Hodgkin lymphoma

hodgkin lymphoma, nodular sclerosis, mixed cellularity, lymphocyte predominant, lymphocyte depletion, lymphocyte rich, ABVD regimen, reed sternberg cells, lacunar cell, popcorn cell

1. HODGKIN’S LYMPHOMA - Dr. Akif A.B - Step to PG-MD/MS/DNB - Dr.Akif A.B

2. Arises in Lymph nodes MC LN to involved is - Cervical - Step to PG-MD/MS/DNB - Dr.Akif A.B

3. CLINICAL FEATURES Pel Ebstein fever Asymptomatic lymphadenopathy Constitutional symptoms (unexplained weight loss [>10% of total body weight] within the past 6 months, unexplained fever >38º C, or drenching night sweats) collectively, these are known as "B symptoms B symptoms unexplained fever >38º C unexplained weight loss drenching night sweats - Step to PG-MD/MS/DNB - Dr.Akif A.B

4. PEL EBSTEIN FEVER (high fever for 1-2 wk, followed by an afebrile period of 1-2 wk) - Observed only in 35% of patients - Step to PG-MD/MS/DNB - Dr.Akif A.B

5. STAGE 1 Only a single lymph node site or extranodal site is involved STAGE 2 Two or more lymph node sites on one side of the diaphragm are involved, -, or limited contiguous extranodal site involvement STAGE 3 Lymph node sites on both sides of the diaphragm are involved, with splenic or limited contiguous extradodal site involvement STAGE 4 Extensive involvement of extranodal sites , with or without lymph node involvement STAGING - Step to PG-MD/MS/DNB - Dr.Akif A.B

6. TYPES Classical Variety CD15+, CD30+ Non classical variety CD15- , CD30- , CD20+ Nodular sclerosis Lymphocyte predominant Mixed cellularity Lymphocyte rich Lymphocyte depletion - Step to PG-MD/MS/DNB - Dr.Akif A.B

7. Nodular Sclerosis Lacunar cells, Bands of fibrosis CD15+ , CD30+ Usually EBV- M=F Good Prognosis MC in world Mixed cellularity Mononuclear cells CD15+ , CD30+ 70% EBV+ M>F Good prognosis MC in India Lymphocyte rich Reed - Sternberg cell CD15+ , CD30+ 40% EBV+ M>F Good prognosis Lymphocyte depletion Reed sternberg cell CD15+ , CD30+ 90% EBV+ M>F Poorest prognosis Lymphocyte predominance Popcorn cell CD15- , CD30- CD20+ EBV- M>F Best prognosis - Step to PG-MD/MS/DNB - Dr.Akif A.B

8. NODULAR SCLEROSIS Bands of fibrosis - Step to PG-MD/MS/DNB - Dr.Akif A.B

9. NODULAR SCLEROSIS Bands of fibrosis - Step to PG-MD/MS/DNB - Dr.Akif A.B

10. In this lymph node, there are numerous scattered large cells with a surrounding prominent clear space surrounding the nucleus, an artefact of formalin fixation. These are the  lacunar cells  characteristic for the nodular sclerosis type of Hodgkin lymphoma. - Step to PG-MD/MS/DNB - Dr.Akif A.B

11. - Step to PG-MD/MS/DNB - Dr.Akif A.B

12. Mixed cellularity Hodgkin lymphoma showing both mononucleate and binucleate Reed-Sternberg cells in a background of inflammatory cells - Step to PG-MD/MS/DNB - Dr.Akif A.B

13. Nodular Lymphoctye Predominant Hodgkin lymphoma (NLPHL), with a popcorn -shaped Reed-Sternberg cel - Step to PG-MD/MS/DNB - Dr.Akif A.B

14. POOR PROGNOSTIC FACTORS Albumin <4 g/ dL Hemoglobin <10.5 g/ dL Male Age ≥45 y Stage IV disease Leukocytosis : white blood cell count (WBC) >15,000/ Μ l Lymphopenia : Lymphocyte count <8% of WBC and/or absolute lymphocyte count <600 cells/ μ L Good risk : 0-1 Fair risk : 2-3 Poor risk : 4-7 - Step to PG-MD/MS/DNB - Dr.Akif A.B

15. TREATMENT A - Adriamycin B - Bleomycin V - Vinblastine D - Dacarbazine - Step to PG-MD/MS/DNB - Dr.Akif A.B