Diagnosis of Leukemia, Lymphoma, and Myeloma
Tariq I Mughal, John M Goldman, Sabena T Mughal in Understanding Leukemias, Lymphomas, and Myelomas, 2017
Patients with Hodgkin lymphoma (HL) often present with constitutional symptoms, such as weight loss, profuse sweating (especially at night), weakness, fatigue, and anorexia. Clinically many of these patients have painless enlargement of lymph nodes, in particular those in the neck. Neck nodes are involved in about 60% to 70% of all patients, followed by involvement of the axillary (armpit) nodes in about 15% of the patients. Other nodes, such as the inguinal (groin) nodes are involved in about 10% of all patients. The nodes often fluctuate in size, and alcohol ingestion may precipitate pain. Splenomegaly is noted in about a third of all patients but it is seldom massive. Enlargement of the liver may also occur. Involvement of sites which are not part of the lymphatic system (called extranodal), such as lung, CNS, skin, and bone is uncommon, but may occur.
Neoplasia in pregnancy
Hung N. Winn, Frank A. Chervenak, Roberto Romero in Clinical Maternal-Fetal Medicine Online, 2021
The majority of women with lymphoma are asymptomatic. On physical examination, 80% will have superficial lymphadenopathy. Those with Hodgkin’s disease are more likely to have localized lymphadenopathy, most often involving cervical, submaxillary, or axillary nodes. A small percentage of patients have fever, night sweats, weight loss, or pruritus, which are associated with poor prognosis. Biopsy is the “gold standard” of diagnosis. The histology of Hodgkin’s lymphoma often shows multinucleated Reed–Sternberg cells with a pattern that is most commonly nodular sclerosing or lymphocytic. Histology is no longer thought to contribute to overall prognosis, as recent evidence demonstrates that the two most important prognostic factors are stage of disease and patient’s age (244). Hodgkin’s lymphoma is staged by the Ann Arbor staging system.
Medicine
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
Daniel, a 21-year-old man, presents to you complaining of feeling an enlarged lump in his neck for the past 6 weeks. You examine it and find it to be 3 cm by 2 cm, painless on palpation and with a ‘rubbery’ feel to it. You suspect lymphoma. List three symptoms he may also complain of. (3)Name two signs you will look for on examination. (2)The biopsy shows the presence of a binucleated cell. The haematologist states it is Hodgkin’s lymphoma.What is the name of this cell that suggests Hodgkin’s lymphoma? (1)State two staging investigations. (2)What staging system is classically used for Hodgkin’s lymphoma? (1)Whilst being investigated, Daniel presents to A&E with dyspnoea, swelling of the face and congested veins in his neck and chest.What has happened? (1)
Non-Hodgkin’s lymphoma of the oral cavity and maxillofacial region: a pathologist viewpoint
Published in Expert Review of Hematology, 2018
Mahmoud Rezk Abdelwahed Hussein
Hodgkin lymphoma typically involves the lymph nodes. The involvement of the extranodal sites is rare. Oral Hodgkin lymphoma is exceptionally rare with only few reports in the English literature to date. The sites of involvement included palate, tonsils, and oropharynx and nasopharynx. The age range was between 37 to 70 years. The clinical presentations included ulcers, facial swelling, and pain [114,115]. Histologically, there is large atypical mononuclear, binucleared, or multinucleated Reed-Sternberg/Hodgkin cells scattered within a background milieu of inflammatory cells (lymphocytes, eosinophils, histiocytes, and plasma cells). These atypical cells are immunoreactive for CD15, CD30, and Fascin and non-reactive for CD45, CD20, and CD3 [114,115].. The treatment modalities included ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, and dacarbazine) and involved field radiation therapy [115,116].
Paraneoplastic Neurologic Symptoms in a Pediatric Patient with Hodgkin Lymphoma
Published in Cancer Investigation, 2021
Claire C. Baniel, Sarah S. Donaldson, Catherine Aftandilian, Susan M. Hiniker
It is not uncommon for patients with Hodgkin lymphoma (HL) to present with systemic symptoms, including: fever, weight loss, and night sweats, known collectively as “B symptoms” (1). While these are prognostic signs of HL, there are also less common presentations that may be difficult to interpret. Some of these associated symptoms include pruritus, alcohol-associated pain, and liver dysfunction. In addition, there are more rare paraneoplastic symptoms that may also delay timely diagnosis and treatment. Among the paraneoplastic neurological syndromes, those arising in adults have an estimated incidence of less than 0.01%; in children, they are even more rare, with an unknown incidence. Herein, we report a child with a neurological paraneoplastic syndrome comprised of cerebellar ataxia and later, achalasia which led to the diagnosis of EBV + HL.
Clinical prognostic risk analysis and progression factor exploration of primary breast lymphoma
Published in Hematology, 2022
Jili Deng, Lan Mi, Xiaopei Wang, Jun Zhu, Chen Zhang, Yuqin Song
Blood test reports were comprehensively collected to explore better this small group of patients’ adverse prognostic factors. Elevated ESR has previously been suggested as a poor prognostic factor for Hodgkin's lymphoma[24]. In our cohort, other general prognostic risk factors, such as ESR, LDH level, B symptoms, and IPI scores, were equally applicable in PB-DLBCL, showing poor prognostic factors for both OS and PFS (P < 0.05). The stage-adjusted IPI can also identify patients with a survival benefit, even if the disease is confined to an early stage. Although B symptoms in patients with non-Hodgkin lymphoma are frequently neither recorded nor accurate, as mentioned in the Lugano classification[25], they are still crucialin lymphoma patients, especially those with weight loss.
Related Knowledge Centers
- Fever
- Groin
- Weight Loss
- White Blood Cell
- Lymphadenopathy
- Lymphocyte
- Cancer
- Lymphoma
- Reed–Sternberg Cell
- Night Sweats