Hodgkin's disease - a large and rather heterogeneous group of diseases related to malignant lymphomas. The incidence in adults is significantly higher than in children and a total of about 0.3 cases per 100 000 population.
The disease usually begins with a lesion of the cervical and supraclavicular lymph nodes on the background of overall health. In this case, as a rule, the lymph nodes are enlarged, painless. Inflammatory changes at the same diseases affect the nasopharynx, as a rule, and submandibular lymph nodes verhnesheynye that must be considered in the differential diagnosis of these diseases. Adult patients are also characterized by the involvement of mediastinal lymph nodes, and these changes are usually clearly visible on chest radiograph. The process may involve mediastinal organs. Lymph nodes below the diaphragm are involved much less frequently.
Diagnosis of Hodgkin's disease is based on the detection of Hodgkin's cells and cells of the Berezovsky-Sternberg. There are 4 types of Hodgkin's disease:
Predominance of lymphoid
Smeshannokletochnaya form
Nodular sclerosis - subtypes grade1 (difficult to treat) and grade2
Lymphoid depletion of
In addition to the histological classification of the clinical use of process steps:
Stage 1 - the defeat of one group of lymph nodes or a single non-lymphoid organ
Stage 2 - the defeat of two or more lymph zones above or below the diaphragm. If the background of a unilateral lesion reveal the involvement of an organ or group of nodes on the other side of the diaphragm, then put a stage IIE.
Stage 3 - involvement of lymph regions on both sides of the diaphragm. With the involvement of nonlymphoid organs exhibited stage IIIE, with the involvement of the spleen - IIIS, with the involvement of the spleen and nonlymphoid organs - IIIES.
Stage 4 - widespread damage non-lymphoid organ (s) or tissue, usually in combination with a defeat of the lymphoid areas.
In the staging also take into account some of the following clinical signs typical of Hodgkin's disease:
Loss of body weight
Unexplained fever
Itching
Lymphadenopathy (increase of cervical and supraclavicular lymph nodes)
Changes in blood counts (a sharp increase in erythrocyte sedimentation rate, leukocytosis, reduced iron, and albumin, increased fibrinogen and alpha2-globulin)
The diagnosis of Hodgkin's disease is on the basis of the survey. Thus in addition to the features listed above, determined by careful examination and analysis of the blood picture, it is necessary to use modern means of medical imaging, pathology (ultrasound of the abdomen, computed X-ray or magnetic resonance imaging of the chest). In identifying changes in the lymph nodes is necessary morphological verification.
