Hodgkin's Disease Health Channel

Definition

Hodgkin's lymphoma is a cancer of lymph tissue found in the lymph nodes, spleen, liver, bone marrow, and other sites.

Alternative Names

Lymphoma - Hodgkin's; Hodgkin's disease; Cancer - Hodgkin's lymphoma

Causes, incidence, and risk factors

The first sign of this cancer is often an enlarged lymph node which appears without a known cause. The disease can spread to nearby lymph nodes. Later it may spread to the spleen, liver, bone marrow, or other organs.

The cause is not known. Hodgkin's lymphoma is most common among people ages 15 - 35 and 50 - 70. Infection with the Epstein-Barr virus (EBV) is thought to contribute to most cases.

Symptoms

• Fatigue
• Fever and chills
• Itching
• Loss of appetite
• Night sweats
• Painless swelling of the lymph nodes in the neck, armpits, or groin (swollen glands)
• Weight loss

Other symptoms that may occur with this disease:

• Clubbing of the fingers or toes
• Excessive sweating
• Flank pain
• Hair loss
• Neck pain
• Pain in the affected areas after drinking alcohol
• Skin blushing or flushing
• Splenomegaly

Signs and tests

The disease may be diagnosed after:

• Biopsy of suspected tissue
• Bone marrow biopsy
• Lymph node biopsy
• Detection of Reed-Sternberg (Hodgkin's lymphoma) cells by biopsy from any site

A staging evaluation (tumor staging) may be done to determine how far the disease has spread. The following procedures may be done:

• Blood chemistry tests
• Bone marrow biopsy
• CT scans of the chest, abdomen, and pelvis
• PET scan
• Physical examination

In some cases, abdominal surgery to take a piece of the liver and remove the spleen may be needed. However, because the other tests are now so good at detecting the spread of Hodgkin's lymphoma, this surgery is usually unnecessary.

Hodgkin's lymphoma may change the results of the following tests:

• Angiotensin converting enzyme (ACE) levels
• Blood differential
• Bone marrow aspiration
• Cryoglobulins
• Ferritin
• Gallium scan
• Lymphocyte count

Treatment

Treatment primarily depends on the following:

• The type of Hodgkin's lymphoma (most people have classic Hodgkin's)
• The stage (where the disease is found)
• Whether the tumor is more than 4 inches (10 cm) wide
• The patient's age and other medical issues
• Other factors, including weight loss, night sweats, and fever

A staging evaluation is necessary to determine the treatment plan.

• Stage I indicates one lymph node region is involved (for example, the right neck).
• Stag

  ...