Lymphogranulomatosis (Hodgkin lymphoma): what it is and how it manifests

Hearing the words "lymphogranulomatosis" or "Hodgkin lymphoma" is frightening, and the first thing that helps is understanding exactly what is being discussed. This is a malignant disease of the lymphatic system that, when detected early, is treatable. Below — what this disease is, how it manifests in adults and children, and by what steps it is identified.

What lymphogranulomatosis and Hodgkin lymphoma are

Lymphogranulomatosis, Hodgkin lymphoma, Hodgkin disease, malignant granuloma — these are names of one disease. It is a malignant disease of lymphoid tissue, the obligatory sign of which is giant Reed — Berezovsky — Sternberg cells and their mononuclear precursors, Hodgkin cells; the physician sees them on microscopy of the affected lymph node.

The lymphatic system is part of immunity: lymph nodes, lymphatic vessels, spleen, thymus, tonsils, bone marrow. Hodgkin lymphoma is one of the two main groups of lymphomas, the second being non-Hodgkin lymphomas. The frequency is approximately 1 case per 25,000 people per year: about 1% of malignant tumors and about 30% of malignant lymphomas. The cause is unknown; the Epstein — Barr virus (its gene is found in 20–60% of biopsies) and heredity are discussed. Men are affected more often — approximately 1.4:1.

Is Hodgkin lymphoma cancer or not

Yes, it is a malignant disease, a cancer of the lymphatic system. Understanding the essence helps to ask the physician precise questions. When detected at an early stage, the disease is usually curable.

Symptoms in adults

The disease often begins with enlargement of lymph nodes against a background of complete health. The nodes are dense, painless, mobile. In 70–75% of cases these are cervical or supraclavicular nodes, in 15–20% — axillary and mediastinal nodes, in 10% — inguinal and intra-abdominal. The nodes may spontaneously decrease and grow again, so the diagnosis is sometimes not made immediately. Mediastinal involvement (45% in stages I–II) is often found incidentally on chest radiography; sometimes it causes cough or difficulty breathing.

• painless enlarged lymph nodes in the neck, under the arm, or in the groin;
• fever without a known cause;
• profuse night sweats;
• weight loss without an explainable cause over the past 6 months;
• skin itching, especially after a shower or alcohol, and fatigue.

In a small proportion of patients, usually older than 50 years with the mixed-cell variant or the variant with lymphoid depletion, general symptoms at early stages worsen the prognosis. There may be pain in the affected nodes after alcohol.

An enlarged lymph node by itself is not a reason to call an ambulance. Call 103 or 112 if severe difficulty breathing appears due to pressure from nodes in the chest.

Features in children

The mixed-cell variant is more often found in children and the elderly, it is more common in men and corresponds to stages II–III. In children with this disease the same signs occur: painless enlarged lymph nodes, fever, night sweats, weight loss.

Variants of Hodgkin lymphoma

Under the microscope, four histological variants are distinguished. Lymphocytic-histocytic — about 15%, more often in men younger than 35 years, early stages, good prognosis. Nodular sclerosis — the most common, 40–50%, usually in young women, often in mediastinal nodes, good prognosis. Mixed-cell — about 30%, more often in children and the elderly, more often in men, corresponds to stages II–III. With lymphoid depletion — less than 5% of cases, corresponds to stage IV, more often in the elderly.

How it is diagnosed: blood test and other methods

First the physician asks about complaints and illnesses, examines and palpates lymph nodes and other areas. Then — laboratory tests: complete blood count, biochemistry, lactate dehydrogenase (LDH), ESR, as well as tests to exclude other diseases. Of imaging, CT and PET are used. The key method is lymph node biopsy: only in the tissue are Reed — Berezovsky — Sternberg cells found, without which the diagnosis is not made.

The disease can also affect other organs: the spleen — in 35% of cases, the bone marrow — in 25–45% in stage IV.

The material is for reference: it helps to understand the disease and prepare questions for the physician, but does not replace consultation — the decision on examination is made only by the physician.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer