Hodgkin's Disease Flashcards
What is Hodgkin’s disease?
A malignancy of unknown etiology usually arising in the lymph nodes
is hodgkin’s disease curable
very curable
What cell is associated with HD
Reed- Sternberg cell
When was HD discovered?
1832 Thomas Hodgkin
-discovered in dead people
Who is the disease most prevalent in?
common in young people
Incidence rates:
biomodal age distribution
first peak 15-34
second @ 50
Incidence rate:
2002
7000 new cases, 3700 male, 3300 female
1400 deaths, 800 male, 600 female
incidence rate:
2007
8190 new, 4470 male, 3720 female
1070 deaths, 770 male, 300 female
incidence rate:
2017
8260 new, 4650 male, 3610
1070 deaths, 630 male, 440 female
9x increase in ____ sex sibs
same
5x increase in ____ sex sibs
opposite
3x increase with _____ degree relation
first
subcategories of Hodgkin’s Disease
Classic Hodgkin Lymphoma (CHL) LRHL MCHL NSHL LDHL Nodular Lymphocyte predominant Hodgkin Lymphoma NLPHL
LRHL
- early stages
- 5% of all hodgkins cases
- stage 1/ stage 2
- Infrequent systemic sym (10%)
- more common in males
- upper body
MCHL
- mix of all types
- -lymphocytes, epithelial histocytes, neutrofills, plasma (inflammatory)
- more common in older folks (38)
- Associated with HIV
- in males
- abdomen and spleen
NSHL
- 75% of all hodgkin’s cases
- 20’s and 30’s, 50-55
- equal distribution b/w males and females
- neck or chest
- *** MOST COMMON
NLPHL
- 5% of Hodgkin’s cases
- asymptomatic young men
- cervical, axillary & inguinal LN
- 30-55 years
- early stages
- longer survival times
- variant of reed-stern cell. Referred to as popcorn cell because of look
CHL
- 95% diagnosed
- main characteristic is the reed- stern cell
- B symptomatic: fever, night sweats, weight loss
LDHL
- rarest of the 4
- common in men
- 30’s- those with HIV
- worst prognosis
- -advanced disease (b symptoms)
- abdomen adenopathy
- spleen, liver, bone marrow
What staging system does Hodgkin’s use?
Ann Arbor and costwold
* higher stage=bad prognosis
Signs and symptoms
- cervical, supraclavicular, mediastinal LN, splenomegaly
- B symptoms (40%)
- elevated sedimentation rate and elevated alkaline phosphatase
paritis
severe itching
malaise
just don’t feel good
erythmatis rash
reddening of skin
most common above diaphragm
80%
how much below diaphragm?
about 10%
elevated sedementation rate
how fast blood count falls to bottom of test tube
How do they diagnose Hodgkin’s disease
history and physical X-rays (CT and PET) labs biopsy of lung LN (enlarged) Stages (1B, 2B, 3, 4)
Clinical features of Hodgkins Disease
painless lymphadenopathy fever night sweats weight loss pruitus alcohol-induced pain
Non- Hodgkin’s Lymphoma
generalized painless lymphadenopathy
vague abdominal discomfort
back pain
gastrointestinal complaints
Treatment
radiation
chemo
combo
-depending on how old
during treatment, what is the therapists job?
provide education and support for pt
treatment symptoms
hypothyroidism reduction in bone marrow percarditis pnuemonitis myelopathy transient aspermia secondary cancers
___% of early stage disease curable
90
___% of advanced stage curable
80
what is the mantle
lymph above diaphragm
What is the invertedY
below the diaphragm
how often is MOPP used
not much anymore
BEACOPP
- bleomycin
- adriomycin
- cyclophosphomide
- oncovin
- procarbisine
- prednisine
developed by german Hodgkin’s study group
toxic, but benefit outweighs risk
used for younger people
about ____-_____ of patients develop breast cancer 15 years post radiation
20-50