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Hodgkin’s disease – causes, symptoms, diagnosis, treatment

Hodgkin’s disease is a malignancy that is morphological characterized by the presence of Sternberg-Reed cell. The origin of this cell is not fully elucidated, in a small number of cases has been demonstrated lymphoid line belonging to B.

This disease has two peaks of incidence: one around the age of 23 to 25 years, and the second is the age of 40-45 years.

Causes of Hodgkin’s disease
In the pathogenesis of Hodgkin’s disease an important role has the Epstein-Barr virus. Molecular genetics have made its mark in this area, showing BCL-2 gene expression (cell death inhibitory activity) and Bax (inducer of cell death) in this condition.

Hodgkin’s Disease Symptoms
Hodgkin’s disease can affect any organ, but affects the lymph nodes and spleen with predilection. Thus, clinically, shows two main signs:

  • adenopathy (increased lymph nodes) – the most common the disorder begins with adenopathy on the left cervical side, then extending it to other lymph node groups (cervical right, above the clavicle, mediastinal, axillary, inguinal), lymph are painless, elastic consistency, an important feature of the adenopathy is the pain after ingestion of alcohol.
  • enlarged spleen and enlarged liver – are rare.

In addition to these signs, if mediastinal lymph nodes are significant increased, can occur the following symptoms: cough, chest pain, shortness of breath.

The clinical picture is complemented by a range of symptoms:

  • fever (irregular);
  • profuse night sweats (abundant);
  • weight loss (over 10% of body weight),
  • pruritus (itching), generalized.

Analysis in Hodgkin’s disease
The disease can be diagnosed with certainty state after lymph node biopsy with histopathology and immunohistochemistry examination.

It can perform the following investigations:

  • Abdominal ultrasound – to highlight hilum lymph nodes of spleen, liver, mesenteric, iliac;
  • Computed tomography – performed for staging, may reveal lymph node groups that were not highlighted as a result of ultrasound;
  • scintigraphy is performed to diagnose the liver, spleen and bone damage;
  • radiological examinations (chest, bone) – for staging;
  • laboratory tests – serum LDH is elevated;
  • alkaline phosphatase is increased (in case of liver damage);
  • serum calcium is increased (in case of damage to bone);
  • ESR, ceruloplasmin and serum protein electrophoresis – modified;
  • Bone marrow biopsy – required for staging.

Complications
In Hodgkin’s disease evolution some complications may occur which may be due to the disease itself and treatment.

Among the complications that arise due to both disease and treatment, the most frequent are infections (occurring due to immune deficiency) and bone marrow failure. May occur a number of compressions given by tumor masses and a second neoplasia (following treatment).

Hodgkin’s disease treatment
Therapeutic means to treat this condition are:

  • radiotherapy;
  • chemotherapy;
  • combined (radiotherapy + chemotherapy).



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