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General Medicine

Hodgkin Lymphoma

Rory M. Shallis, MD and John L. Reagan, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

Historical background: 

  • Described in 1832 by Thomas Hodgkin in “On some morbid appearance of the absorbent glands and spleen”

  • First neoplasm to be (i) defined by cytologic grounds base...

DIAGNOSIS

HISTORY

  • Asymptomatic lymphadenopathy (cervical/supraclavicular)

  • Pel-Ebstein (cyclic) fever

  • Constitutional symptoms: night sweats, weight loss, fatigue, anorexia

  • Alcohol-induced pain

  • Pruritus

PHYSICAL EXAM

TREATMENT

  • Ann Arbor staging with Cotswold modification

    • Stage I: single lymph node or of a single extralymphatic organ or site

    • Stage II: ≥2 lymph node regions on the same side of diaphragm alone or wit...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • During therapy: CBC, nutrition, and hydration

  • Restage with PET after 2 to 4 cycles of chemotherapy: sensitive prognostic indicator

  • Posttreatment m...

REFERENCES

1
Barrington SF, Kirkwood AA, Franceschetto A, et al. PET-CT for staging and early response: results from the Response-Adapted Therapy in Advanced Hodgkin Lymphoma study. Blood.  2016;1...

ADDITIONAL READING

  • American Cancer Society. American Cancer Society Recommendations for Early Breast Cancer Detection in Women without Breast Symptoms. Atlanta, GA: American Cancer Society; 2013.

  • Cen...

CODES

ICD10

  • C81.90 Hodgkin lymphoma, unspecified, unspecified site

  • C81.91 Hodgkin lymphoma, unsp, lymph nodes of head, face, and neck

  • C81.92 Hodgkin lymphoma, unspecified, intrathoracic lymph nodes

  • C81.95...

CLINICAL PEARLS

  • Neoplastic disease of lymphatics

  • RS cells of monoclonal lymphoid B-cell origin within inflammatory background of lymphocytes

  • Two subtypes: CHL 95% of cases and NLPHL 5% of cases

  • Cure rate...

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Related Images
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Several multinucleated Reed-Sternberg cells are present in an inflammatory background including histiocytes, lymphocytes, and a few plasma cells and eosinophils.
Several multinucleated Reed-Sternberg cells are present in an inflammatory background including histiocytes, lymphocytes, and a few plasma ...
Pleomorphic mononuclear Hodgkin cells predominate in this field.
Pleomorphic mononuclear Hodgkin cells predominate in this field.
FIGURE 57.6. Bilateral hilar and right paratracheal lymphadenopathy caused by Hodgkin lymphoma.
FIGURE 57.6. Bilateral hilar and right paratracheal lymphadenopathy caused by Hodgkin lymphoma.
Figure 27-12 Hodgkin lymphoma. Large, fixed cervical masses in a 14-year-old with weight loss. (Courtesy of Mary L. Brandt, MD.)
Figure 27-12 Hodgkin lymphoma. Large, fixed cervical masses in a 14-year-old with weight loss. (Courtesy of Mary L. Brandt, MD.)
FIGURE 20-72. Reed-Sternberg and Hodgkin cells. The cells are positive for CD30 (immunohistochemistry)
FIGURE 20-72. Reed-Sternberg and Hodgkin cells. The cells are positive for CD30 (immunohistochemistry)
FIGURE 20-73. Hodgkin lymphoma; nodular sclerosis. A. A cut section of matted lymph nodes shows broad bands of fibrosis that divide the parenchyma into distinct nodules. Several foci of necrosis are evident. B. A low-power photomicrograph demonstrates broad bands of fibrosis.
FIGURE 20-73. Hodgkin lymphoma; nodular sclerosis. A. A cut section of matted lymph nodes shows broad bands of fibrosis that divide the par...
FIGURE 20-73. Hodgkin lymphoma; nodular sclerosis. A. A cut section of matted lymph nodes shows broad bands of fibrosis that divide the parenchyma into distinct nodules. Several foci of necrosis are evident. B. A low-power photomicrograph demonstrates broad bands of fibrosis.
FIGURE 20-73. Hodgkin lymphoma; nodular sclerosis. A. A cut section of matted lymph nodes shows broad bands of fibrosis that divide the par...
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