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Lymphogranulomatosis; Hodgkin's lymphoma
Our lymphatic system can be affected by malignant tumors - the best known of which is Hodgkin lymphoma. According to the English pathologist Thomas Hodgkin M.D. (1798-1866). He was a very innovative and socially committed doctor who was one of the first to bring the stethoscope to England, described acute appendicitis 50 years before it was discovered, and discovered “Hodgkin's Disease” in 1832, as it is called in English to this day.
Hodgkin's disease is included in the international classification of diseases under the code C81. listed as Hodgkin lymphoma (lymphogranulomatosis), with various sub-forms such as nodular sclerosing (classic) Hodgkin lymphoma (C81.1), mixed cell (classic) Hodgkin lymphoma (C81.2) and lymphocyte-poor (classic) Hodgkin -Lymphoma (C81.3) and lymphocyte-rich (classic) Hodgkin lymphoma (C81.4) can be distinguished. Characteristic of all forms of Hodgkin lymphoma is the presence of the Hodgkin cells and the so-called Sternberg-Reed giant cells. Hodgkin's disease is one of the malignant lymphomas (lymph gland cancer).
Symptoms of Hodgkin's lymphoma
According to the German Cancer Research Center (DKFZ), Hodgkin's disease begins in the majority of cases in the lymph nodes on the neck and neck. Sufferers or doctors usually notice swelling of the lymph nodes on the neck, under the armpit and in the groin region as the first symptoms, but other areas can also be affected. DKFZ reports that about a third of those affected have lymph node swellings behind the breastbone where the so-called mediastinal lymph nodes are affected. In such cases, breathing difficulties and a persistent cough are often symptoms. In all forms of the disease, the lymphoma cells can theoretically leave the lymphatic system via the bloodstream and affect the liver and other organs as well as the bone marrow.
Typical for tumors is the additional appearance of general symptoms such as night sweats, weight loss and fever. In addition, cancer is fundamentally characterized by uncontrolled cell growth, which in the case of lymphogranulomatosis is caused by altered B lymphocytes. From these, the Hodgkin cells develop, which fuse to form the multinucleate Sternberg-Reed giant cells, which can also be seen in the histological examination of affected lymph nodes under the microscope, reports the DKFZ. In addition, a deficiency of special white blood cells (lymphopenia) occurs in the course of the disease, which can be decisive when making a diagnosis.
Causes of Hodgkin's Lymphoma
As is so often the case with tumors, so far only risk factors can be assumed as part of the cause research. To what extent lifestyle-related risk factors or environmental risks for the emergence
responsible for Hodgkin's lymphoma, has so far remained unclear, according to the Robert Koch Institute (RKI). Long-term cigarette consumption is suspected as a risk factor, but the connection has not yet been conclusively clarified. According to the RKI, innate or acquired peculiarities of the immune system as well as viral infections are discussed as possible triggers. For example, recent studies have shown that Epstein-Barr viruses (EBV), the pathogens of Pfeiffer's glandular fever (infectious mononucleosis), were involved in the development of Hodgkin's lymphoma. According to the RKI, other viruses may also be involved in the development of Hodgkin's lymphoma.
Last but not least, hereditary factors are considered as possible causes of the disease, since Hodgkin's disease often occurs frequently within a family.
The disease is divided into different sub-forms and stages, which are particularly important for the adequate form and level of therapy (chemotherapy and radiation treatment). Basically, the treatment should be based on the stage of the disease. According to the DKFZ, patients with early Hodgkin's lymphoma (I and II) are usually treated with chemotherapy consisting of several medications lasting about two months and followed by radiation. The treatment can often be done on an outpatient basis and a hospital stay is usually not necessary. Which combination of the individual medications and which number of treatment cycles is selected also depends on the general health of those affected and the presence of certain risk factors. Such risk factors include, for example, very extensive lymph node involvement or the involvement of tissue outside the lymph nodes, spleen, thymus and lymphatic tissue of the mucous membranes (e.g., liver involvement).
If stage IA lymphocyte-dominant Hodgkin's lymphoma is present, DKFZ reports that radiation therapy alone can also be considered if there are no other risk factors. In the case of Hodgkin's disease in the later stage of the disease (III and IV), according to the DKFZ, intensive chemotherapy is provided for all those affected, and only if radiation is detectable after such treatment is even larger tumor residues available.
The chemotherapy and radiation treatment are very stressful for the body and can be associated with considerable side effects, which is why those affected should in any case inquire with the treating physician about possible risks, according to the DKFZ. Overall, medicine has made significant progress in the treatment of Hodgkin's disease in the past few decades, so that the prognoses are now significantly better. In the context of naturopathy, only a strengthening of the immune system can be recommended as a preventive measure. (tf, fp)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch
- German Cancer Society: Hodgkin's disease (accessed: 07.08.2019), krebsgesellschaft.de
- German Society for Hematology and Medical Oncology: Hodgkin Lymphoma (accessed: August 7, 2019), onkopedia.com
- German Society for Hematology and Medical Oncology (DGHO): S3 guideline for diagnosis, therapy and aftercare of Hodgkin lymphoma in adult patients, status: June 2018, detailed guideline view
- Association of the Scientific Medical Societies e. V., the German Cancer Society e. V. and the German Cancer Aid Foundation: Hodgkin Lymphoma patient guidelines, as of December 2013, krebshilfe.de
- Information portal www.kinderkrebsinfo.de: Hodgkin's lymphoma (Hodgkin's disease) (accessed: 07.08.2019), kinderkrebsinfo.de
- Mayo Clinic: Hodgkin's lymphoma (Hodgkin's disease) (access: 07.08.2019), mayoclinic.org
- National Cancer Institute: Adult Hodgkin Lymphoma Treatment (accessed: August 7, 2019), cancer.gov
- American Cancer Society: Hodgkin Lymphoma (accessed: August 7, 2019), cancer.org
- National Organization for Rare Disorders (NORD): Hodgkin’s Disease (accessed: 07.08.2019), rarediseases.org
ICD codes for this disease: C81ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.