Hodgkin Disease is a malignant lymphoma whose pathological hallmark is the Reed-Sternberg (RS) cell. The disease may affect persons of any age but occurs most often in adults in their early 30s. Its incidence is higher in males than in females. It is slightly more common in Caucasians than in other racial groups. The disease has a bimodal age distribution: it is common in people between the ages of 15 and 35 and in another group of patients older than 50. About 7500 new cases of the disease are diagnosed annually in the U.S. This lymphoma typically begins in a single lymph node in the neck, axilla, groin, or near the aorta and spreads to adjacent nodes if it is not recognized and treated early. It may metastasize gradually to lymphatic tissue on both sides of the diaphragm or disseminate widely to tissues outside the lymph nodes. The degree of metastasis defines the stage of the disease early disease stage I or II is present in one or a few lymph nodes, whereas widespread disease has spread to both sides of the diaphragm, stage III or throughout the body stage IV. The lower the stage of the disease the better the prognosis. Patients with stage I Hodgkin lymphoma have a 90% survival rate 5 years after diagnosis. ETIOLOGY
Epstein-Barr virus has been found in the cells of nearly half of all patients with Hodgkin disease. DIAGNOSIS
The presence of the giant, multinucleated RS cell in tissue obtained for biopsy is diagnostic.
Early stage patients may have no symptoms other than a painless lump or enlarged gland in the armpit or neck. Others may develop fevers, night sweats, loss of appetite, and weight loss. TREATMENT
The goal of therapy is cure, not only palliation of symptoms. Treatment depends on accurate staging. Combinations of radiation therapy with chemotherapy have been traditionally used radiation alone for stages I and II, radiation and chemotherapy for stage III, and chemotherapy for stage IV , although chemotherapies that rely on...