Hodgkin Lymphoma
Pat Price, Karol Sikora in Treatment of Cancer, 2020
An excisional biopsy of a suspicious enlarged lymph node or from another affected organ should be performed to establish the diagnosis of Hodgkin lymphoma (HL). Differential diagnoses of HL include all types of benign or malignant lymph node swelling owing to infectious or reactive disease, other types of lymphoma, or solid tumors. HL patients are allocated to risk groups based on the clinical stage according to the Ann Arbor classification and the presence of clinical risk factors. Clinical, biological, and serological parameters also influence the risk group allocation. Younger patients with HL recurrence after first-line treatment are candidates for high-dose chemotherapy followed by autologous stem cell transplantation in the majority of cases. Patients diagnosed with early or intermediate stages, are usually treated with brief chemotherapy followed by consolidation radiotherapy whereas patients with advanced HL receive chemotherapy alone in most cases.
Hodgkin Lymphoma
Dongyou Liu in Tumors and Cancers, 2017
This chapter presents a state of the art summary of Hodgkin lymphoma (HL) to its biology, epidemiology, disease mechanisms, clinical signs, diagnosis, treatment and prognosis. Classified under the mature lymphoid, histiocytic, and dendritic neoplasms category, HL makes up about 15% of lymphoma cases and is divided on the basis of histological and phenotypic features of the tumor cells into nodular lymphocyte predominant HL and classical HL (CHL). HL is responsible for about 1% of all cancers and 6% of childhood cancers, with an annual incidence of about three cases per 100,000 and a propensity to affect younger adults. About 40% of HL patients manifest nonspecific constitutional symptoms of which unexplained fever, unexplained weight loss, and drenching night sweats are commonly referred to as B symptoms. Diagnosis of HL requires the identification of characteristic neoplastic cells within an inflammatory milieu.
Hodgkin Lymphoma
Tariq I. Mughal in Precision Haematological Cancer Medicine, 2018
This chapter describes advances in the pathogenesis, diagnosis and optimal clinical management of patients with Hodgkin lymphoma (HL). Most patients with HL present with painless lymphadenopathy, sometimes associated with alcohol-induced pain, fatigue, pruritis and the presence or absence of systemic 'B' symptoms. The clinical features are largely dependent on the subtype of HL. The concept of staging, following a definitive diagnosis of HL, was recognized in 1971, in tandem with the introduction of the Ann Arbor staging system. The staging systems are largely anatomical, and with the increasing use of positron emission tomography-CT scans and molecular genetic tests, are constantly being revised. By 2003, adriamycin, bleomycin, vinblastine and dacarbazine was established as the treatment of choice for patients with advanced-stage HL. Shortly thereafter, to improve clinical outcomes by increasing the intensity of initial treatment, the German Hodgkin Group introduced the BEACOPP (bleomycin, etoposide, daunorubicin, cyclophosphamide, vincristine, procarbazine and prednisone) regimen, initially at standard doses and then at increased doses.
Hodgkin Lymphoma revealed by epidural spinal cord compression
Published in The Journal of Spinal Cord Medicine, 2019
Khalil Ghedira, Nidhal Matar, Sofiene Bouali, Alia Zehani, Adnen Boubaker, Hafedh Jemel
Context: Hodgkin Lymphoma is rarely diagnosed as spinal cord compression syndrome. Caused by an epidural mass, this complication is often encountered in a late stage of the disease. We report the case of a 40-year-old man presenting with symptoms of low thoracic spinal cord compression due to an epidural tumor on the MRI. Findings: Emergent surgery was undertaken on this patient, consisting in laminectomy and tumor resection. After surgery, pain relief and mild neurological improvement were noticed. The histological study revealed a Hodgkin Lymphoma and the patient was referred to chemotherapy and radiotherapy. Conclusion: Though chemotherapy is the gold standard treatment for Hodgkin Lymphoma, surgical spinal decompression may be required in epidural involvement of the disease. Diagnosis may be suspected in the presence of lymphadenopathy and general health decay.
Before it crumbles: Fulminant Hepatic Failure secondary to Hodgkin's Lymphoma
Published in Journal of Community Hospital Internal Medicine Perspectives, 2014
Paras Karmacharya, Naresh Bhandari, Madan R. Aryal, Aashrayata A. Pandit, Ranjan Pathak, Sailu Ghimire, Pragya Shrestha, Vijaya R. Bhatt
Fulminant hepatic failure (FHF) is a relatively rare manifestation of Hodgkin's lymphoma. Clinical features, laboratory findings, and imaging of the liver are usually inconclusive, and liver biopsy may be required for confirmation. We present a case of an FHF in a woman 1 week after the diagnosis of Hodgkin's lymphoma. Chemotherapy could not be instituted due to hepatic encephalopathy and other complications. Autopsy revealed diffuse infiltration of the liver parenchyma. This case illustrates the importance of early diagnosis and institution of chemotherapy, which may reverse the liver failure.
Socioeconomic impact of Hodgkin lymphoma in adult patients: a systematic literature review
Published in Leukemia & Lymphoma, 2019
Rakel Pálmarsdóttir, Andreas Kiesbye Øvlisen, Marianne Tang Severinsen, Ingrid Glimelius, Karin E. Smedby, Tarec El-Galaly
Hodgkin lymphoma is a highly curable disease with a peak incidence in young adulthood at times where education, family, and social relations are established. We performed a systematic literature review to assess the impact of Hodgkin lymphoma on the socioeconomic status of adolescent and adult survivors (including educational achievements, occupational aspects, marriage, and parenthood). In total, 39 articles were included. Overall, 26–36% of survivors perceived Hodgkin lymphoma as negatively affecting their socioeconomic status. Studies consistently found educational achievements in line with general population. Employment rates for survivors were comparable to the general population, but lower than before Hodgkin lymphoma diagnosis, with a post-diagnosis increase in disability pension and early retirement. Employed survivors encountered problems related to physical restrictions and recruitment. Marriage and parenthood were not substantially affected. In conclusion, current studies suggest acceptable socioeconomic outcomes following a Hodgkin lymphoma diagnosis but the use of standardized reporting methods hampers comparability across studies.
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