Description and symptoms of Hodgkin’s disease
Hodgkin lymphoma is a malignant disease which has unknown etiology and pathogenesis. The etiology is the cause of disease pathogenesis and understand mechanisms of development of the disease.
Predominantly affects young people and represents about 30% of all lymphomas (second group forms a so-called lymphomas. Non-Hodgkin’s lymphomas, such as multiple myeloma).
Biological and clinical studies have shown that there are two basic variants of the disease:
a) Hodgkin’s lymphoma nodular lymphocyte predominance of
b) classical Hodgkin’s lymphoma, which are divided into several subtypes:
- nodular sclerotic
- mixed cell
- rich in lymphocytes
- poor in lymphocytes
The emergence of the disease probably involves several factors. One is the so-called humaninfection. Virus (EBV Ebstein Barr virus), then it is impaired immune response, and genetic influences.
The whole problem is not yet sufficiently elucidated, but it appears that the EB virus infection induces in genetically predisposed individual with defective immune response disease.
The tumor occurs in all ages, including childhood. Most often in the second – 3rd decade of life.Overall, the incidence ranging from 2.6 to 2.9 cases per 100,000 inhabitants. Men get sick more often than women, at a ratio of 3: 2nd In Europe and in the USA are two peaks of incidence of disease, in the 30th and 60th year of life.
Risk factors for Hodgkin’s disease
Are unknown, was considered a retrovirus infections and EBV.
Prevention of Hodgkin’s disease
It is not currently possible.
Přínaky and symptoms of Hodgkin’s disease
Disease primarily affects the lymph nodes (lymph nodes). The most commonly affected cervical lymph nodes around the aorta in the thoracic and armpits.
Tumor lymph node is enlarged, has wiped structure. Malignant cell clone is probably based on B cells (a type of lymphocytes, a type of white blood cell).
After lymphadenopathy may punish nonlymphatic organs and bone marrow.
Disease often affects a group of lymph nodes most commonly in the neck, then spreads to other nodes lymphogenic way further hematogenous route and finally per kontinuitatem (ie through the lymph vessels, the blood vessels, and ultimately direct transmission).
The most common symptom is painless swelling of the lymph nodes in the neck. Where there is an increase in the thoracic lymph nodes around the lungs, the formation of the cough andshortness of breath on exertion (after movement or other physical activity leads to subjective feeling of respiratory insufficiency). Analogously, when enlargement of lymph nodes in the peritoneal cavity is increased abdominal pressure and the difficulties in the digestive system.
May or may not be present hepatosplenomegaly (enlarged liver and spleen).
General symptoms include temperature (it’s called. Pel- Ebstein temperature type), as well asweight loss, sweating, itching and rarely pain in the affected lymph nodes after drinking alcohol.
In the laboratory examination is high sedimentation rate, increased lactate dehydrogenase, furthermore lymphocytopenia (lack of cells), anemia (red cell deficiency) and eosinophilia(increase the number of eosinophilic granulocytes, a type of white blood cells).
Under a microscope, the tumor is found in the characteristic type of cell. Are cells Reedové- Sternberg (called here they also mirror cells or the appearance of the eyes of owl) having two mirror-built core. Another type of cells that are found in lymphomas are Hodgkin’s cells. These two types of cells are tumor. In Hodgkin’s lymphoma we find a variety of other cells, but these are not the tumor. According to the agency, and the microscopic structure of the aforementioned distinguish variants of Hodgkin lymphoma.
Nodular Hodgkin lymphoma with a predominance of lymphocytes (earlier sign is Hodgkin paragranulom, further designation is lymphocyte predominance Hodgkin’s disease) is characterized by lymphadenopathy have fully or partially wiped structure is replaced by a nodular (shape node) or nodulárně- diffuse infiltrates. Here we find the so-called. Lymphoid cell histiocytosis, which are irregular and lobed nucleus, so they are sometimes called popcorn cells (cell is Eng.) Cell. In this type of lymphoma cells lacking Reed-Sternberg. Hopes of a recovery in this type of tumor is very good.
Classical Hodgkin lymphoma and nodular sclerotic variant is characterized in that it is evident nodularity, i.e. different size nodes cells which are surrounded by a thick layer of connective tissue.In this type of tumor, we see called. Lacunar cells, which are a remnant of the fixation artifact preparation formulation tumor.
Mixed cell variant is separate their cellular polymorphism (found are a number of species of cells), and Reed-Sternberg cells of Hodgkin’s cells, epithelioid cells, eosinophilic and neutrophilic granulocytes, lymphocytes and plasma cells.
Variant rich and poor in lymphocytes differ, as the name implies, the number of white blood cells.
Treatment of Hodgkin’s disease
Strategy depends on the degree of damage, development, the localization of the affected lymph nodes. In the early stages is used radiotherapy (irradiation) of the main groups of nodes in nadbrániční called localization. Jacketed field at podbrániční localization field then inverted letter Y. The total dose of 35-40 Gy.
In complex cases, the combined chemotherapy (gives 4 cycles of chemotherapy) with radiotherapy to prevent back return disease. In the most severe cases, it uses 6-8 cycles of chemotherapy, which is then supplemented with radiotherapy. The most commonly used chemotherapy, which is combined as follows: COPP, ABVD, BEACOPP.
COPP: cyclophosphamide, vincristine, procarbazine, prednisone
ABVD: adriamycin, bleomycin, vinblastine, dacarbazine
BEACOPP: bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone
The prognosis is relatively favorable, but it depends on the stage, histological type and the like. Specific types of lymphoma prognosis of full recovery of about 50-90%.
How can I help myself
Hodgkin’s disorders or cancer, and therefore self-help is not possible.
Complications of Hodgkin’s disease
Relatively good prognosis Hodgkin lymphoma is worsened by the complicating factors which often result from side effects of radiotherapy and chemotherapy.
During radiation therapy and chemotherapy may occur over a time horizon of 15 years of secondary malignant tumors: breast cancer, thyroid cancer and blood malignancies: non-Hodgkin’s lymphoma, acute myeloid leukemia.
Another complication is damage to some organs chemo- and radiotepaií: it is especially heart damage, damage to the gonads that will result in a loss of menstruation and infertility, as well as lung damage, after bleomycin and eventually damage the thyroid gland.
Other names: Hodgkin’s disease, malignant lymphogranuloma
