CASE STUDY A Hodgkin\'s Disease J.R., age 32 years, noticed a lump on the side o

Question

CASE STUDY A Hodgkin's Disease J.R., age 32 years, noticed a lump on the side of his neck a few months ago. The lump is relatively large, painless, and not tender to the touch. A few days ago he experienced some dif- ficulty swallowing as if there was something putting pressure on his esophagus. He has also noticed unexplained weight loss, fever, night sweats, and general fatigue over the last few weeks. A visit to his physician produced lab results showing a marked decrease in the lymphocyte count as well as the presence of a giant cell in the tissue of a biopsied lymph node, subsequently confirmed as a Reed-Sternberg cell. The lab results confirmed Hodgkin's lymphoma.

Explanation / Answer

a) Hodgkin's Lymphoma is of the following types as classified by the WHO:

Nodular sclerosing, mixed cellularity, lymphocyte rich, lymphocyte depleted and nodular lymphocyte predominant. However, the case mentioned above deals with nodular sclerosis type. Large number of Reed-Sternberg cells and bizarre sarcomatous variants are seen.The Reed-Sternberg cells are large multinucleated lymphocyte cells comprising 1-2% of tumor mass, originating from B cells from lymphnodes mostly but do not produce antibody. NSHL is seen in young adults and adolescents.lt is marked by a painless swelling of the lymph nodes and are more likely to arise in the upper portion of the body (the neck, underarms, or chest). Patients can have symptoms such as weight loss, fevers, and night sweats.It involves mediastinum and other supradiaphragmatic sites. Nodules at the lymphnodes us major indication of this type.

b)The four according to Ann Arbor stages are as follows:

Stage 1-indicates that the cancer is located in a single region, usually one lymph node and the surrounding area. No outward symptomd are observed.

Stage 2-indicates that the cancer is located in two separate regions, an affected lymph node or lymphatic organ and a second affected area, and that both affected areas are confined to one side of the diaphragm—that is, both are above the diaphragm, or both are below the diaphragm.

Stage 3-indicates that the cancer has spread to both sides of the diaphragm, including one organ or area near the lymph nodes or the spleen.

Stage 4-indicates diffuse or disseminated involvement of one or more extralymphatic organs, including any involvement of the liver, bone marrow, or nodular involvement of the lungs.

c)differences between non hodgkin's and hodgkin's lymphoma are:

Microscopic examination of tumor cells if detects the presence of a specific type of abnormal cell called a Reed-Sternberg cell, the lymphoma is classified as Hodgkin's. While these are absent in case of Non-Hodgkin's.The former arises in lymphnodes while the later may arise in other organs as well.There are more than 60 distinct types of non-Hodgkin lymphoma, whereas Hodgkin lymphoma is a more homogeneous disease.Hodgkin lymphoma tends to progress slowly and can be detected in early stages. However, Non-Hodgkin's is detected in advance stages.

d) Treatments vary depending on the type of disease, its aggressiveness, and location, along with the age and general health of the patient.Three types of standard treatment are used; Chemotherapy, Radiation therapy, Surgery.For pregnant patients with Hodgkin lymphoma, treatment options also include:Watchful waiting, Steroid therapy. New types of treatment are being tested in clinical trials.Chemotherapy and radiation therapy with stem cell transplant and Monoclonal antibody therapy.

Related Questions

Navigate

• Browse (All)
• Browse C
• Subjects

---

---

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.