Hodgkin's Lymphoma | Esha Godbole

HODGKIN'S LYMPHOMA Malignant neoplasm of the lymphoreticular system ,involves lymph nodes,spleen,liver etc. PATHOLOGY Axial lymphatic system affected,cellular pleomorphism with reed sternberg cells CLASSIFICATION 1.Classical hodgkin a.Nodular sclerosis b.Lymphocyte rich c.Lymphocyte depletion d.Mixed cellularity 2.REAL classic(Revised European American Lymphoma) CLINICAL FEATURES. a.generalised lymphadenopathy lymph node >2cm,node in consistency,palpable node b.hepatosplenomegaly c.Para-aortic nodes felt in umbilical region d.Intermittent fever e.Multiple body pains f.Sup. vena caval obstr. CLINICAL STAGING Stage1-node involved. in one anatomical region or involved. of single extralymphatic organ Stage2-node involved. at two or more anatomical group to same side of diaphragm Stage3-node involved. on both sides of diaphragm with or without spleen Stage4-diffuse involves. of one or more extralymphatic organs INVESTI. 1.Complete blood picture 2.Creatinine and BUN 3.Chest x ray 4.USG For nodes,splenomegaly 5.Intravenous pyelography 6.Lymph node biopsy 7.Mediastinoscopy 8.Bipedal lymphangiography TREATMENT Stage 1 and 2 Radiotherapy 3500 to 4500 centigray (cGy)units local radiotherapy for confined group nodes,mantle field of therapy for both sides of neck involve.,inverted Y field therapy for para aortic and bilateral inguinal nodes Stage 3 And 4 chemotherapy MOPP regimen a.Mechlorethamine 6mg/sq.Metre body area on 1st and 8th day b.Oncovin 1.4mg/sq.Metre body area iv on 1st and 8th day c.Procarbazine 100mg orally for 1to 10 days d.Prednisolone 15mg 8th hourly orally 1 to 10 days min. 6 cycles side effects-infertility,development of acute myeloid leukaemia,hemato suppression.