Hodgkin Lymphoma: Difference between revisions

Revision as of 23:50, 18 February 2022

Hodgkin lymphoma, or malignant lymphogranuloma, is a cancer of the lymphatic tissue. The exact etiology is unknown (genetic predisposition, immune disorder, EBV, HIV). It is most often diagnosed between the ages of 20 and 30 and after the age of 50. The disease emerges in the Lymph node (most often in axial lymph nodes), from where it it spread to neighboring lymph nodes as well as to the systemic circulation.

Histologically, they are divided according to the number of Reed-Sternberg cells (cells formed by mutated B-cell) and according to the degree of cellular response.

type I is also known as lymphocyte-rich HL with predominant lymphocytes (few RS cells with many lymphocytes; best prognosis) (5%);
type II is also known as nodular sclerosing Hodgkin lymphoma (NSHL) (nodular foci with reticular cells, lymphocytes and histiocytes surrounded by collagens) (70%);
type III is also known as mixed cellularity type (20-25%);
type IV is also known as lymphocyte-depleted HL with small populations of lymphocytes (abundant proliferated RS cells; worst prognosis) (1%).

Clinical Manifestation

Painless enlargement of the nodes (cervical, axillary, inguinal);
Fever (pediatrics) (typically with Pel-Ebstein fever), itching, sweating, malaise, fatigue, weight loss;
Splenomegaly;
cough, dyspnea, superior vena cava syndrome (involvement of mediastinum);
pleural/pericardial effusion, infiltration of parenchymal organs and/or bone marrow (in advanced stages).

Diagnostics

Nodular extirpation and its subsequent histopathological examination - the presence of RS cells or Hodgkin's cell (RS cell precursors)
Chest X-ray, abdominal ultrasound, scintigraphy of liver, spleen, CT and lymphography, PET;
Trepanobiopsy of bone marrow.

Stages

thumb|right|Mikroskopický obraz Hodgkinova lymfomu

Stage I (involvement of single lymph node region or one extra-lymphatic organ);
Stage II (involvement of 2 or more lymph node regions on a same side of diaphragm);
Stage III (involvement of lymph node on both sides of the diaphragm, including extra-lymphatic organ or spleen);
Stage IV (disseminated involvement of extra-lymphatic organs independent of nodal involvement).

Each stages are further divided into A and B:

A- the patient is without systemic symptoms;
B - the patient is with systemic symptoms (weight loss of 10% in 6 months, fever more than 38 ° C, night sweats).

Complications

Infections, spinal cord compression when the vertebrae are affected.

Therapy

The basic treatment method is systemic treatment by a combined chemotherapy, in localized stages radiotherapy is used to supplement. Basic regimens used are: ABVD (adriamycin, bleomycin, vinblastine, decarbazine), BEACOPP (bleomycin, stoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone).

Localized (early) stages I, II: 2 × ABVD and radiotherapy 20 Gy with favorable prognosis (without risk factors). 2×BEACOPP + 2×ABVD and radiotherapy 20 Gy with unfavorable prognosis (with risk factors)
Advanced stages III, IV: 6×BEACOPP escalated mode
In recurrent cases - rescue regimen (based on platinum derivatives), autologous transplantation.
New drugs - brentuximab vedotin (anti-CD30 antibody) is used to treat recurrent HL. ^[1]

Prognosis

Patients have a good prognosis, about 70-80% of patients recover. The tumor is quite curable.

Links

Související články

Reference

↑

Bibliography

Template:Navbox - onemocnění krve

Kategorie:Hematologie Kategorie:Patologie Kategorie:Onkologie Kategorie:Vnitřní lékařství

[1] ↑

[1]

