About Hodgkin’s Lymphoma

Q: What is Hodgkin’s disease?
A: Hodgkin’s disease, sometimes called Hodgkin’s lymphoma, is a cancer that starts in lymphatic tissue. Lymphatic tissue includes the lymph nodes and related organs that are part of the body’s immune and blood-forming systems. The lymph nodes are small, bean-shaped organs found underneath the skin in the neck, underarm, and groin. They are also found in many other places in the body such as inside the chest, abdomen, and pelvis.

Q: What are Lymph nodes?
A: Lymph nodes make and store infection-fighting white blood cells, called lymphocytes. They are connected throughout the body by lymph vessels (narrow tubes similar to blood vessels). These lymph vessels carry a colorless, watery fluid (lymphatic fluid) that contains lymphocytes. Eventually the lymphatic fluid is emptied into the blood vessels in the left upper chest. The lymph nodes are a part of the lymphatic system. Other components of the lymphatic system include the spleen, the bone marrow, and the thymus.

Q: What is the spleen?
A: The spleen is an organ in the left side of the upper abdomen that is composed primarily of mature and immature lymphocytes. It removes old cells and other debris from the blood.

Q: What is the bone marrow?
A: The bone marrow is the spongy tissue inside the bones that creates new red and white blood cells including lymphocytes.

Q: What is the thymus?
A: The thymus is a small organ in the chest that is important in developing a special lymphocyte called a T cell.

Q: Where does Hodgkin’s disease start and where does it spread?
A: Hodgkin’s disease can start almost anywhere, but most often starts in lymph nodes in the upper part of the body. The most common sites are in the chest, neck, or under the arms. Hodgkin’s disease enlarges the lymphatic tissue, which can then cause pressure on important structures. It can spread through the lymphatic vessels to other lymph nodes. This is the major way it spreads. Most Hodgkin’s disease spreads to nearby lymph node sites in the body, not distant ones. It rarely gets into the blood vessels and can spread to almost any other site in the body, including the liver and lungs.

Q: What are the signs and symptoms of Hodgkin’s disease?
A: You can have Hodgkin’s disease and feel perfectly well. You may have noticed that a lymph node in the neck, under the arm, or in the groin is enlarged. Sometimes this will go away only to come back. Eventually, it doesn’t go away, and although it doesn’t hurt, it will become more noticeable and lead you to go to the doctor. There may even be several areas of enlarged lymph nodes.

When Hodgkin’s disease affects lymph nodes inside your chest, the swelling of these nodes may compress the trachea (windpipe) and make you cough or even have trouble breathing. Some patients with Hodgkin’s disease have fever, drenching night sweats, or weight loss. The fever can come and go over several days or weeks. Itching, tiredness, and decreased appetite are other symptoms that may occur. Sometimes, your only symptom is being tired all the time. Various conditions, such as other cancers, tuberculosis (TB), or infectious mononucleosis (mono), can produce similar symptoms. If you have any of these symptoms, discuss them with your doctor without delay.

Q: How is it diagnosed?
A: The only way to be sure that you have Hodgkin’s disease is by biopsy (examination of a tissue sample under the microscope). There are several types of biopsy procedures, and doctors choose one based on the unique aspects of your situation. Their goal is to get enough tissue to be sure of the diagnosis. Also, if you have Hodgkin’s disease, the doctor needs to know exactly which type (lymphocyte predominance, nodular sclerosis, mixed cellularity, or lymphocyte depletion) you have. Some types are treated differently.

Q: What are the causes of Hodgkin’s disease?
A: The exact cause of Hodgkin’s disease is not known. However, scientists have found that the disease is associated with a few conditions, such as infectious mononucleosis and lowered immunity.

Q: What are Reed-Sternberg cells?
A: The cancer cells in Hodgkin’s disease are called Reed-Sternberg cells, after the two doctors who first described them in detail. Under a microscope they look different from cells of non-Hodgkin’s lymphomas and other cancers. Most scientists now believe that Reed-Sternberg cells are a type of malignant B lymphocyte. Normal B lymphocytes are the cells that make antibodies that help fight infections.

Source: American Cancer Society