Hodgkin’s Disease

Hodgkin’s Disease:
Malignant lymphoma that is pathologically distinct from other lymphoid malignancies.
Affects all ages – bimodal peaks at 25 and 55 yrs; annual incidence of 4/100 000

4 types:
• nodular sclerosis
• lymphocyte predominant
• mixed cellularity
• lymphocyte depletion

Pathognomonic to all types is the Reed-Sternberg cells (bilobed or multilobed nucleus surrounded by clear halo).

Clinical features:
Rubbery lymphadenopathy (usually neck) – usually painless at presentation; 30% have splenomegaly or hepatomegaly or both at diagnosis; systemically may have fever, night sweats, pruritis

Ann Arbor Classification/Clinical Stages:
Stage 1 - Involvement of a single lymph node region (1) or extralymphatic site (1E)
Stage 2 – Involvement of 2 or more lymph node regions (2) or an extralymphatic site and lymph nodes regions on the same side of the diaphragm (2E)
Stage 3 – Involvement of lymph node regions on both sides of the diaphragm with (3E) or without (3) localised extralymphatic involvement or involvement of the spleen (3S) or both (3SE)
Stage 4 –diffuse involvement of one or more extralymphatic tissues
A – No systemic symptoms
B – Weight loss, drenching sweats

Management:
Radiotherapy
Chemotherapy

Prognosis:
90% with stage 1 are cured by radiotherapy

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