Hodgkin’s Disease

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pet scan hodgkins lymphoma

Hodgkin’s Disease Definition

Hodgkin’s disease, also referred to as Hodgkin’s lymphoma, is a form of lymphatic cancer that is part a of the body’s immune system. [1]

In Hodgkin’s lymphoma, the cells may grow abnormally and spread to the lymphatic system. As the disease progresses, it fights the body’s ability to fight against any type of infection.

This type of cancer is considered the most treatable type of cancer. Early diagnosis of the symptoms helped people to have higher chance of recovery.

Hodgkin’s Disease Causes

There are no clear causes of Hodgkin’s lymphoma.

Medical studies show that Hodgkin’s lymphoma grows when the infection-fighting cell referred as B cell develops a mutation in the DNA. The mutation instructs the cells to divide swiftly and continue to survive while a healthy cell would die.

The mutation results to oversized, irregular B cells that may grow and build in the lymphatic system. These mutated cells may swarm the healthy cells and may lead to symptoms of Hodgkin’s lymphoma. [1]

Symptoms of Hodgkin’s Disease

Signs and symptoms of Hodgkin’s lymphoma may include: [1]

  • Painless inflammation of lymph nodes in the neck, armpits and groin
  • Chronic fatigue
  • Fever
  • Chills
  • Excessive night sweats
  • Difficulty in breathing
  • Lack of appetite
  • Itchiness
  • Unexplainable weight loss
  • May feel extra sensitive to the pain that affects the lymph nodes after consuming alcohol.

Hodgkin’s Disease Histology

histology of hodgkins lymphoma

 

  Picture 1 : Histology of Hodgkins Lymphoma

 Image Source : wikipedia.org

In the past several years, greater knowledge about the spectrum and biology of Hodgkin’s disease had increased.

In standard texts, there are two types of Hodgkin’s lymphoma, the nodular lymphocyte predominant Hodgkin’s lymphoma and classical Hodgkin’s lymphoma.

However, recent medical studies show that the classical Hodgkin’s lymphoma is not only a single entity. However, the varied cellularity and the lymphocyte-depleted subtypes are part of the biologic continuum. The nodular subtype carries a distinct epidemiology, clinical presentation and histology.

The nodular sclerosis Hodgkin’s disease especially with the mediastinal properties are seen related to primary mediastinal B cell lymphoma. At present, there is more understanding of borderline cases of classic B cell lymphomas. [2]

pet scan hodgkins lymphoma

 

 Picture 2 : PET scan of Hodgkins Lymphoma in cadaver

  Source : canceradvice.co.uk

The enlarged lymph nodes are seen here in the PET scan in relation to Hodgkin’s disease.

The histological image in Hodgkin’s disease is a combination of cells. The malignant cell that comes from Sternberg-Reed cell had originated from the lineage of lymphocytes. The image may only have one percent of the complete cellular picture known as Hodgkin’s disease but there are variants of the classic.

Sternberg-Reed cell contains two nuclei and a large cell, which is in an unmistakable microscopic picture, has no given examples in the biopsy specimen, thus, the diagnosis is quite a challenged.

In the background, the specimen image shows the appearance of Hodgkin’s disease and a varied combination of lymphocytes, histiocytes, plasma cells and the granulocytes. How much of the cell populations are reactive are still being discussed but every histologist agrees that the Sternberg-Reed cells and its variants should be found in any given biopsy for the proper diagnosis of the Hodgkin’s lymphoma. [3]

CD Markers for Hodgkin’s Disease

CD or cluster of differentiation is a protocol that is use in identifying and investigating the presence of cell surface molecules that are found in the leukocytes. These CD molecules are found to act in numerous ways but they often serve as receptors that are important to the cell.

Some CD proteins are not responsible for signaling of the cells however, it has other functions like adhesion. As of the present, there are 250 different proteins. [4]

CD markers of hodgkins lymphoma

Picture 3 : CD markers of Hodgkins Lymphoma

Source : Clinicalflow.com

Stages of Hodgkin’s Disease

Stages of cancer indicate whether the cancer is localized in just one area or if it affects other areas as well.

Several tests are required to determine the diagnosis of the stage of cancer. The possible treatment will be based on the results of the several tests.

