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Hodge, Hugh Lennox

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(hoj) U.S. gynecologist, 1796–1873.

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H.'s pessary A pessary used to correct retrodeviations of the uterus.

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H.'s plane A plane running parallel to the pelvic inlet and passing through the second sacral vertebra and the upper border of the os pubis.

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Hodgkin, Thomas

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(hoj′kĭn) Brit. physician, 1798–1866.

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H.'s disease ABBR: HD. A malignant lymphoma whose pathological hallmark is the Reed-Sternberg (RS) cell. SYN: Hodgkin lymphoma. SEE: non-Hodgkin lymphoma; Reed-Stern-berg cell; Nursing Diagnoses Appendix.

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 INCIDENCE: In 2013, the National Cancer Institute estimated that nearly 9,300 people would be diagnosed with Hodgkin lymphoma and that approx. 1,200 would die of the disease. The disease may affect people of any age, but it occurs most often in adults in their early 30s. Its incidence is higher in males than in females. It is slightly more common in Caucasians than in other racial groups. The disease has a bimodal age distribution: it is common in people between the ages of 15 and 35 and in another group of patients older than 50.

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 CAUSES: Epstein-Barr virus has been found in the cells of nearly half of all patients with Hodgkin disease.

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 SYMPTOMS AND SIGNS: Early-stage patients may have no symptoms other than a painless lump or enlarged gland in the armpit or neck. Others may develop fevers, night sweats, loss of appetite, and weight loss.

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 DIAGNOSIS: The presence of the giant, multinucleated RS cell in tissue obtained for biopsy is diagnostic.

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 IMPACT ON HEALTH: This lymphoma typically begins in a single lymph node (esp. in the neck, axillae, groin, or near the aorta) and spreads to adjacent nodes if it is not recognized and treated early. It may metastasize gradually to lymphatic tissue on both sides of the diaphragm or disseminate widely to tissues outside the lymph nodes. The degree of metastasis defines the stage of the disease; early disease (stage I or II) is present in one or a few lymph nodes; widespread disease has disseminated to both sides of the diaphragm (stage III) or throughout the body (stage IV). The lower the stage of the disease, the better the prognosis. Patients with stage I Hodgkin lymphoma have a 90% survival rate 5 years after diagnosis. Although many childhood Hodgkin's survivors are concerned that treatment may adversely affect fertility, most treated patients under 40 who have not had pelvic radiation do not have problems with infertility.

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 TREATMENT: The goal of therapy is cure, not merely palliation of symptoms. Treatment depends on accurate staging. Combinations of radiation therapy with chemotherapy have been traditionally used (radiation alone for stages I and II, radiation and chemotherapy for stage III, and chemotherapy for stage IV); chemotherapies ...

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