Hodgkin's Lymphoma

Hodgkin's lymphoma (HL) is a unique type of lymphoma and one of the most common malignant tumors among young people. The disease initially occurs in a group of lymph nodes, which are common in the cervical lymph nodes and supraclavicular lymph nodes, and then spread to other lymph nodes. In the later stages, it can invade blood vessels, involving the spleen, liver, bone marrow, and digestive tract. Classical Hodgkin's lymphoma can be divided into four histological types: lymphocyte predominant type, nodular sclerosis type, mixed cell type and lymphocyte depletion type. In recent years, a nodular lymphocyte-based type has been added to the WHO classification

Cause

The etiology of Hodgkin's lymphoma is still unknown, and EB virus genome fragments can be detected in about 50% of patients' RS cells. It is known that patients with immunodeficiency and autoimmune diseases are at increased risk of developing Hodgkin’s lymphoma.

Clinical manifestations

1. Enlarged lymph nodes

Ninety percent of the patients presented with lymphadenopathy, most of which presented with cervical lymphadenopathy and mediastinal lymphadenopathy. Swollen lymph nodes are often painless and progressive. Pain after drinking alcohol is a relatively specific manifestation of lymphoma diagnosis.

2. Extranodal disease

Late involvement of the organs outside the lymph nodes can cause anatomy and dysfunction of the corresponding organs and cause a variety of clinical manifestations.

3. Systemic symptoms

20%-30% of patients present with fever, night sweats, and weight loss. The fever may be low fever, sometimes intermittent high fever. In addition, there may be itching, fatigue and so on.

4. Clinical manifestations of different histological types

Nodular lymphocytes predominantly (NLPHL), more common in men, the ratio of male to female is 3:1. The lesions usually involve peripheral lymph nodes, and most of them are early localized lesions at first diagnosis. About 80% of them belong to stage I and II. The natural course is slow and the prognosis is good. The treatment complete remission rate can reach 90%, and the 10-year survival rate is about 90%. However, the prognosis of patients with advanced stages (stage III and IV) is poor. In typical Hodgkin’s lymphoma, the lymphocyte-rich type accounts for about 6%, the average age is older, and it is more common in men. The clinical features are between nodular lymphocyte-based and classic Hodgkin’s lymphoma. It often presents as early localized lesions and has a better prognosis, but the survival rate is lower than that of NLPHL. Nodular sclerosis is the most common type in developed countries. Common, more common in young adults and adolescents, slightly more women. It often manifests as mediastinum and other parts of the diaphragm and lymph node disease, with a good prognosis; mixed cell types account for 15% to 30% in European and American countries, and they can be affected by different ages. Clinical manifestations: Abdominal lymph node and splenic lesions are common. About half of the patients are in advanced stages (stages III and IV) at the time of treatment, and the prognosis is poor. Lymphocyte depletion is rare, about 1%, more common in the elderly and people infected with human immunodeficiency virus (HIV), often involving abdominal lymph nodes, spleen, liver and bone marrow, often accompanied by systemic symptoms, rapid disease progression, poor prognosis.