good to very good, especially for children.