1. Introduction and Historical Background: Pediatric Hodgkin Lymphoma
- Author
-
Sarah S. Donaldson
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Cancer ,medicine.disease ,Dermatology ,Palpation ,Lymphoma ,Nodular sclerosis ,immune system diseases ,hemic and lymphatic diseases ,Epidemiology ,medicine ,Etiology ,Histopathology ,Radical surgery ,business - Abstract
Prior to 1960, Hodgkin lymphoma was considered a uniformly fatal cancer. Hodgkin described the disease in 1832, but most attributed its pathophysiology to an infl ammatory condition. Sternberg and Reed are credited for the fi rst defi nitive description of the histopathology (Reed 1902; Sternberg 1898). Fox later refi ned the defi nition, and noted the occurrence of this entity in young patients (Fox 1926). However, little was known about its etiology and/or epidemiology. Th ere was neither a uniform histopathologic classifi cation, nor consistently used workup or staging system. Th e clinical assessment, largely by observation and palpation, was gradually supplemented by laboratory studies that characterized specifi c abnormalities. Imaging studies lacked precision, and staging was not precise. Th erapy was largely symptomatic. Early aft er Roentgen’s discovery of the X-ray in 1896, Pusey fi rst used X-rays to treat a young man with a presumed lymphoma; he noted dramatic shrinkage of enlarged neck adenopathy aft er 21 exposures to the X-rays (Pusey 1902). He soon used the X-ray treatment on a 4-year-old boy with bilateral cervical swelling from Hodgkin lymphoma and reported the swollen glands were “reduced to the size of an almond” within 2 months. During the time period from 1920 to 1940, there was some interest in the use of radical surgery followed by postoperative radiotherapy for the treatment of localized lymphoma. Th e good results from the X-ray treatment, and the cosmetic disfi gurement from the extensive surgery, led most surgeons to consider that radical surgery was not indicated in the treatment of this disease. As a byproduct of the World War II development of mustard gases, investigators observed nitrogen musIntroduction and Historical Background: Pediatric Hodgkin Lymphoma
- Published
- 2007
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