Hodgkin's disease - case presentation

Abstract

Hodgkin’s lymphoma is a type of cancer of the lymph tissue found in the lymph nodes, spleen, liver, and bone marrow. The diagnosis can be set strictly morphological and it is based on the presence of Stemberg-Reed cells in the structure of an enlarged lymph node. The disease occurrence shows two peaks: the first in young adulthood (age 15-35) and the second in those over 55 years old. The cause is not known but risk factors include male gender, history of Epstein-Barr virus infection and a genetic predisposition. At onset the disease affects one lymph node and it slowly disseminates either through the lymph, or through the blood, affecting all the lymphatic system and other organs. Female patient, aged 22, without significant pathological history, is admitted in 2005 to the Hematological Clinic from Iasi for special diagnosis and therapy after the appearance of a left developing latero-cervical adenopathy. The clinical and paraclinical exams (lymph node biopsy, stem al puncture, thoracic and abdominal CT) have set the Hodgkin’s lymphoma diagnosis with mixed cellularity, stage IV В and the cytostatic treatment was begun. Despite all treatment, the disease progressed rapidly - generalized adenopathies , osteolytic lesions in the lower Vi of the sternum and finally hepatorenal failure with exitus. Although the global cure rate of Hodgkin’s lymphoma is about 85%, in this case diagnosing the disease in an advanced stage (because of the absence of symptoms) has determined the unfavorable evolution of the disease, with lack of response to treatment administered according to international standards and exitus in 4 years.