Hodgkin's Lymphoma Flashcards
What is the incidence of hodgkin’s lymphoma in the western world?
3 per 100,000
At what age do majority of hodgkin’s lymphoma cases occur?
16 to 65
What virus do 40% of hodgkin lymphoma patients have increased antibodies to at the time of diagnosis?
Epstein barr Virus (EBV) —> mononucleosis —-> kissing virus
What is the hallmark of classical hodgkin’s lymphoma?
Reed-Sternberg cell
What is the most common presentation of hodgkin’s lymphoma?
- painless cervical lymphadenopathy
(rubbery on palpation) - axillary and inguinal nodes can be affected
- nodes may increase/decrease size sponataneously
B symptoms:
- weightloss
- fever
- sweats
- pruritis
- lethargy
- alcohol induced lymph node paon
How do a some young women present with hodgkin’s lymphoma?
cough due to localised mediastinum lymphadenopathy
What are the “B” symptoms of Hodgkin’s lymphoma?
- hepatosplenomegaly
- weight loss
- fever
- sweats
- pruritus
- alcohol related pain at site of lymphadenopathy
What are the signs of hodgkin’s lymphoma?
- lymph node enlargement
- cachexia
- anaemia
- spleno/hepatomegaly
What tests are done for hodgkin’s L?
1) lymph node excision biopsy
2) image guided needle biopsy
3) BLOODS :
FBC
Blood film
ESR
LFT
LDH
Urate
Ca2+
What blood tests indicate the worst prognosis for hodgkins L?
raised ESR
Decreased Haemaglobin
How is Hodgkin’s L staged?
Ann Arbor system:
1) confined to single lymph node region
2) Involvement of 2 or more lymph node areas on the same side of the diaphragm
3) Involvement of nodes on both sides of diaphragm
4) Spread beyond lymph nodes - to bones, liver.
A - no symptoms
B - symptoms
What is the treatment of hodgkin’s L?
- chemoradiotherapy
(radiotherapy can increase risk of second malignancies e.g breast, lung)
Chemotherapy has side effects such as nausea, alopecia and immunosuppression.
What are the emergency presentations of hodgkin’s L?
- infection
- superior vena cava obstruction —> raised JVP.
- sensation of fullness in head
- SOB
- blackouts
- facial oedema
