Hodgkin's lymphomas are called tumor-forming entities that affect the lymphatic system, which is a lymph node, united by a network of lymphatic vessels.
Hodgkin's disease or lymphogranulomatosis is found in men much more often than in the fairer sex. And pathology usually prefers patients 14-40-year-old age group.
Concept of the disease
Lymphogranulomatosis refers to lymph systemic pathologies of a malignant nature. Affected lymphocytic cells are constantly in the process of division, the formed abnormal cellular structures spread to the organs of the somatic system and lymph nodes, leading to a disruption in their functionality.
What is Hodgkin's lymphoma, its symptoms and principles of treatment are told in the following video:
Pathology sequentially affects one lymph node after another, which most often belong to the regional group.
Case history of Hodgkin's lymphoma
Lymphogranulomatosis was first described by Thomas Hodgkin when he was studying patients who had weakness and impotence, swollen lymph nodes and spleen lesions.
Usually all these clinical cases had a fatal end. The pathology was first called Hodgkin's disease, and then Hodgkin's lymphoma.
Types of
There are several varieties of Hodgkin's lymph:
- Classical Hodgkin's lymphoma;
- Hodgkin's lymphoma with nodular sclerosis;
- Hodgkin's lymphoma with lymphopenia;
- Mixed cell Hodgkin's lymphoma;
- Classical Hodgkin's lymphoma with a predominance of lymphocytes;
- Nodular Hodgkin's lymphoma with a predominance of lymphocytes.
Nodular sclerosis
Nodular sclerosis is one of the histological forms of Hodgkin's lymphoma, which is characterized by a dense proliferation of connective tissue structures. A characteristic beginning of a similar pathology is the swelling of the lymph nodes. Such lymphoma can form in various organs, characterized by the presence of lymphoid tissues.
Causes of
While specialists could not definitively determine the specific causes of lymphogranulomatosis. Some scientists tend to viral etiology of the disease.
They believe that the root cause of Hodgkin's lymphoma is the Epstein-Barr virus, which provokes the development of cellular changes and mutations at the gene level.
In addition, experts identified several pathological factors:
- Living in adverse environmental conditions;
- Radiation exposure;
- Presence in the family history of ancestors with pathologies of the lymphatic system( inconsistent factor);
- Work with carcinogenic or chemical substances such as pesticides, benzenes, herbicides, solvents of organic origin, etc.
The appearance of lymphomas often reflects medicinal anti-cancer drugs used in chemotherapeutic treatment or hormone-based drugs. In addition, the disease can be affected by autoimmune diseases like lupus, rheumatoid arthritis, etc.
Contrary to popular belief, the genetic factor is not particularly important in the formation of lymphomas. Although in the event that the lesion is found in one of the identical twins, it will also be in another twin.
Symptoms and signs
As previously clarified, lymphoma occurs first in one lymph node, after which it spreads to another, etc.
The most basic sign of Hodgkin's lymphoma is the swelling of the lymph nodes. Theoretically, any localization of nodes can be the first to increase, although in practice it turns out that most often pathological processes begin with cervical, thoracic and axillary lymph nodes.
The picture clearly shows an increase in peripheral lymph nodes with Hodgkin's lymphoma
Usually, swollen lymph nodes do not cause painful sensations, but alcohol can provoke the appearance of such a symptomatology.
In the process of increasing the size of the lymph nodes begin to squeeze the surrounding tissue, which is often accompanied by a variety of symptoms:
- Unproductive cough, sometimes with impurities of blood in the sputum;
- Heart pain;
- Shortness of breath;
- Painful discomfort in the lumbar region.
Granulomatosis is characterized by a feeling of heaviness and soreness from the enlarged spleen( left hypochondrium) or with increasing liver size( right hypochondrium).Often disturbed by causeless hyperthermia, constant fatigue, weight loss, general exhaustion and other typical manifestations of cancer.
Often, Hodgkin's lymphoma is accompanied by itchy sensations on the surface of the skin, which can be felt on the entire surface of the body or localized in a particular area. If cancer processes metastasize into bone tissue, the patient often complains of ossalgia.
Lymphogranulomatosis in children
Among children, Hodgkin's lymphoma is found in one child of 100,000, which indicates a low prevalence of this pathological condition among children. In addition, lymphogranulomatosis never affects children for up to a year.
