Hodgkin's lymphoma
Background
- Spreads from source lymph node to adjacent nodes
- About half of cases related to Epstein-Barr virus[1]
- HIV is also a risk factor
- More common in males
- Bimodal distribution: young adulthood and older aged
- Most common malignancy in ages 15-19 years
- Survival >90% in low-risk patients
Clinical Features
- Painless, firm, lymph node (usually cervical or supraclavicular)
- "B" symptoms: fever, night sweats, weight loss
Differential Diagnosis
Cervical Lymphadenopathy
- Hodgkin's lymphoma
- Non-Hodgkin's lymphoma
- Mononucleosis
- Toxoplasmosis
- Branchial cleft lesions
- Cat scratch disease
- Mycobacterial adenitis
Acute Leukemia/Lymphoma
Evaluation
- CXR
- CT neck/chest/abdomen/pelvis
- Lymph node biopsy
- Reed-Sternberg cells next to normal lymphocytes
Management
- Manage acute complications
- Superior vena cava syndrome
- Upper airway compression
- Do NOT give steroids (citation/rationale?)
- Tumor lysis syndrome
- Neutropenic fever
- Chemo-induced nausea/vomiting
References
- World Cancer Report 2014. World Health Organization. 2014. pp. Chapter 2.4
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