Hodgkin's disease

Alternative names

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

Definition

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

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 adjacent lymph nodes and later may spread outside the lymph nodes to the lungs, liver, or bone marrow.

The cause is not known. The incidence is 2 in 10,000 people. Hodgkin's lymphoma is most common among people 15 to 35 and 50 to 70 years old.

Symptoms

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

Additional symptoms that may be associated with this disease:

• Excessive sweating
  
• Skin blushing or flushing
  
• Neck pain
  
• Hair loss
  
• Flank pain
  
• Clubbing of the fingers or toes
  
• Splenomegaly
  

Signs and tests
The disease may be diagnosed after:

• A lymph node biopsy
  
• A bone marrow biopsy
  
• A biopsy of suspected tissue
  
• Detection of Reed-Sternberg (Hodgkin's lymphoma) cells by biopsy
  

A staging evaluation (tumor staging) to determine extent of disease includes:

• A physical examination
  
• CT scans of the chest, abdomen, and pelvis
  
• A bone marrow biopsy
  
• Blood chemistry tests
  
• A PET scan (a nuclear medicine test that looks for tumor cells throughout the body)
  
• Abdominal surgery to biopsy the liver and take out the spleen to see if it is affected by the lymphoma. However, because the other tests are now so good at detecting the spread of Hodgkin's lymphoma, this surgery is usually unnecessary.