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Hodgkin's lymphoma is a type of cancer in the lymphatic system. The lymphatic system is part of the immune system and functions to fight disease and infections. The lymphatic system also helps maintain the fluid balance in different parts of the body by bringing excess fluid back into the bloodstream.
The lymphatic system includes the following:
- lymph - fluid containing white blood cells, especially those called lymphocytes.
- lymph vessels - thin tubes that carry lymph fluid throughout the body.
- lymphocytes - white blood cells that fight infection and disease.
- lymph nodes - bean-shaped organs, found in the underarm, groin, neck, chest, abdomen, and other parts of the body, that act as filters for the lymph fluid as it circulates through the body.
Hodgkin's lymphoma causes the cells in the lymphatic system to abnormally reproduce, eventually making the body less able to fight infection and causing swelling in the lymph nodes. Hodgkin lymphoma cells can also spread (metastasize) to other organs and tissue. It is a rare disease, occurring in about 8,500 people in the US every year. Hodgkin's lymphoma occurs most often in people between the ages of 15 and 40, and in people over age 55. About 10 percent to 15 percent of cases are found in children and teenagers. The disease, for unknown reasons, affects males more often than females.
The following are the most common symptoms of Hodgkin's lymphoma. However, each person may experience symptoms differently. Symptoms may include:
- painless swelling of the lymph nodes in neck, underarm, groin, and/or chest
- difficulty breathing (dyspnea), coughing, or chest pain due to enlarged nodes in the chest
- night sweats
- tiring easily (fatigue)
- weight loss/decreased appetite
- itching skin (pruritus)
- frequent viral infections (i.e., cold, flu, sinus infection)
In addition to a complete medical history and physical examination, diagnostic procedures for Hodgkin's lymphoma may include:
- blood and urine tests
- x-rays of the chest - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film.
- lymph node biopsy - a sample of tissue is removed from the lymph node and examined under a microscope. A biopsy is needed to confirm the diagnosis of Hodgkin disease and to tell what type it is.
- computed tomography scan of the abdomen, chest, and pelvis (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
- bone marrow aspiration and/or biopsy - a procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells. This test may be used to see if cancer cells have reached the bone marrow.
Staging is the process of determining what parts of the body are affected. One method of staging Hodgkin's lymphoma is the following:
- stage I - usually involves a single lymph node region or organ.
- stage II - involves two or more lymph node regions on the same side of the body (above or below the diaphragm) or the cancer has spread from one lymph node into a nearby organ.
- stage III - involves lymph node regions on both sides of the body and is further classified depending on the organs and areas involved.
- stage IV - involves wide spread of the disease in other areas outside the lymphatic system (metastasis), in addition to the lymphatic system involvement
Stages are also noted by the presence or absence of certain symptoms of the disease:
- asymptomatic (A)
- symptomatic (B) - symptoms include fever, night sweats, or weight loss
For example, stage IIIB is disease that is symptomatic, involves lymph node regions on both sides of the body, and is further classified depending on the organs and areas involved .
Specific treatment for Hodgkin's lymphoma will be determined by your physician based on:
- your age, overall health, and medical history
- extent/stage of the disease
- type of Hodgkin disease
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Treatment may include (alone or in combination):
- bone marrow/stem cell transplant
- supportive care (for pain, fever, infection, and nausea/vomiting)
- continued follow-up care (to determine response to treatment, detect recurrent disease, and manage side effects of treatment)
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