FN: Hodgkins lymphoma Flashcards Preview

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Flashcards in FN: Hodgkins lymphoma Deck (10):
1

Epi

M>F =@:1 (esp. in paeds)
Bimodal age incidcen: 20-29yrs and >60yrs
May be association with EBV

2

FEatures

Lymphadenopathy
B symptoms
OTher

3

Lymphadenopathy

Painless
Asymmetric
Spreads contiguously to adjacent LNS
Cervical nodes in 70% (also axillary and inguinal)
May be alcohol-induced LN pain
Mediastinal LN may - mass effects
1. SVC obstruction
2. Bronchial obstruction

4

B symptoms

Fever
Night sweats
Wt. loss

5

Other symptoms

Itch
Pel Ebstein Fever: cyclical fever
Hepato- and/or spleno-megaly

6

Investigations

1. FBC, film, ESR, LFT, LDH, Ca - raise ESR and reduced HB = worse prognosis
2. LN excision biopsy or FNA - Reed-sternbery cells )owls eye nucleus)
3. Staging: CT/MRI chest, abdomen, pelvs
4. BM biopsy if B symptoms or stage 3/4 disease

7

staging

Ann Arbour system

8

Ann Arbour system

1. Single LN region
2. >2 nodal are on same side of diaphragm
3. Nodes on both sides of diaphragm
4. Spread beyond nodes e.g. liver, BM
--> + B if constitutional symptoms

9

Management

Chemo, radio or both
ABVD regimen
BMT for relapse

10

Prognosis

Depends on stage and grade
1A >95% 5 yrs
4B

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