Hodgkin Lymphoma Labelled diagram of lymphatic system

Hodgkin Lymphoma
Labelled diagram of lymphatic system:
-676275133675Lymph Vessels
Lymph Nodes (inguinal)
Lymph Nodes (axillary)
Lymph Nodes (supratrochlear)
Lymph Nodes (abdominal)
Lymph Nodes (popliteal)
Thymus
Spleen
Tonsils
Lymph Vessels
Lymph Nodes (inguinal)
Lymph Nodes (axillary)
Lymph Nodes (supratrochlear)
Lymph Nodes (abdominal)
Lymph Nodes (popliteal)
Thymus
Spleen
Tonsils

Lymph Vessels
Are thin-walled, valve structures that carry lymph. As part of the lymphatic system, lymph vessels are complementary to the cardiovascular system. Lymph vessels are lined by endothelial cells, and have a thin layer of smooth muscles, and adventitia that bind the lymph vessels to the surrounding tissue. Lymph vessels are devoted to the propulsion of the lymph from the lymph capillaries, which are mainly concerned with absorption of interstitial fluid from the tissues. Lymph capillaries are slightly larger than their counterpart capillaries of the vascular system. Lymph vessels that carry lymph to a lymph node are called afferent lymph vessels, and those that carry it from a lymph node are called efferent lymph vessels, from where the lymph may travel to another lymph node, may be returned to a vein, or may travel to a larger lymph duct. Lymph ducts drain the lymph into one of the subclavian veins and thus return it to general circulation.

Lymph nodes
Lymph nodes are small, bean-shaped glands throughout the body. They are part of the lymph system, which carries fluid (lymph fluid), nutrients, and waste material between the body tissues and the bloodstream. The lymph system is an important part of the immune system, the body’s defence system against disease. The lymph nodes filter lymph fluid as it flows through them, trapping bacteria, viruses, and other foreign substances, which are then destroyed by special white blood cells called lymphocytes. Lymph nodes may be found singly or in groups. And they may be as small as the head of a pin or as large as an olive. Groups of lymph nodes can be felt in the neck, groin, and underarms. Lymph nodes generally are not tender or painful. Most lymph nodes in the body cannot be felt.

Lymphatic thymus
The thymus gland is the main organ of the lymphatic system. Located in the upper chest region, the primary function of this gland is to promote the development of specific cells of the immune system called T lymphocytes. T lymphocytes or T-cells are white blood cells that protect against foreign organisms (bacteria and viruses) that have managed to infect body cells. They also protect the body from itself by controlling cancerous cells. From infancy to adolescence, the thymus is relatively large in size. After puberty, the thymus begins to decrease in size and continues to shrink with age.

Tonsils
The tonsils are a pair of soft tissue masses located at the rear of the throat (pharynx). Each tonsil is composed of tissue similar to lymph nodes, covered by pink mucosa. Running through the mucosa of each tonsil are pits, called crypts. The he tonsils are part of the lymphatic system, which helps to fight infections. However, removal of the tonsils does not seem to increase susceptibility to infection. Tonsils vary widely in size and swell in response to infection.

Lacteals
Lacteal, one of the lymphatic vessels that serve the small intestine and, after a meal, become white from the minute fat globules that their lymph contains. The smallest of the lacteals are the lacteal capillaries, each a minute vessel running down the centre of a villus, or finger like projection, in the mucous membrane lining the small intestine. The lacteal capillaries empty into lacteals in the submucosa, the connective tissue directly beneath the mucous membrane. The largest lacteals empty into the lymph nodes of the mesentery, the fold of membrane that encloses most of the intestines and anchors them to the rear wall of the abdomen.

Spleen
The spleen is an organ in the upper far left part of the abdomen, to the left of the stomach. The spleen varies in size and shape between people, but it’s commonly fist-shaped, purple, and about 4 inches long. Because the spleen is protected by the rib cage, you can’t easily feel it unless it’s abnormally enlarged. The spleen has multiple supporting roles in the body. It acts as a filter for blood as part of the immune system. Old red blood cells are recycled in the spleen, and platelets and white blood cells are stored there. The spleen also helps fight certain kinds of bacteria that cause pneumonia and meningitis.

Formation of lymph
1390015150685500Blood supplies nutrients and important metabolites to the cells of a tissue and collects back the waste products they produce, which requires exchange of respective constituents between the blood and tissue cells. This exchange is not direct, but instead occurs through an intermediary called interstitial fluid, which occupies the spaces between cells. As the blood and the surrounding cells continually add and remove substances from the interstitial fluid, its composition continually changes. Water and solutes can pass between the interstitial fluid and blood via diffusion across gaps in capillary walls called intercellular clefts; thus, the blood and interstitial fluid are in dynamic equilibrium with each other.

Functioning of the lymphatic system in a diseased state
Diseases and disorders of the lymphatic system are typically treated by immunologists. Vascular surgeons, dermatologists, oncologists and physiatrists also get involved in treatment of various lymphatic ailments. There are also lymphedema therapists who specialize in the manual drainage of the lymphatic system. The most common diseases of the lymphatic system are enlargement of the lymph nodes (also known as lymphadenopathy), swelling due to lymph node blockage (also known as lymphedema) and cancers involving the lymphatic system. When bacteria are recognized in the lymph fluid, the lymph nodes make more infection-fighting white blood cells, which can cause swelling. The swollen nodes can sometimes be felt in the neck, underarms and groin. Lymphadenopathy is usually caused by infection, inflammation, or cancer. Infections that cause lymphadenopathy include bacterial infections such as strep throat, locally infected skin wounds, or viral infections such as mononucleosis or HIV infection.

