Hodgkin's lymphoma

What is Hodgkin's Lymphoma?

Hodgkin's lymphoma, also known as Hodgkin disease, is a type of cancer that affects the immune system. It begins when healthy cells in the lymphatic system change and grow out of control.

• Lymphatic System: The lymphatic system is part of the body's germ-fighting and disease-fighting immune system. It includes lymph nodes, spleen, liver, and bone marrow.
• Cancerous Cells: In Hodgkin's lymphoma, cancerous cells called lymphocytes grow out of control in the lymphatic system.

Types of Lymphomas

There are two main types of lymphoma: Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). They come from different types of cells and behave differently.

• Hodgkin Lymphoma: HL starts in white blood cells called lymphocytes. It is a group of blood cancers that affects the lymphatic system.
• Non-Hodgkin Lymphoma: NHL also starts in white blood cells, but it comes from different types of cells and behaves differently.

Symptoms

The most common symptom of Hodgkin's lymphoma is a painless swelling in a lymph node, usually in the neck, armpit, or groin. Other symptoms may include:

• Lumps: Lumps associated with Hodgkin's lymphoma are not painful and not associated with an injury.
• Bruise, Lump, or Bump: A bruise, lump, or bump that arises out of nowhere and doesn't disappear as you'd normally expect it would.

Causes and Risk Factors

The exact cause of Hodgkin's lymphoma is unknown. However, some risk factors have been identified:

• Age: It can occur at any age, but most cases are diagnosed in people between 20 and 40 years old.
• Genetics: Some people may be more likely to develop Hodgkin's lymphoma due to their genetic makeup.

Treatment

Hodgkin's lymphoma is a serious disease that requires prompt treatment. Treatment options include:

• Chemotherapy: Using medications to kill cancer cells.
• Radiation Therapy: Using high-energy rays to destroy cancer cells.
• Surgery: Removing affected lymph nodes or other tissues.

Citations: 1. [1] Hodgkin lymphoma is a type of cancer that affects the lymphatic system. The lymphatic system is part of the body's germ-fighting and disease-fighting immune system. 2. [3] Hodgkin lymphoma begins when healthy cells in the lymphatic system change and grow out of control. 3. [9] The most common symptom of Hodgkin lymphoma is a painless swelling in a lymph node, usually in the neck, armpit or groin. 4. [10] Lumps associated with Hodgkin's lymphoma are not painful and not associated with an injury. 5. [14] Hodgkin lymphoma starts when an abnormal change to the DNA of a white blood cell (called a lymphocyte) causes it to become a lymphoma cell that, if untreated, results in the uncontrolled growth of cancerous lymphocytes.

Common Signs and Symptoms of Hodgkin's Lymphoma

Hodgkin's lymphoma, a type of cancer that affects the immune system, can manifest in various ways. The symptoms can be non-specific and similar to those of other conditions, making it essential to consult a doctor for an accurate diagnosis.

• Painless Swollen Lymph Nodes: The most common symptom is the appearance of painless, swollen lymph nodes in the neck, armpits, or groin [3]. These lymph nodes may not go away even after a few weeks.
• Fever: Unexplained fevers can be a sign of Hodgkin's lymphoma [7].
• Drenching Night Sweats: Excessive sweating, especially at night, is another common symptom [8].
• Unexplained Weight Loss: Unintended weight loss can occur due to the disease [2].
• Fatigue: Feeling very tired or exhausted is a frequent complaint among patients with Hodgkin's lymphoma [1].

Other possible symptoms include:

• Loss of Appetite
• Heavy Night Sweats
• Pain in Lymph Nodes after Drinking (in some cases)
• Unusual Sweating

It's essential to note that not everyone will experience all these symptoms, and the severity can vary from person to person. If you're experiencing any of these symptoms, it's crucial to consult a doctor for proper evaluation and diagnosis.

References: [1] - Context result 2 [2] - Context result 4 [3] - Context result 3 [7] - Context result 7 [8] - Context result 8

Diagnostic Tests for Hodgkin Lymphoma

Hodgkin lymphoma diagnosis often begins with a physical exam to check for swollen lymph nodes in the neck, underarm, and groin [2]. Other tests include imaging tests and removing some cells for testing. A biopsy is a procedure to remove a sample of tissue for testing in a lab, which is typically used to diagnose Hodgkin lymphoma [3].

Types of Diagnostic Tests

• Blood Tests: Complete blood count (CBC) and erythrocyte sedimentation rate (ESR) are commonly used to rule out other conditions and determine if the lymphoma has spread [8][9].
• Imaging Tests: PET/CT scans, CT scans, and MRI scans may be used to stage the cancer and check for any potential spread [5][6].
• Biopsy: An excisional or incisional lymph node biopsy is considered the most definitive way to confirm a diagnosis of Hodgkin lymphoma [14]. A core needle biopsy or bone marrow aspiration and biopsy may also be performed.
• Bone Marrow Aspiration and Biopsy: This test checks for any cancer cells in the bone marrow [5][6].

