Hodgkin lymphoma — formerly known as Hodgkin disease — is a cancer of the lymphatic system, which is part of your immune system. The doctors can identify it by the presence of Reed-Sternberg cells, which are abnormally large B lymphocytes. In people with Hodgkin lymphoma, the cancer usually moves from one lymph node to an adjacent one. It may affect people of any age, but is most common in people between 20 and 40 years old and those over 55. In Hodgkin’s lymphoma, cells in the lymphatic system grow abnormally and may spread beyond it.
The most common symptom of HD is swelling of the lymph nodes, which causes a lump to form under the skin. This lump usually isn’t painful. It may form in one or more of the following areas:
• in the armpit
• on the side of the neck
• around the groin
Other symptoms of HD include:
• night sweats
• itchy skin
• persistent cough, trouble breathing, chest pain
• enlarged spleen
• unintended weight loss
• pain in the lymph nodes after consuming alcohol
Doctors aren’t sure what causes Hodgkin lymphoma. But it begins when an infection-fighting cell called a lymphocyte develops a genetic mutation. The mutation tells the cell to multiply rapidly, causing many diseased cells that continue multiplying.
The mutation causes a large number of oversized, abnormal lymphocytes to accumulate in the lymphatic system, where they crowd out healthy cells and cause Hodgkin lymphoma.
Once an HD diagnosis has been made, the cancer is assigned a stage. Staging describes the extent and severity of the disease.
There are four general stages of HD:
• Stage 1 (early stage)
It means that cancer is found in one lymph node region, or the cancer is found in only one area of a single organ
• Stage 2 (locally advanced disease)
It means that cancer is found in two lymph node regions on one side of the diaphragm, which is the muscle beneath your lung, or that cancer was found in one lymph node region as well as in a nearby organ.
• Stage 3 (advanced disease)
It means that cancer is found in lymph node regions both above and below your diaphragm or that cancer was found in one lymph node area and in one organ on opposite sides of your diaphragm.
• Stage 4 (widespread disease)
It means that cancer was found outside the lymph nodes and has spread widely to other parts of your body, such as your bone marrow, liver, or lung.
Risk Factors –
Factors that can increase the risk of Hodgkin’s lymphoma include –
• Being male.
Males are slightly more likely to develop Hodgkin’s lymphoma than are females.
• Your age.
Hodgkin’s lymphoma is most often diagnosed in people between 15 and 30 years old and those over 55.
• A family history of lymphoma.
Having a blood relative with Hodgkin lymphoma or non-Hodgkin lymphoma increases your risk of developing Hodgkin lymphoma.
• HIV infection.
This can weaken the immune system and increase the risk of lymphoma.
• Past Epstein-Barr infection.
People who have had illnesses caused by the Epstein-Barr virus, such as infectious mononucleosis, are more likely to develop Hodgkin lymphoma.
• A physical exam.
Your doctor checks for swollen lymph nodes, including in your neck, underarm and groin, as well as a swollen spleen or liver.
• Blood tests.
A sample of your blood is examined in a lab to see if anything in your blood indicates the possibility of cancer.
• Imaging tests.
Your doctor may recommend imaging tests to look for signs of Hodgkin’s lymphoma in other areas of your body. Tests may include X-ray, CT and positron emission tomography.
• Removing a lymph node for testing.
Your doctor may recommend a lymph node biopsy procedure to remove a lymph node for laboratory testing. He or she will diagnose classical Hodgkin’s lymphoma if abnormal cells called Reed-Sternberg cells are found within the lymph node.
• Removing a sample of bone marrow for testing.
A bone marrow biopsy and aspiration procedure involves inserting a needle into your hipbone to remove a sample of bone marrow. The sample is analyzed to look for Hodgkin’s lymphoma cells.
• Chemotherapy .
Chemotherapy is a drug treatment that uses chemicals to kill lymphoma cells. Chemotherapy drugs travel through your bloodstream and can reach nearly all areas of your body.
Chemotherapy is often combined with radiation therapy in people with early-stage classical type Hodgkin lymphoma. Radiation therapy is typically done after chemotherapy. In advanced Hodgkin’s lymphoma, chemotherapy may be used alone or combined with radiation therapy.
Radiation therapy uses high-energy beams, such as X-rays and protons, to kill cancer cells. For classical Hodgkin’s lymphoma, radiation therapy is often used after chemotherapy. People with early-stage nodular lymphocyte-predominant Hodgkin lymphoma may undergo radiation therapy alone.
• Bone marrow transplant.
Bone marrow transplant, also known as stem cell transplant, is a treatment to replace your diseased bone marrow with healthy stem cells that help you grow new bone marrow. A bone marrow transplant may be an option if Hodgkin lymphoma returns despite treatment.
• Other drugs therapy.
Other drugs used to treat Hodgkin lymphoma include targeted drugs that focus on specific vulnerabilities in your cancer cells and immunotherapy that works to activate your own immune system to kill the lymphoma cells.
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