Hodgkin Lymphoma
What is it?
Hodgkin’s disease is a type of lymphoma, which is a blood cancer that starts in the lymphatic system. The lymphatic system helps the immune system get rid of waste and fight infections. HD is also called Hodgkin disease, Hodgkin lymphoma, and Hodgkin’s lymphoma. Hodgkin’s disease originates in white blood cells that help protect you from germs and infections. These white blood cells are called lymphocytes. In people with Hodgkin’s disease, these cells grow abnormally and spread beyond the lymphatic system. As the disease progresses, it makes it more difficult for your body to fight infections.

What are the Causes?
Hodgkin lymphoma is caused by a change (mutation) in the DNA of a type of white blood cell called B lymphocytes, although the exact reason why this happens isn’t known. The DNA gives the cells a basic set of instructions, such as when to grow and reproduce. The mutation in the DNA changes these instructions so the cells keep growing, causing them to multiply uncontrollably. The abnormal lymphocytes usually begin to multiply in one or more lymph nodes in a particular area of the body, such as your neck or groin.

What are the symptoms?
Lumps under the skin
The most common symptom of Hodgkin lymphoma is a lump in the neck, under the arm, or in the groin, which is an enlarged lymph node. It doesn’t usually hurt, but the area may become painful after drinking alcohol. The lump might grow larger over time, or new lumps might appear near it.

Cough, trouble breathing, chest pain
If Hodgkin lymphoma affects lymph nodes inside the chest, the swelling of these nodes might press on the windpipe (trachea) and make you cough or even have trouble breathing, especially when lying down. Some people might have pain behind the breast bone.

Other symptoms will depend on where in the body the enlarged lymph glands are. For example, if the abdomen (tummy) is affected, you may have abdominal pain or indigestion
A few people with lymphoma have abnormal cells in their bone marrow when they’re diagnosed. This may lead to:
persistent tiredness or fatigue
an increased risk of infections
excessive bleeding – such as nosebleeds, heavy periods and spots of blood under the skin
How is it diagnosed?
Biopsy
A biopsy involves removing some or all of an affected lymph node, which is then studied in a laboratory. Biopsies are small operations that can often be carried out under a local anaesthetic (where the area is numbed). In some cases, the affected lymph node isn’t easily accessible and a general anaesthetic may be required. A pathologist will then check the tissue sample for the presence of cancerous cells. If they find cancerous cells, they can also identify exactly which type of Hodgkin lymphoma you have, which is an important factor in planning the treatment.

Blood tests  – samples of blood will be taken throughout your diagnosis and treatment to check your general health, the levels of red and white cells and platelets in your blood, and how well organs such as your liver and kidneys are working
Bone marrow sample – another biopsy may be carried out to see if the cancer has spread to your bone marrow; this involves using a long needle to remove a sample of bone marrow from your pelvis and can be done using a local anaesthetic
Chest X-ray – this can check whether the cancer has spread to your chest or lungs
Computerised tomography (CT) scan  – this scan takes a series of X-rays that build up a 3D picture of the inside of the body to check the spread of the cancer
Magnetic resonance imaging (MRI) scan  – this scan uses strong magnetic fields to build up a detailed picture of areas of your body, to check the spread of the cancer
How does it affect the lymphatic structure?
Lymphomas, like all cancers, are a disease of the body’s cells. Normally cells in our body divide and grow in a controlled way. But, sometimes cells keep dividing and grow out of control. This is how cancer develops. In lymphomas white blood cells called lymphocytes become abnormal and grow out of control. These lymphocytes can build up in one part of the body and form a lump (tumour).
There are two main types of lymphoma:
Hodgkin lymphoma
Non-Hodgkin lymphoma
Hodgkin lymphoma sometimes affects lymph nodes in just one area of the body, but lymphocytes travel round the body so the lymphoma can spread from where it started. It can spread through the lymphatic system, from lymph nodes in one part of the body to lymph nodes elsewhere. It also can be spread through the bloodstream to other parts of the body such as the spleen or bone marrow. When the lymphoma cells reach a new area they may start growing and form a new lump (tumour).

Non-Hodgkin lymphoma:
Non-Hodgkin lymphoma is an uncommon cancer that develops in the lymphatic system, which is a network of vessels and glands spread throughout your body. The lymphatic system is part of your immune system. Clear fluid called lymph flows through the lymphatic vessels and contains infection-fighting white blood cells known as lymphocytes. In non-Hodgkin lymphoma, the affected lymphocytes start to multiply in an abnormal way and begin to collect in certain parts of the lymphatic system, such as the lymph nodes (glands). The affected lymphocytes lose their infection-fighting properties, making you more vulnerable to infection. The most common symptom of non-Hodgkin lymphoma is a painless swelling in a lymph node, usually in the neck, armpit or groin.