Hodgkin lymphoma
Summary
Definition
History and exam
Key diagnostic factors
- lymphadenopathy
Other diagnostic factors
- unexplained fevers
- night sweats
- weight loss
- dyspnea
- cough
- chest pain
- superior vena cava syndrome
- abdominal pain
- generalized pruritus
- alcohol-induced pain at involved sites
- hepatomegaly and/or splenomegaly
- tonsillar enlargement
Risk factors
- history of Epstein-Barr virus (EBV) infection
- family history of Hodgkin lymphoma
- young adults from higher socioeconomic class
- HLA types
- Jewish ancestry
Diagnostic investigations
1st investigations to order
- CBC with differential
- metabolic panel
- erythrocyte sedimentation rate (ESR)
- CXR
- PET-CT scan
- gallium scan
- contrast CT neck, chest, and abdomen/pelvis
- excisional lymph node biopsy
- immunohistochemical studies
Investigations to consider
- bone marrow biopsy
- thyroid function tests
- echocardiogram or multigated acquisition (MUGA) scan
- pulmonary function tests
Treatment algorithm
early (stage I to stage II) classical HL
advanced (stage III to stage IV) classical HL
early (stage I to stage II) nodular lymphocyte-predominant HL
advanced (stage III to stage IV) nodular lymphocyte-predominant HL
refractory and relapsed disease after first-line therapy
Contributors
Authors
Alison Moskowitz, MD
Assistant Attending
Lymphoma Service
Memorial Sloan-Kettering Cancer Center
New York City
NY
Disclosures
AM has received honoraria for serving on advisory boards for Seattle Genetics, BMS, Merck, and Erytech. She has received honoraria from Seattle Genetics and Takeda for educational lectures.
Acknowledgements
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.
Disclosures
CRK, LRP, and TMZ declare that they have no competing interests.
Peer reviewers
Joachim Yahalom, MD
Radiation Oncologist
Director of Postgraduate Education
Department of Radiation Oncology
Memorial Sloan-Kettering Cancer Center
New York
NY
Disclosures
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
Disclosures
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
Disclosures
KA declares that he has no competing interests.
Differentials
- Non-Hodgkin lymphoma (NHL)
- Lymphadenopathy from other malignancies
- Infectious mononucleosis
More DifferentialsGuidelines
- NCCN clinical practice guidelines in oncology: Hodgkin lymphoma
- Hodgkin lymphoma
More Guidelines
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