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Morbus Hodgkin

Hodgkin- and Sternberg-Reed giant cells in Hodgkin-Lymphoma (Source: Wikimedia Commons)

Hodgkin's lymphoma is a malignant tumor of the lymph system. The disease manifests itself mainly by an initially painless swelling of lymph nodes mostly in the neck region, under the armpit or in the groin. However, there is often an inconspicuous infestation in the mediastinum or the abdomen.

In addition to the infestation of the lymph nodes, further symptoms of the disease develop, including nonspecific disease symptoms such as fever, night sweats and weight loss (B-symptomatics). In advanced disease stages, other organs can also be affected by spreading of the tumor cells.

Histologically, mononuclear Hodgkin cells and Sternberg-Reed giant cells are prominent (see illustration on the right), which are derived from the B lymphocytes (white blood cells) and which represent the actual malignant cells of the lymphoma.

In addition to adults in the third and seventh decades of life, children and adolescents are increasingly affected by this malignant disease. More information about Hodgkin's lymphoma can be found here, for example.

Current project status

Patient with large mediastinal tumor mass.

At present, I am working on the question concerning the prognosis of the disease in children and adolescents based on the initial medical findings using nuclear medical images (PET-CT/MRI) of typical tumor formations.

Given on the left side is an example with initial findings of a large mediastinal tumor mass in a young patient with Hodgkin-Lymphoma. The tumor presents itself as mostly a dense bulky mass compressing major vessels, and bronchial tubes as well as displacing the heart and the lungs.

A major goal of my research is the analysis of the heterogeneity of the tumor using different methods e.g. first and second order heterogeneity markers from textural feature extraction as Gray Level Cooccurence Matrices (GLCM).

Another approach is the analysis of the tumor topography by analysing its inner structure with the distribution of PET-hot-spots probably resembling inflammation reactions in active tumor-nests.

 

 

The following pictures show a more complex representation of the tumor topography as a result from the textural analysis of the inner tumor structure using different algorithms which find and classify tumor hotspots in the volume of interest.

The left picture demonstrates the total tumor contour in 3D with blue spheres in the inside showing the position and approximate size of PET-hotspots. The picture on the right shows a more analytical view on neighbourly relations between the tumor hotspots. The size of the spheres approximate the size of the hotspot in the tumor, the color of the sphere gives an impression of the SUV-value of the hotspot - the lighter the color the higher the SUVmax in that hotspot.

It shows that hotspot-size and SUVmax-values do not necessarily bear any relation to each other.