Hodgkin's Lymphoma
Definition
Lymphoma: Malignant proliferation of lymphocytes
Hodgkin's Lymphoma: Lymphoma with presence of Reed-Sternberg cells (mirror image nuclei)
Epidemiology
Risk Factors
Clinical Features
Symptoms
Signs
Investigations
Bloods: FBC, blood film, ESR (inc = poor prognosis), LDH (inc due cell turnover), CMP (inc Ca2+), LFT
Others: Lymph node biopsy (Reed-Sternberg cells)
Lymphoma: Malignant proliferation of lymphocytes
Hodgkin's Lymphoma: Lymphoma with presence of Reed-Sternberg cells (mirror image nuclei)
Epidemiology
- M>F, 2:1
- Peak incidence: young adults, elderly
Risk Factors
- EBV
- SLE
- Post transplantation
- Infected sibling
- Obesity
- Westernisation
Clinical Features
Symptoms
- Enlarged, painless, rubbery, non-tender lymph nodes (60-70% cervical)
- Constitutional sx
Signs
- Lympho/ hepato/ splenomegaly
Investigations
Bloods: FBC, blood film, ESR (inc = poor prognosis), LDH (inc due cell turnover), CMP (inc Ca2+), LFT
Others: Lymph node biopsy (Reed-Sternberg cells)
Staging
Ann Arbor Staging
I: single node region
II: multiple nodal regions on same side of diaphragm
III: multiple nodal regions on both sides of diaphragm
IV: spread outside lymph nodes (eg bone marrow, liver)
A: asymptomatic except pruritus
B: symptomatic (constitutional)
Management
Chemoradiotherapy
Prognosis
5yr survival: 95% if stage I-A, 40% if stage IV-B
Source
OHCM 9th Ed 2014
Ann Arbor Staging
I: single node region
II: multiple nodal regions on same side of diaphragm
III: multiple nodal regions on both sides of diaphragm
IV: spread outside lymph nodes (eg bone marrow, liver)
A: asymptomatic except pruritus
B: symptomatic (constitutional)
Management
Chemoradiotherapy
Prognosis
5yr survival: 95% if stage I-A, 40% if stage IV-B
Source
OHCM 9th Ed 2014