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The hidden origins of Hodgkin's lymphoma: How does this cancer develop so quietly?
Hodgkin lymphoma (HL) is a cancer caused by a specific type of white blood cell, the lymphocyte, and multinucleated Reed-Sternberg cells (RS cells) appear in the patient's lymph nodes. .
The condition was first described by British physician Thomas Hodgkin in 1832, hence the name. Symptoms of Hodgkin lymphoma may include fever, night sweats, and weight loss, often with painless swollen lymph nodes in the neck, armpits, or groin. People may also feel tired or have itchy skin. Based on the type, Hodgkin lymphoma can be mainly divided into two categories: classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma.
In about half of all cases of Hodgkin lymphoma, there is an association with the Epstein-Barr virus (EBV), usually of the classic type. Other risk factors include a family history of the disease and infection with HIV/AIDS. In addition, confirming the presence of cancer and identifying Reed-Sternberg cells through lymph node biopsy are important steps in confirming the diagnosis.
Treatments for Hodgkin lymphoma include chemotherapy, radiation therapy, and stem cell transplantation. The treatment chosen often depends on how advanced the cancer is and whether it has favorable characteristics.
In the United States, the five-year survival rate for Hodgkin lymphoma is as high as 88%, and for patients under 20 years old, the survival rate is even higher, reaching 97%. It is important to note that although survival rates for most cancers are high, radiation therapy and certain chemotherapy drugs increase the risk of developing other cancers, heart disease, or lung disease in the coming decades. According to data from 2015, approximately 574,000 people worldwide are affected by Hodgkin lymphoma, of which 23,900 (approximately 4.2%) die from it.
Signs and symptoms
People with Hodgkin lymphoma may experience the following signs:
- Swallowed lymph nodes: Painless enlarged lymph nodes are the most common symptom and usually feel like swelling under the skin.
- Systemic symptoms: About one-third of patients may experience systemic symptoms, such as itchy skin, night sweats, weight loss of more than 10% within six months, low-grade fever, and fatigue.
- Enlarged spleen: Enlargement of the spleen is common in people with Hodgkin lymphoma.
- Pain after alcohol: Some patients experience pain after drinking alcohol, although this is relatively uncommon.
These symptoms help identify Hodgkin lymphoma early and call for further testing to confirm the condition.
Diagnosis and Staging
The diagnosis of Hodgkin lymphoma needs to be distinguished from other causes of lymph node enlargement (such as from various infections) and from other types of cancer. The diagnosis is usually confirmed by lymph node biopsy, and blood tests are done to assess major organ function and the safety of treatment. Positron emission tomography (PET) is used to detect small lesions that are not visible on CT scans. Staging tests can determine how far the cancer has spread.
Types and Pathology
Hodgkin lymphoma is mainly divided into classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. Classical Hodgkin lymphoma can be further divided into four pathologic subtypes. These subtypes differ in morphology, phenotype, and clinical behavior.
In addition, infection with EBV differs among the different subtypes, and ongoing research explores their role in cell biology.
Management and Prognosis
Current treatment modalities are designed to reduce acute and chronic toxicities during and after treatment for Hodgkin lymphoma. Patients in the early stages have a good prognosis with radiation therapy or chemotherapy. For patients with advanced disease, more intensive treatment is often combined with chemotherapy and radiation therapy.
With the evolution of treatment strategies in recent decades, the survival rate of Hodgkin lymphoma has improved significantly, and recent clinical trials have shown a five-year survival rate of up to 98%.
Conclusion
While more is known about Hodgkin lymphoma, the exact origins of this cancer remain a source of curiosity. With the advancement of science, will we be able to unravel the deeper mysteries behind it?