  • Stage I indicates that the Hodgkin’s lymphoma only affects one group of lymph nodes. This possibly means that only one organ is affected by lymphoma.[5]

Hodgkins disease stage 1

 

Picture 4 : Image of   Hodgkins Lymphoma stage 1

Source : Cancerresearchuk.org

  • Stage II indicates that the Hodgkin’s disease is shown to affect two or more groups of lymph nodes. It can also affect one organ and two or more lymph nodes. The cancer is only restricted in the body that is neither above nor below the diaphragm.

Hodgkins disease stage 2

Picture 5 : Image of  Hodgkin’s Disease stage 2

Source: Cancerresearchuk.org

  • Stage III This occurs when the cancer moves the lymph nodes in both below and above the diaphragm. The cancer may also affect one portion of tissue or the organ that is adjacent to the lymph node groups or even in the spleen area.

Hodgkins disease stage 3

 Picture 6 : Image of Hodgkins Disease stage 3

 Source : Cancerresearchuk.org

  •  Stage IV This is the most advanced stage of the disease. This indicates that the cancer cells had occupied more than one organs and tissues. During this stage, the lymphoma had affect more than just the lymph nodes but also other areas of the body like liver, lungs and bones.

Hodgkins disease stage 4

Picture 7 : Image of Hodgkins Disease  stage 4

Source: Cancerresearchuk.org

 

In addition, doctors use letters A and B to indicate the symptoms of Hodgkin’s lymphoma.

  • A means that the patient does not show significant symptoms in relation to cancer.
  • B may indicate that the patient exhibits signs and symptoms like fever, unexplained weight loss and extreme night sweating.

Prognosis and Survival Rate

The survival rate of Hodgkin’s disease is considerably good. It is considered as one of the most curable forms of cancer. Early detection plays an important role in its survival. Compared to other cancers, Hodgkin’s is potentially curable even if it is found in the late stages.

The survival rate of patients with stage I and stage II are between 90 to 95 percent. Recent studies show that those in the advanced stage may still have five year survival rate of 90% however, it is unknown if the cancer will return.

Patients who even survived fifteen years after receiving treatment have increased risks of dying with other causes that are not related to Hodgkin’s disease. [6]

Treatment of Hodgkin’s Disease

The treatments used for Hodgkin’s lymphoma may depend on the type and stage of the disease. The goal of the treatment is to destroy the cancer cells. [7]

Chemotherapy

This drug treatment is used to kill lymphoma cells. The drugs used in this therapy may travel in the bloodstream and may reach all other parts of the body.

This kind of therapy is often combined with other therapy like radiation. Radiation treatment followed by chemotherapy is normally given to patients with early stage classical type of lymphoma.

For advanced stages, chemotherapy may be used alone.

Some side effects attributed with the use of chemotherapy are hair loss and nausea. Complications like heart damage, lung damage and fertility problems and even other type of cancers like leukemia.

Radiation

Radiation therapy uses high-energy beams to fight the cancer cells. During the therapy, a large machine is moved near the patient. Directing the beams to the location affected with cancer cells. Usually the lymph nodes and the nearby nodes where the disease may progress are targeted during the radiation.

Symptoms of radiation therapy are hair loss and redness of the skin. Majority of people who undergo the radiation may fell fatigue during the session. Other serious risks may include cardiovascular disease, thyroid disorders, breast cancer, and lung cancer and infertility problems.

Stem Cell Transplant

This treatment aims to replace the bone marrow with healthier stem cells that aids you in growing a new bone marrow. This treatment is an option if the cancer cells return even after treatment.

References:

  1. http://www.mayoclinic.com/health/hodgkins-disease/DS00186
  2. http://www.ncbi.nlm.nih.gov/pubmed/19390308
  3. http://www.canceradvice.co.uk/hodgkins-disease/
  4. http://www.clinicalflow.com/Cases/Introduction_to_Flow_Cytometric_Analysis/Cluster_of_Differentiation_%28CD_Markers%29
  5. http://www.cancerresearchuk.org/cancer-help/type/hodgkins-lymphoma/treatment/the-stages-of-hodgkins-lymphoma
  6. http://health.nytimes.com/health/guides/disease/hodgkins-lymphoma/prognosis.html
  7. http://www.mayoclinic.com/health/hodgkins-disease/DS00186/DSECTION=treatments-and-drugs

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