Hodgkin lymphoma - cervical swelling (Source: Shutterstock)
Definition of 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 of Hodgkin's Disease
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.
Diagnosis of Hodgkin's Disease
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.