Hodgkin's Lymphoma Flashcards
Define Hodgkin’s Lymphoma?
Lymphomas are neoplasms of lymphoid cells, originating in the lymph nodes or other lymphoid tissues
How is Hodgkin’s Lymphoma diagnosed?
Histopathologically by the presence of Reed-Sternberg Cells (binucleate lymphocytes)
What percentage of all lymphomas is Hodgkin’s Lymphoma?
15% of all lymphomas
What is the aetiology of Hodgkin’s Lymphoma?
Likely to be an environmental trigger in a genetically susceptible individual
EBV genome has been detected in 50% of Hodgkin’s Lymphoma
What is the epidemiology of Hodgkin’s Lymphoma?
Bimodal age distribution with peaks at 20-30 yrs and > 50 yrs
More common in Males
What are the presenting symptoms of Hodgkin’s Lymphoma?
Painless Enlarging Mass
B symptoms of Lymphoma
Other Symptoms
What are some of the other features of the mass in Hodgkin’s Lymphoma?
Most commonly in the neck
Can also be in the axilla or the groin
The mass may become painful after alcohol ingestion
What are the B symptoms of Lymphoma in Hodgkin’s Lymphoma?
Fever > 38 degrees
Night Sweats
Weight loss > 10% body weight in the past 6 months
What is it called if the fever is cyclical?
Pel-Ebstein Fever
What are the other symptoms in Hodgkin’s Lymphoma?
Pruritis
Cough
Dyspnoea
What are the signs of Hodgkin’s Lymphoma on physical examination?
Non-tender firm rubbery lymphadenopathy (may be cervical, axillary or inguinal)
Splenomegaly (or sometimes, hepatosplenomegaly)
Skin excoriations
Signs of intrathoracic disease (e.g. pleural effusion, superior vena cava obstruction)
What investigations would you do for Hodgkin’s Lymphoma?
Bloods Lymph Node Biopsy Bone Marrow Aspirate and Trephine Biopsy Imaging Ann Arbor Staging
What bloods would you do for Hodgkin’s Lymphoma and what might you see?
FBC:
- Anaemia of Chronic Disease
- Leucocytosis
- High Neutrophils
- High Eosinophils
- Lymphopaenia in advanced disease
High ESR and CRP
What imaging would you do in Hodgkin’s Lymphoma?
CXT
CT
PET
What is Ann Arbor Staging?
I = Single Lymph node region II = 2+ lymph node regions on one side of the diaphragm III = lymph node regions on both sides of the diaphragm IV = extranodal involvement A = absence of B symptoms B = presence of B symptoms E = localised extranodal extension S = involvement of spleen