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HODGKIN'S LYMPHOMA
By- Dr. Armaan Singh
Hodgkin's lymphoma is a
malignant tumor of the lymphatic system
that is characterised histologically by the
presence of multinucleated giant cells
(Reed-Sternberg cells) and associated
abnormal and smaller mononuclear cells
originating from B lymphocytes in the
germinal centres of lymphoid tissue.
SYMPTOMS:
 Most patients present with an enlarged but otherwise asymptomatic lymph
node, typically in the lower neck or supraclavicular region.
 Mediastinal masses are frequent and are sometimes discovered on a
routine CXR.
 Patients might complain of chest discomfort with a cough or dyspnoea.
 Systemic symptoms of drenching night sweats, unexplained fever >38°C,
and weight loss of >10% over six months are termed B symptoms and are
identified in approximately 25% of patients.Alcohol-induced pain at sites of
nodal disease is specific but occurs in fewer than 10% of patients.
 Findings on examination include lymphadenopathy, hepatomegaly,
splenomegaly, and superior vena cava syndrome; there may also be
features caused by paraneoplastic syndromes - eg, cerebellar
degeneration, neuropathy or Guillain-Barré syndrome.
DIFFERENTIAL DIAGNOSIS
 Infectious mononucleosis, AIDS, Non-Hodgkin's lymphoma,
Tuberculosis, Leukaemia, Sarcoidosis
 Myeloma, Toxoplasmosis, Cytomegalovirus infection,Tularaemia
 Radiation therapy, chemotherapy or combined therapies are the
treatments used in managing Hodgkin's lymphoma.
 Both chemotherapy and radiation therapy increase the risk of
developing secondary solid tumours - eg, cancers of the lung,
breast, and stomach.
 Vaccinations: polyvalent pneumococcal vaccine and influenza
vaccine should be given to all patients with Hodgkin's lymphoma.
Meningococcal group C conjugate vaccine and Haemophilus
influenzae type b vaccine are also recommended, especially for
patients receiving treatment and those with asplenia or splenic
dysfunction.
 The role of allogeneic hematopoietic stem cell transplantation for
Hodgkin's lymphoma is being explored.

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Hodgkin's lymphoma

  • 2. Hodgkin's lymphoma is a malignant tumor of the lymphatic system that is characterised histologically by the presence of multinucleated giant cells (Reed-Sternberg cells) and associated abnormal and smaller mononuclear cells originating from B lymphocytes in the germinal centres of lymphoid tissue.
  • 3. SYMPTOMS:  Most patients present with an enlarged but otherwise asymptomatic lymph node, typically in the lower neck or supraclavicular region.  Mediastinal masses are frequent and are sometimes discovered on a routine CXR.  Patients might complain of chest discomfort with a cough or dyspnoea.  Systemic symptoms of drenching night sweats, unexplained fever >38°C, and weight loss of >10% over six months are termed B symptoms and are identified in approximately 25% of patients.Alcohol-induced pain at sites of nodal disease is specific but occurs in fewer than 10% of patients.  Findings on examination include lymphadenopathy, hepatomegaly, splenomegaly, and superior vena cava syndrome; there may also be features caused by paraneoplastic syndromes - eg, cerebellar degeneration, neuropathy or Guillain-Barré syndrome.
  • 4. DIFFERENTIAL DIAGNOSIS  Infectious mononucleosis, AIDS, Non-Hodgkin's lymphoma, Tuberculosis, Leukaemia, Sarcoidosis  Myeloma, Toxoplasmosis, Cytomegalovirus infection,Tularaemia  Radiation therapy, chemotherapy or combined therapies are the treatments used in managing Hodgkin's lymphoma.  Both chemotherapy and radiation therapy increase the risk of developing secondary solid tumours - eg, cancers of the lung, breast, and stomach.  Vaccinations: polyvalent pneumococcal vaccine and influenza vaccine should be given to all patients with Hodgkin's lymphoma. Meningococcal group C conjugate vaccine and Haemophilus influenzae type b vaccine are also recommended, especially for patients receiving treatment and those with asplenia or splenic dysfunction.  The role of allogeneic hematopoietic stem cell transplantation for Hodgkin's lymphoma is being explored.