Additional Tests

• Blood Chemistry Studies: These tests measure various substances in the blood to determine if the lymphoma has spread [9].
• Sedimentation Rate: This test measures how quickly red blood cells settle at the bottom of a test tube, which can indicate inflammation or infection [8].
• HIV Test and Hepatitis B and C virus tests may also be performed to rule out other conditions that could mimic Hodgkin lymphoma symptoms.

It's essential to note that the specific diagnostic tests used will depend on individual circumstances and the stage of cancer. A healthcare provider will determine which tests are necessary based on a patient's unique situation.

References: [2] - Search result 2 [3] - Search result 3 [5] - Search result 5 [6] - Search result 6 [8] - Search result 8 [9] - Search result 9 [14] - Search result 14

Treatment Options for Hodgkin Lymphoma

Hodgkin lymphoma, also known as Hodgkin disease, is a type of cancer that affects the immune system. The main treatment options for Hodgkin lymphoma are chemotherapy, radiation therapy, and immunotherapy.

• Chemotherapy: Chemotherapy uses anti-cancer drugs to destroy cancer cells. Common chemotherapy drugs used to treat Hodgkin lymphoma include:
  • Adriamycin (doxorubicin)
  • Bleomycin
  • Etoposide
  • Cyclophosphamide
  • Brentuximab vedotin (Adcetris) [2][3]
• Radiation Therapy: Radiation therapy uses high-energy rays to kill cancer cells. It is often used in combination with chemotherapy.
• Immunotherapy: Immunotherapy uses the body's immune system to fight cancer. Examples of immunotherapies used to treat Hodgkin lymphoma include:
  • Brentuximab vedotin (Adcetris)
  • Nivolumab (Opdivo)
  • Pembrolizumab (Keytruda) [3]

Common Treatment Regimens

The most common treatment regimen for Hodgkin lymphoma is called ABVD, which stands for Adriamycin (doxorubicin), Bleomycin, Vinblastine, and Dacarbazine. This chemotherapy combination is given every 2 weeks for 2 to 8 cycles [4][7].

Targeted Therapies

Monoclonal antibodies are a type of targeted therapy that specifically target cancer cells. Examples of monoclonal antibodies used to treat Hodgkin lymphoma include: + Brentuximab vedotin (Adcetris) + Rituximab [5]

Stem Cell Transplantation

In some cases, chemotherapy may be combined with stem cell transplantation to help the body recover from treatment.

References:

[1] Oct 20, 2020 — Drugs Approved for Hodgkin Lymphoma [2] Oct 30, 2024 — Which chemo drugs are used to treat Hodgkin lymphoma? [3] Oct 30, 2024 — Treatment with an immunotherapy drug such as brentuximab vedotin (Adcetris), nivolumab (Opdivo), or pembrolizumab (Keytruda) might be another ... [4] Chemotherapy drugs used for Hodgkin lymphoma [5] Monoclonal antibodies (MABs) are the most common type of targeted drug used for Hodgkin lymphoma. [6] The main treatments for Hodgkin lymphoma are chemotherapy alone, or chemotherapy followed by radiotherapy. [7] Oct 21, 2024 — The most commonly used regimen, and one endorsed by the National Comprehensive Cancer Network (NCCN), is ABVD (doxorubicin [Adriamycin], bleomycin, vinblastine, and dacarbazine).

Differential Diagnosis of Hodgkin's Lymphoma

Hodgkin's lymphoma, also known as classic Hodgkin lymphoma (CHL), is a type of cancer that affects the immune system. Due to its broad differential diagnosis, medicolegal problems may arise from misdiagnosis or delayed diagnosis [1]. The differential diagnosis of CHL includes several entities that can mimic the clinical presentation of Hodgkin's lymphoma.

Reactive Epstein-Barr Virus (EBV)-Driven Entities

The most problematic differential diagnosis of CHL is EBV-positive diffuse large B-cell lymphoma, which is characterized by frequent EBV infection [2]. This entity can present with similar symptoms to CHL and may require careful histopathological examination to distinguish between the two.

Other Differential Diagnoses

Other entities that can be considered in the differential diagnosis of Hodgkin's lymphoma include:

• Brucellosis
• Cat Scratch Disease (Cat Scratch Fever)
• Histoplasmosis
• Pediatric Lymph Node Disorders
• Pediatric Non-Hodgkin's Lymphoma

Importance of Accurate Diagnosis

Accurate diagnosis of Hodgkin's lymphoma is crucial for effective treatment and management. Misdiagnosis or delayed diagnosis can lead to inappropriate treatment, which may worsen the patient's prognosis [1].

References:

[1] Oct 21, 2024 — Because Hodgkin lymphoma is considered a curable malignancy and the differential diagnosis is broad, medicolegal problems may arise from misdiagnosis or delayed diagnosis.

[2] by T Takahara · 2022 · Cited by 5 — The most problematic differential diagnosis of MCCHL, which is characterized by frequent EBV infection, is EBV-positive diffuse large B-cell lymphoma.

[3] by AR Sohani · 2023 · Cited by 1 — The differential diagnosis of classic Hodgkin lymphoma (CHL) includes the reactive Epstein-Barr virus (EBV)-driven entities of acute infectious mononucleosis and other conditions that can mimic CHL.