Hodgkin's lymphoma

Question 1

Define Hodgkin’s lymphoma

Answer 1

malignant proliferation of lymphocytes characterised by the presence of Reed-Sternberg cells.

Question 2

what are the histology of Hodgkin’s lymphoma ?

Answer 2

• nodular sclerosing (most common + good prognosis)
• mixed cellularity (good prognosis)
• lymphocyte predominant (best prognosis)
• lymphocyte depleted (worst prognosis)

Question 3

risk factors for Hodgkin’s lymphoma ?

Answer 3

• EBV genome has an association

Question 4

epidemiology of Hodgkins lymphoma?

Answer 4

peaks between 20-30 years and older than 70 years

Question 5

presenting symptoms of Hodgkins lymphoma?

Answer 5

• Lymphadenopathy (75%)
• B symptoms of Lymphoma (25%)
• More painful after drinking alcohol

Question 6

examples of B symptoms of lymphoma?

Answer 6

o Fever > 38 degrees
o Night sweats
o Weight loss > 10% body weight in the past 6 months

Question 7

initial investigation for Hodgkin’s lymphoma?

Answer 7

• Bloods

Question 8

gold standard for Hodgkins?

Answer 8

• Lymph Node Biopsy

o In order to identify Reed-Sternberg cells

Question 9

how might Reed-Sternberg cells be described?

Answer 9

o ‘mirror image nuclei’

o ‘prominent eosinophilic nucleoli’

Question 10

staging for Hodgkins lymphoma?

Answer 10

• Ann Arbor Staging
o I = single lymph node region
o II = 2+ lymph node regions on one side of the diaphragm
o III = lymph node regions on both sides of the diaphragm
o IV = spread beyond the lymph nodes