Hodgkin's Disease

Hodgkin's lymphoma usually begins in a lymph node. This node enlarges, but may or may not cause the pain that typically results when lymph nodes enlarge as a consequence of an infection by a microorganism. Hodgkin's lymphoma progresses in a fairly predictable way, traveling from one group of lymph nodes on to the next. More advanced cases of Hodgkin's include involvement of the spleen, the liver, and bone marrow.

Constitutional symptoms (symptoms which affect the whole body) are common, and include fever, weight loss, heavy sweating at night, and itching. Some patients note pain after drinking alcoholic beverages.

As the lymph nodes swell, they may push on other nearby structures. This pressure produces other symptoms. These symptoms include pain from pressure on nerve roots, as well as loss of function of specific muscle groups served by the compressed nerves. Kidney failure may result from compression of the ureters, the tubes that carry urine from the kidneys to the bladder. The face, neck, or legs may swell due to pressure slowing the flow in veins that should drain blood from those regions (superior vena cava syndrome). Pressure on the spinal cord can result in paralysis of the legs. Compression of the trachea and/or bronchi (airways) can cause wheezing and shortness of breath. Masses in the liver can cause the accumulation of certain chemicals in the blood, resulting in jaundice (a yellowish discoloration of the skin and the whites of the eyes).

As Hodgkin's lymphoma progresses, a patient's immune system becomes less and less effective at fighting infection. Thus, patients with Hodgkin's lymphoma become increasingly more susceptible to both common infections caused by bacteria and unusual (opportunistic) infections caused by viruses, fungi, and protozoa.

The exact cause of Hodgkin's disease is not known. Viruses, particularly the Epstein-Barr virus (a herpes virus that causes infectious mononucleosis), are found in tissues of 20-50% of people with Hodgkin's disease. However, a link between the virus and Hodgkins disease has not been established.

Another suggested cause is socio-economic conditions. Studies have demonstrated that Hodgkin's disease is more prevalent in wealthier people in the developed A scanning electron micrograph (SEM) image of dividing Hodgkin's cells from the pleural effusions (abnormal accumulations of fluid in the lungs) of a 55-year-old male patient. Photograph by Dr. Andrejs Liepins. National Audubon Society Collection/Photo Researchers, Inc. Reproduced by permission. world. It has been speculated that the hygienic conditions that most of these people grow up in does not stress their immune systems in a way that is healthy for them. Other suggested causes include exposure to chemicals, and a genetic disposition (including the activity of cancerous genes known as oncogenes).