For children's lymphogranulomatosis, the presence of malignant changes in the tissues of the lymphatic system is associated with the prevalence of lymphogranulomas in all organs and tissues.
All of the above processes are symptomatic:
- Puffiness of the face, supplemented with cyanosis;
- Intense dyspnea;
- An exhausting cough that does not bring relief;
- Tachycardia Symptoms.
Gradually, the pathology covers the spleen( sometimes the liver), which causes:
- Increased drowsiness and fatigue;
- Hyperthermia;
- Hyperbolism at night;
- Apathetic condition;
- Lack of appetite.
If the pathology is localized in the intrathoracic lymph nodes, the child is troubled by a cough - at first he just coughs, but with the progression of the pathological process the cough acquires a paroxysmal and exhausting character. At each similar attack at the kid there are complaints on pains in a breast.
For diagnosis of pediatric lymphogranulomatosis it is necessary to undergo a biopsy and laboratory tests, radiography, computer tomography. If necessary, it may be necessary to perform trepanobiopsy, scanning bone, liver or kidney tissues.
In pregnancy,
Even in the event of termination of pregnancy, this factor has an aggravating effect on the course of the pathology. In general, there are two scenarios for the development of a similar pathological condition:
- When lymphogranulomatosis began to develop with an existing pregnancy;
- When a woman becomes pregnant, having an anamnesis pathology, such as Hodgkin's lymphoma.
In both cases, the menstrual function of the patient is significantly impaired. When treated by irradiating the inguinal lymph nodes, the loss of ovarian functions occurs with the development of subsequent amenorrhea. To return girls and women ovulation, they are carried out ovarian transposition( when the ovaries are outside the area of exposure to the rays).
Later, when performing radiotherapy, 10-centimeter lead blocks are used to protect the ovaries. This approach preserves the ability to ovulate more than half the patients( in 60% of cases).
Stages and prognosis
In accordance with the size of the formation, the degree of its prevalence in the tissues, specialists distinguish 4 stages of the pathological process of Hodgkin's lymphoma:
- Stage 1 is characterized by a limited location of the lesion in the area of only one lymph node or in the lymph nodes of a certain area;
- Stage 2 is typical for the prevalence of lesions in the region of two or more lymph nodes, located on one half of the body relative to the position of the diaphragm;
- In the 3 stages of lymphogranulomatosis, lymph node groups are already affected on both sides with respect to the diaphragm;
- The 4th stage of Hodgkin's lymphoma is characterized by the spread of the pathological process along all the elements of the lymphatic system, along internal organs with the development of diffuse lesions.
Diagnosis
Diagnostic processes for Hodgkin's lymphoma are based on the following procedures:
- Lymph node biopsy;
- Laboratory blood test;
- Bone biopsy;
- Radiography and CT;
- Laparoscopic and tarakoscopic examination.
Treatment Scheme
Medical capabilities allow achieving positive results in the treatment of Hodgkin's lymphoma in the majority of clinical cases. Using a variety of methods of treatment, depending on the stage of the pathological process and the general well-being of the patient, specialists achieve a positive outcome of therapy.
In general, methods such as:
- Radiation therapy - is considered the main direction in the treatment of lymphogranulomatosis, special radiation programs are used, which ensures the greatest possible effectiveness, especially at the initial stages of the disease;
- The chemotherapeutic effect on Hodgkin's lymphoma is based on the use of cytostatic anticancer agents, which inhibit the reproduction of malignant cellular structures. This technique leads to the cessation of the further spread of pathology to the internal organs and the elimination of the symptoms of the disease;
- Bone marrow transplantation or stem cell transplantation is the only technique that can finally relieve a patient of lymphogranulomatosis. First, a massive polychemotherapeutic course is conducted, suppressing all pathological germs of reproduction. Then a stem cell or bone marrow transplant is performed. After a few days, the transplanted biomaterial is established and the hematopoietic system begins to function in a well-functioning regime.
After treatment, the patient is shown to follow a diet based on the principles of proper nutrition.
How many live and survival prognosis
Pathology is considered curable, although the final predictions depend on the stage of the tumor process, the size of the formation and the intensity of the response to treatment.
Video on the causes and symptoms of lymphogranulomatosis: