Definition and causes
Hodgkin's disease (HS), also known as Hodgkin's lymphoma, together with Non-Hodgkin lymfomerne sygdomskategorienlymfekræftormalignant lymphoma. The disease is deleted from a particular type of white blood cells, which share the sudden uncontrollable in a lymph node and then spreading.All blood cells develop from stamcellen in the bone marrow. Stamcellen divides into 2 lines, respectivelymyeloidandlymphoidstem cell. The myeloid stem cell develops again in 3 different lines, resulting in the formation of red blood cells, some of the white blood cells and platelets (see the blood in general ). Apart from the lymphoid stem cell developed B-lymfocytten and T-lymfocytten (white blood cells), both of which play an important role in the immune system. B-lymfocytten migrate from the bone marrow to the lymph nodes (see Lymfesystemet below), which further developed to improve the efficiency of the immune system. In Hodgkin's disease, there is an error in the development, causing a malignant (malignant) overproduction of B-lymphocytes. The body's immune system reacts with a response in the lymph nodes. These grow and will also have a distinctive appearance in microscope with the so-called Reed-Sternberg kæmpeceller, which is a sure sign of Hodgkin's disease. Depending on how the tissue in lymfeknuden seems, can HS divided into 2 divisions, which constitute the majority of HS: - Nodulær sclerosis (NS) 60%.
- Mixed cellularity (MC) 30%.
HS starts in one lymph node, but as the disease develops, it spreads to other lymph nodes. In the most difficult cases HS also spread to other organs, such as the spleen and liver. The reason for the development of HS is probably due to many different things. In particular, suspect Monday Epstein-Barr virus infection to play a role in the development of HS. There is no evidence that heredity has no meaning. There are around. 125 new cases of HS in Denmark each year, and the disease tends to have 2 peaks during their lives. Most frequently hit young people of 20-30 years and the second most affected 45 to 50-year-olds. Lymfesystemet
This is a system which consists of lymfekar and lymph node. Lymfekarrene drain the body of the excess fluid that out in the tissue and lead it back to the bloodstream. During the bloodstream run lymfekarrene through the lymph nodes, continues in major lymfekar, and finally running out of the big halsvener. In this way, næringstoffer, proteins, etc. recycled in the body, while not accumulate fluid in the tissue. Lymfocytter (white blood cells) and the antibodies are also transported r Lymfeknuder found in greatest numbers in the neck, armhulen, stomach and lysken. They form a kind of filter and development of the immune system, as infectious substances from the tissue runs through them. B lymphocytes develop in the lymph nodes, while the formation of antibodies against a bug. infection in the body. So you can feel sore and swollen lymph nodes by an infection. In the event that cancer cells spread by lymfekarrene, these will be detained in a lymph node, which will be enlarged (but s Symptoms of Hodgkin's disease
In the early stages of the disease HS will only be associated lymph nodes, why symptoms most often are:- Raised and uømme lymph especially in the neck (60%) of armhulen (20%) and in lysken (15%). Ømme lymph nodes indicates more on an infection.
- At the very swollen lymph nodes which can block the air, can be seen breathing problems.
- At the beginning of the disease may be 40% of cases seen the so-called B-symptoms: weight loss, night sweats, fever and hudkløe.
- In severe cases can be felt a bump on the left side of the abdomen just below the ribs by an enlarged spleen and the right side by an enlarged liver.
Precautions and diagnosis
Developer Monday the above symptoms should contact a doctor. A blood test can not be used to diagnose HS why we take a vævsbiopsi of lymfeknuden. Is the swollen lymph node just under the skin, it is a simple little action, but is the swollen lymph node deeper, for example. around the lungs, it may be necessary to take a ultralydsvejledt biopsy through the trachea. Vævsprøven will be studied through a microscope by a specialist, and by HS seen the characteristic Reed-Sternberg kæmpeceller.To look at the deep lymph nodes can you create a CT or MRI scan to assess whether it is swollen lymph nodes, for example. lungs and stomach. When you make the diagnosis, doing the same time a stadieinddeling, which tells something about the widespread and serious case of HS is. In this division takes into account how many regions (neck, armpit, groin, abdomen) containing swollen lymph nodes. Moreover, the involvement of bodies such as. liver and spleen a significant role in the assessment. The severity of HS rises, the more swollen lymph nodes to locate, and the more bodies are affected. Treatment of Hodgkin's disease
In mild cases of HS provides local radiotherapy against the swollen lymph nodes and sometimes also chemotherapy (cellegifte). In severe cases are always given chemotherapy in combination with radiation therapy and chemotherapy is given for periods up to ½ to 1 year. By repeatedly relapse can be after an intensive period of chemotherapy to try a bone marrow .
Select and complications
The forecast depends strongly on the severity of HS, the person's age and size and number of involved lymph nodes. In most cases you are healed, and langtidsudsigten is good in the mild case of the HS.
In severe cases there may come a relapse after recovery, and this is done after 2 or 3 times with chemotherapy, can knoglemarvs transplantation be one opportunity for healing.After radiotherapy, there may be damage to the mucous membranes, in order to experience reduced spytproduktion, dry mouth and increased state of holes in the teeth. Similarly, thyroid damage, and thus can develop myksødem . |
