Hodgkin's Lymphoma
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Introduction
bimodal age distribution
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.
Causes and Risk Factors
Pathophysiology
Subtypes
- Nodular sclerosing
- mixed cellularity
- lymphocyte predominant
- lymphocyte depleted
Signs and Symptoms
- history
- physical exam
History
Typically presents with painless lymphadenopathy
nodal involvement usually follows orderly anatomic progression
Physical Exam
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Reed-Sternburg cell, a B lymphocyte, is diagnostic
CBC, ESR, LDH
- CXR
- CT chest, abdomen, pelvis
- gallium scan
- bone marrow aspiration/biopsy
- excisional biopsy whenever possible
Diagnostic Imaging
Differential Diagnosis
Treatments
Overall, mor ethan 75% of folks may be cured
Stage IA, IIA: radiation
Stage IB, IIB, III, IV: chemo (ABVD)
- next step: BMT
Consequences and Course
Prognosis predicted by:
- stage
- presence of B symptoms (fever, night sweats, weight loss
- advanced age
- bulk disease
- certain histologies
- anemia
- elevated LDH
- elevated ESR
Resources and References
Topic Development
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