小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 淋巴结肿大
其他诊断因素
- 不明原因的发热
- 盗汗
- 体重减轻
- 呼吸困难
- 咳嗽
- 胸痛
- 上腔静脉综合征
- 腹痛
- 全身瘙痒
- 累及部位有饮酒导致的疼痛症状
- 肝大和/或脾大
- 扁桃体肿大
危险因素
- EB 病毒 (EBV) 感染病史
- 霍奇金淋巴瘤家族史
- 社会经济地位较高的年轻成人
- HLA 类型
- 犹太人血统
诊断性检查
首要检查
- FBC 和分类计数
- 生化检查
- 红细胞沉降率 (ESR)
- 胸部 X 线检查 (CXR)
- PET-CT 扫描
- 镓扫描
- 颈部、胸部、腹部/盆腔增强 CT 检查
- 淋巴结切除活检
- 免疫组织化学检查
需考虑的检查
- 骨髓活检
- 甲状腺功能检测
- 超声心动图或多门控采集 (MUGA) 扫描
- 肺功能检查 (PFT)
治疗流程
典型霍奇金淋巴瘤 (HL) 早期(I 期 - II 期)
典型霍奇金淋巴瘤 (HL) 晚期(III 期 - IV 期)
结节性淋巴细胞为主的霍奇金淋巴瘤 (HL) 早期(I 期 - II 期)
结节性淋巴细胞为主的霍奇金淋巴瘤 (HL) 晚期(III 期 - IV 期)
使用一线治疗方案后难治性疾病或复发性疾病
撰稿人
作者
Alison Moskowitz, MD
Assistant Attending
Lymphoma Service
Memorial Sloan-Kettering Cancer Center
New York City
NY
利益声明
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.
鸣谢
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.
利益声明
CRK, LRP, and TMZ declare that they have no competing interests.
同行评议者
Joachim Yahalom, MD
Radiation Oncologist
Director of Postgraduate Education
Department of Radiation Oncology
Memorial Sloan-Kettering Cancer Center
New York
NY
利益声明
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
利益声明
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
利益声明
KA declares that he has no competing interests.
鉴别诊断
- 非霍奇金淋巴瘤 (NHL)
- 其他恶性肿瘤导致的淋巴结病
- 传染性单核细胞增多症
更多 鉴别诊断指南
- NCCN 肿瘤学临床实践指南:霍奇金淋巴瘤
- 采用本妥昔单抗治疗 CD30 阳性霍奇金淋巴瘤
更多 指南登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
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