4. DIFFERENCE
HODGKIN’ LYMPHOMA NON HODGKIN’S
LYMPHOMA
MORE OFTEN LOCALISED IN
SINGLE AXIAL GROUP OF
LYMPHNODES
MORE FREQUENT INVOLVEMENT
OF PERIPHERAL NODES
ORDERLY SPREAD BY
CONTIGUITY
NON CONTIGUOUS SPREAD
MESENTRIC LYMPHNODES AND
WALDAYER RING RARELY
INVOLVED
COMMONLY INVOLVED
EXTRA NODAL INVOLVEMENT
UNCOMMON
EXTRA NODAL INVOLVEMENT
COMMON
6. CLINICAL FEATURES
PAINLESS ENLARGEMENT OF
LYMPHNODES IS THE COMMON
PRESENTING SYMPTOM.
Can be associated with fever (Pel Ebstein
Fever) and night sweats in disseminated
disease.
Wt loss > 10 % of body wt.
A strange paraneoplastic syndrome in HL is
pain in the affected lymphnodes on
consumption of alcohol.
7. UNUSUAL MANIFESTATIONS
Severe and unexplained itching
Cutaneous disorders such as erythema
nodosum and icthyosis form atrophy.
Nephrotic syndrome
Immune hemolytic anemia and
thrombocytopenia
Hypercalcemia
Paraneoplastic cerebellar degeneration
8. NODULAR
SCLEROSIS
MIXED
CELLULARITY
LYMPHOCYTE
RICH
LYMPHOCYE
DEPLETED
LYMPHOCYTE
PREDOMINAN
T
MC TYPE OF
HL
MC TYPE IN
INDIA
ASSOCIATED
WITH HIV
INCIDENCE
EQUAL IN M &
F
M>F M>F M>F M>F
RS CELL
VARIANT IS
LACUNAR
CELL
MAXIMUM NO
OF RS CELLS
MONO
NUCLEAR RS
CELLS
MUMMIFIED,
NECROBIOTIC
POPCORN
CELLS
CD 15+, CD
30+
CD 15+, CD
30+
CD 15+, CD
30+
CD 15+, CD
30+
CD 20 +, BCL
6+ & EMA +
NOT
ASSOCIAT
WITH EBV
ASSOCIATED WITH EBV NOT
ASSOCIAT
WITH EBV
EXCELLENT
PROGNOSIS
PROGNOSIS
VERY GOOD
GOOD POOR
PROGNOSIS
EXCELLENT
PROGNOSIS
12. TREATMENT
Patients with localised disease are cured 90%
of time.
In patients with good prognostic factors,
extended field radiotherapy has a high cure
rate.
Patients with more extensive disease or those
with B symptoms receive a complete course of
chemotherapy.
14. Today in US most patients receive ABVD but a
weekly chemotherapy regimen administered
for 12 weeks called stanford V is becoming
increasingly popular.
Patients who relapse after primary
chemotherapy can frequently still be cured.
15. The most serious late side effects include:
1. Acute leukemias
2. Second malignancies- Lung, Breast
3. Coronary artery disease
4. Hypothyroidism
5. Lhermittes’s syndrome
6. Infertility
16. DD OF A LN BIOPSY
SUSPICIOUS FER HODGKIN’S
DISEASE
INFECTIOUS MONONUCLEOSIS
NON HODGKINS LYMPHOMA
PHENYTOIN INDUCED ADENOPATHY
NON LYMPHOMATOUS MALIGNANCIES