在查看本专题的其他语言版本时,您可能会发现内容结构上的一些差异,但仍然是最新的循证指导。

Hodgkin's lymphoma

Last reviewed: 20 八月 2025
Last updated: 01 七月 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • lymphadenopathy
Full details

Other diagnostic factors

  • unexplained fevers
  • night sweats
  • weight loss
  • dyspnoea
  • cough
  • chest pain
  • superior vena cava syndrome (SVCS)
  • abdominal pain
  • pruritus
  • alcohol-induced pain at involved sites
  • hepatomegaly and/or splenomegaly
  • tonsillar enlargement
Full details

Risk factors

  • age 20-34 years and >55 years
  • history of Epstein-Barr virus (EBV) infection
  • family history of Hodgkin's lymphoma
  • young adults from higher socio-economic class
  • human leukocyte antigen (HLA) types
  • Jewish ancestry
Full details

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • FBC with differential
  • comprehensive metabolic panel
  • erythrocyte sedimentation rate (ESR)
  • thyroid function tests
  • screening for HIV, hepatitis B, hepatitis C
  • CXR
  • PET/CT scan
  • gallium scan
  • contrast-enhanced CT (neck, chest, abdomen, pelvis)
  • excisional lymph node biopsy or core biopsy
  • immunohistochemical studies
Detalhes completos

Investigações a serem consideradas

  • bone marrow biopsy
  • echocardiogram or multi-gated acquisition (MUGA) scan
  • pulmonary function tests
Detalhes completos

Algoritmo de tratamento

AGUDA

early (stage I to II) classical HL: favourable disease and intended for combined-modality therapy

early (stage I to II) classical HL: favourable disease and intended for chemotherapy alone

early (stage I to II) classical HL: unfavourable disease (non-bulky or bulky) and intended for combined-modality therapy

early (stage I to II) classical HL: unfavourable disease (non-bulky) and intended for chemotherapy alone

early (stage I to II) classical HL: unfavourable disease (bulky) and intended for chemotherapy alone

advanced (stage III to IV) classical HL: intended for standard induction therapy (chemotherapy)

advanced (stage III to IV) classical HL: intended for standard induction therapy (chemoimmunotherapy)

advanced (stage III to IV) classical HL: intended for intensive induction chemotherapy

asymptomatic early (stage IA to IIA) NLPHL, non-bulky disease

asymptomatic early (stage IA to IIA) NLPHL, bulky disease; and symptomatic early (stage IB to IIB) NLPHL

advanced (stage III to IV) NLPHL

CONTÍNUA

refractory or relapsed classical HL

refractory or relapsed NLPHL

Colaboradores

Autores

Alison Moskowitz, MD

Associate Attending

Lymphoma Service

Memorial Sloan-Kettering Cancer Center

New York City

NY

Declarações

AM has received research support from ADC Therapeutics, Beigene, Miragen, Seattle Genetics, Merck, Bristol-Myers Squibb, Incyte, and SecuraBio. AM has received honoraria from Seagen, Affimed, Astra Zeneca, Bio Ascend, Imbrium Therapeutics L.P./Purdue, Janpix Ltd., Merck, Seattle Genetics, Pfizer, Tessa Therapeutics and Takeda.

Agradecimentos

Dr Alison Moskowitz would like to gratefully acknowledge Dr Chris R. Kelsey, Dr Leonard R. Prosnitz, and Dr Timothy M. Zagar, the previous contributors to this topic.

Declarações

CRK, LRP, and TMZ declare that they have no competing interests.

Revisores

Joachim Yahalom, MD

Radiation Oncologist

Director of Postgraduate Education

Department of Radiation Oncology

Memorial Sloan-Kettering Cancer Center

New York

NY

Declarações

JY declares that he has no competing interests.

Rebecca Connor, MD

Chief Fellow

Section of Hematology and Oncology

Department of Internal Medicine

Wake Forest University Baptist Medical Center

Winston-Salem

NC

Declarações

RC declares that she has no competing interests.

Kirit Ardeshna, MD, MA (Cantab), MB, BChir, FRCP, FRCPath

Consultant Haematologist

University College London Hospitals

London

UK

Declarações

KA declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Eichenauer DA, Aleman BM, André M, et al. Hodgkin lymphoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018 Oct 1;29(4 suppl):iv19-29.Texto completo  Resumo

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: Hodgkin lymphoma [internet publication].Texto completo

Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014 Sep 20;32(27):3059-68.Texto completo  Resumo

Follows GA, Barrington SF, Bhuller KS, et al. Guideline for the first-line management of classical Hodgkin lymphoma - a British Society for Haematology guideline. Br J Haematol. 2022 Jun;197(5):558-72.Texto completo  Resumo

McKay P, Fielding P, Gallop-Evans E, et al. Guidelines for the investigation and management of nodular lymphocyte predominant Hodgkin lymphoma. Br J Haematol. 2016 Jan;172(1):32-43.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Hodgkin's lymphoma images
  • Diagnósticos diferenciais

    • Non-Hodgkin's lymphoma (NHL)
    • Lymphadenopathy from other malignancies
    • Infectious mononucleosis
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Suspected cancer: recognition and referral
    • NCCN clinical practice guidelines in oncology: Hodgkin lymphoma
    Mais Diretrizes
  • padlock-lockedConectar-se ou assinar para acessar todo o BMJ Best Practice

O uso deste conteúdo está sujeito ao nosso aviso legal