Lymphadenoma.—Hodgkin's Disease (Pseudo-leukæmia of German authors).—This is a rare disease, the origin of which is as yet unknown, but analogy would suggest that it is due to infection with a slowly growing micro-organism. It is chiefly met with in young subjects, and is characterised by a painless enlargement of a particular group of glands, most commonly those in the cervical region ([Fig. 80]).
Fig. 80.—Chronic Hodgkin's Disease in a boy æt. 11.
The glands are usually larger than in tuberculosis, and they remain longer discrete and movable; they are firm in consistence, and on section present a granular appearance due to overgrowth of the connective-tissue framework. In time the glandular masses may form enormous projecting tumours, the swelling being added to by lymphatic œdema of the overlying cellular tissue and skin.
The enlargement spreads along the chain of glands to those above the clavicle, to those in the axilla, and to those of the opposite side ([Fig. 81]). Later, the glands in the groin become enlarged, and it is probable that the infection has spread from the neck along the mediastinal, bronchial, retro-peritoneal, and mesenteric glands, and has branched off to the iliac and inguinal groups.
Two clinical types are recognised, one in which the disease progresses slowly and remains confined to the cervical glands for two or more years; the other, in which the disease is more rapidly disseminated and causes death in from twelve to eighteen months.
Fig. 81.—Lymphadenoma (Hodgkin's Disease) affecting left side of neck and left axilla, in a woman æt. 44. Three years' duration.