@@ Line 32: / Line 32: @@
 Histologically, they are divided according to the number of '''Reed-Sternberg cells''' (cells formed by mutated [[B-cell]]) and according to the degree of cellular response.
-* '''type I''' is with predominant [[Lymphocyte|lymphocytes]] (few RS cells with many [[Lymphocyte|lymphocytes]]; best prognosis) (5%);
+* '''type I''' is also known as lymphocyte-rich HL with predominant [[Lymphocyte|lymphocytes]] (few RS cells with many [[Lymphocyte|lymphocytes]]; best prognosis) (5%);
-* '''type II''' is also known as nodular sclerosing Hodgkin lymphoma (NSHL) (nodular foci, cells (reticulocyte
+* '''type II''' is also known as nodular sclerosing Hodgkin lymphoma (NSHL) (nodular foci with reticular cells, lymphocytes and histiocytes surrounded by collagens) (70%);
+*'''type III''' is also known as mixed cellularity type (20-25%);
+*'''type IV''' is also known as lymphocyte-depleted HL with small populations of lymphocytes (abundant proliferated RS cells; worst prognosis) (1%).
-== Klinický obraz ==
+== Clinical Manifestation ==
-* Nebolestivé zvětšení uzlin (krční, axilární, ingvinální);
+* Painless enlargement of the nodes (cervical, axillary, inguinal);
-* [[horečka]] (typická [[Pelova-Ebsteinova horečka|Pelova-Ebsteinova]]), svědění, pocení, malátnost, únava, pokles hmotnosti;
+*[[Fever (pediatrics)]] (typically with [[Pel-Ebstein Fever|Pel-Ebstein fever]]), itching, sweating, malaise, fatigue, weight loss;
-* [[splenomegalie]];
+*[[Splenomegaly]];
-* kašel, dušnost, [[syndrom horní duté žíly]] (při postižení [[mediastinum|mediastina]]);
+*cough, dyspnea, [[superior vena cava syndrome]] (involvement of [[mediastinum]]);
-* výpotek, infiltrace parenchymatózních orgánů, skeletu (při pokročilém postižení).
+*pleural/pericardial effusion, infiltration of parenchymal organs and/or bone marrow (in advanced stages).
-== Diagnostika ==
+== Diagnostics ==
-* Extirpace uzliny a její následné histopatologické vyšetření – přítomnost R-S buněk, nebo buněk Hodgkinových (prekurzory R-S buněk);
+* Nodular extirpation and its subsequent histopathological examination - the presence of RS cells or Hodgkin's cell (RS cell precursors)
-* [[rtg]] hrudníku, [[sono]] břicha, [[scintigrafie]] jater, sleziny, [[CT]] a [[lymfografie]], [[PET]];
+*[[Chest imaging|Chest X-ray]], abdominal [[ultrasound]], [[scintigraphy]] of liver, spleen, [[Computed tomography|CT]] and [[lymphography]], [[Positron emission tomography|PET]];
-* trepano[[biopsie]] kostní dřeně.
+*Trepanobiopsy of bone marrow.
-== Stádia ==
+== Stages ==
 [[Soubor:Hodgkin lymphoma cytology large.jpg|thumb|right|Mikroskopický obraz Hodgkinova lymfomu]]
-* '''Stádium I''' (postižení jedné lymfatické oblasti, nebo jednoho extralymfatického orgánu);
-* '''stádium II''' (postižení dvou nebo více oblastí na jedné straně bránice);
-* '''stádium III''' (postižení lymfatických uzlin na obou stranách bránice, i s extralymfatickým orgánem, nebo slezinou);
-* '''stádium IV''' (diseminované postižení extralymfatických orgánů nezávisle na postižení uzlin).
-Dále se každé stádium dělí na A a B:
+* '''Stage I''' (involvement of single lymph node region or one extra-lymphatic organ);
-* '''A''' – pacient je bez celkových příznaků;
+* '''Stage II''' (involvement of 2 or more lymph node regions on a same side of diaphragm);
-* '''B''' – s celkovými příznaky (úbytek na váze o 10 % za 6 měsíců, horečka více než 38&nbsp;°C, noční pocení).
+* '''Stage III''' (involvement of lymph node on both sides of the diaphragm, including extra-lymphatic organ or spleen);
+* '''Stage IV''' (disseminated involvement of extra-lymphatic organs independent of nodal involvement).
-== Komplikace ==
+Each stages are further divided into A and B:
-* [[Infekce]], míšní komprese při postižení obratlů.
-== Terapie ==
+* A- the patient is without systemic symptoms;
-Základní léčebnou modalitou je systémová léčba ve formě kombinované [[Protinádorová terapie#Chemoterapie|chemoterapie]], v lokalizovaných stádiích jí doplňujeme radioterapií. Základní používané režimy: '''ABVD''' (adriamycin, bleomycin, vinblastin, dekarbazin), '''BEACOPP''' (bleomycin, etoposid, adriamycin, cyclofosfamid, vinkristin, prokarbazin, prednison).
+* B - the patient is with systemic symptoms (weight loss of 10% in 6 months, fever more than 38 ° C, night sweats).
-* '''Lokalizovaná''' (časná) stádia I,II: s příznivou prognózou (bez rizikových faktorů) 2× ABVD a radioterapie 20 Gy, s nepříznivou prognózou (s rizikovými faktory) 2× BEACOPP + 2× ABVD a radioterapie 20 Gy.
-* '''Pokročilá''' stádia III, IV: 6× BEACOPP eskalovaného režimu.
+== Complications ==
-* V případě relapsu – '''záchranný režim''' (založený na platinových derivátech), autologní [[transplantace]].
+* [[Infection|Infections]], spinal cord compression when the vertebrae are affected.
-* '''Nové léky''' – k léčbě relapsů se používá ''brentuximab vedotin'' (anti-CD30 protilátka). <ref>{{Citace
+== Therapy ==
+The basic treatment method is systemic treatment by a combined [[chemotherapy]], in localized stages radiotherapy is used to supplement. Basic regimens used are: '''ABVD''' (adriamycin, bleomycin, vinblastine, decarbazine), '''BEACOPP''' (bleomycin, stoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone).
+* '''Localized''' (early) stages I, II: 2 × ABVD and radiotherapy 20 Gy with favorable prognosis (without risk factors). 2×BEACOPP + 2×ABVD and radiotherapy 20 Gy with unfavorable prognosis (with risk factors)
+*'''Advanced''' stages III, IV: 6×BEACOPP escalated mode
+*In recurrent cases - '''rescue regimen''' (based on platinum derivatives), autologous [[transplantation]].
+*'''New drugs''' - brentuximab vedotin (anti-CD30 antibody) is used to treat recurrent HL. <ref>{{Citace
 | typ = kniha
 | isbn = 978-80-7387-895-5
@@ Line 77: / Line 81: @@
 | rozsah = 909
 }}</ref>
-== Prognóza ==
+== Prognosis ==
-Pacienti mají dobrou prognózu, asi 70–80 % pacientů se vyléčí. Nádor má dobrou kurabilitu.
+Patients have a good prognosis, about 70-80% of patients recover. The tumor is quite curable.
 <noinclude>
-== Odkazy ==
+== Links ==
 === Související články ===
-* [[Maligní lymfom]]
+* [[Malignant lymphoma]]
-* [[Nehodgkinské maligní lymfomy]]
+* [[non-Hodgkin malignant lymphoma]]
-* [[Difuzní velkobuněčný B-lymfom]]
+* [[Diffuse large B-cell lymphoma]]
-* [[Leukémie]]
+* [[Leukemia]]
-* [[Chemoterapie]]
+* [[Chemotherapy]]
-* [[Radioterapie]]
+* [[Radiotherapy]]
 === Reference ===
 <references />
-=== Použitá literatura ===
+=== Bibliography ===
 * {{Citace
 | typ = kniha