16. Hodgkin Disease: origin, pathogenesis, clinical manifestation, diagnosis, staging, treatment.

Question 1

whom dose hodgkin lymphoma occur to ?

Answer 1

int he young

Question 2

what s the etiology of hodgkin lymphoma ?

Answer 2

EBV

increasd in pateientwith HIV

Question 3

what is the clinical presentationof hodkin lymphoma ?

Answer 3

solitary or generalised lymphadenopathy - limited to a region of lymph nodes
SUPRACLVICULAR , CERVICAL
NOT PAINFUL AND RUBBERY CONSISTENCE

slight splenomegaly

B symptoms
fever = pel ebstein fever - low grade fever with spikes
night sweats
weight loss

pain at te sight of lymphoma with ingestion of alcohol

Question 4

what are the histopathological classification of hodgkin lymphoma ?

Answer 4

there is nodular lymphocytic predominant
= it is CD15 AND CD30 negative
but CD20 positive
few reedsternberg cells
but there are moderate amount of popcorn cells

there is then the classical hodkin lympma

Question 5

what are the classial hodgkin lymphoma and describe them ?

Answer 5

lymphocyte preodminant
lymphocytic rich 
with popcorn cells 
low amount of reedsternberg cells 
stage 1 presnetation good prognosis

nodular sclerosis
lacunar reed sternberg
collagenous banr
usually affected cervical and mediastinal

mixed cellularity = diffuse lympma present not good prognosis

lymphocyte depeltion
lymphocytes , histiocytes , eosinophila , red stern bern

retropertonal nodes

worst prognosisi

Question 6

what is the diagnosis of hodgkin lymphoma ?

Answer 6

immunohistochemistry of cd15 and cd30
FISH analaysisi of cd30 positive reed stern berg cells

use CORE NEEDLE BIOPSY OR EXCISION
for histopathology
reed stern berg cells seen
bilobed nucleus with prominent eosinophilic nucleoli

CBC 
anemia 
MONOCYTOSISI 
LEUKOCYTOSISI / GRANULOCYTOSIS 
EOSINOPHILIA

if lymphocytopena = bad prognosisi

Question 7

what is the staging of hodgkin disease ?

Answer 7

stage 1 - signle lymph node or lymph region

stgae 2 = 2 or more lymph nodes or regions affecetd

stage 3 = both sides of the diagphrgm is involved

stage 4 = extranodal sites suc as the organs

Question 8

what is the treatmnet for hodgkin disease ?

Answer 8

stage 1to 2a = radiotherapy

2b to four
BEACOPP (bleomycin , etoposid adriamycin )

or ABVD (adriamycin and bleomycin , vinblastin)

follwed by radiation

Question 9

what are the side effects of chemotherapy

Answer 9

azospermia
pulmonary finrossi
secondary lymphoma or leukemia