Hodgkin's Lymphoma

Question 1

Hodgkins Lymphoma General + Classification

Answer 1

• Reed-Sternberg cells ‘Owl’s eyes’
• Characterised by lymphoma moving adjacently from node to node
• Two distinct entities
• Classical Hodgkins lymphoma (nodular sclerosis, mixed cellularity, lymphocyte-rich, lymphocyte-depleted,)
• Nodular lymphocyte-predominant Hodgkins lymphoma (NLPHL) (rare, rest is about classical)

Question 2

Hodgkins Lymphoma Epidemiology

Answer 2

-Peak incidence 20-34 and >70

Question 3

Hodgkins Lymphoma RFs

Answer 3

• EBV
• Previous mononucleosis
• HIV

Question 4

Hodgkins Lymphoma Presentation

Answer 4

• Enlarged but asymptomatic lymph node, typically in lower neck or supraclavicular region
• Mediastinal masses frequent
• Patients may get chest discomfort with cough or dyspnoea
• Night sweats, unexplained fever, weight loss in 25% of patients

Question 5

Hodgkins Lymphoma Differentials

Answer 5

• Infectious mononucleosis
• AIDS
• Non-hodgkins
• TB
• Leukaemia
• Sarcoidosis

Question 6

Hodgkins Lymphoma Ix

Answer 6

• FBCs to exclude leukaemia, mononucleosis and other causes of lymphadenopathy
• Tests for infectious mononucleosis
• ESR
• LFTs
• HIV, HBV, HCV
• Lymph node biopsy
• CXR
• CT scans

Question 7

Hodgkins Lymphoma Staging

Answer 7

-Ann Arbor staging

Question 8

Hodgkins Lymphoma Management

Answer 8

• Different chemo regimens

- Radiotherpay if severe

Question 9

Hodgkins Lymphoma Treatment Complications

Answer 9

• Leukaemia can be caused by chemotherapy
• Infertility from chemotherapy
• Second solid tumours can occur after radiotherapy
• Hypothyroidism and CV disease from radiotherapy

Question 10

Hodgkins Lymphoma Prognosis

Answer 10

• Both localised and advanced can usually be cured
• 80-90% of patients achieve remission
• Poor prognostic indicators include- increasing tumour burden, age, male…
• Long term survivors have increased mortality