HL

Question 1

Malignancy of mature B lymphocytes

Answer 1

Hodgkin’s Lymphoma

Question 2

4 Histologic subtypes of HL

Answer 2

1. Nodular sclerosis – most common in young adults (US)
2. Mixed cellularity
3. Lymphocyte-rich
4. Lymphocyte-depleted

nodular sclerosis + mixed cellularity = ~95% of cases

Question 3

Diagnostic cell of cHL

Answer 3

**Reed-Sternberg (HRS) **

Large cell
Abundant cytoplasm
Bilobed or multinucleated nucleus

Question 4

Detected in 20–40% of all HL

~100% of HIV-associated cHL

Answer 4

Epstein-Barr virus (EBV)

EBV genomes are episomal & clonal → supports role in early lymphomagenesis

Question 5

Rare cyclic fever pattern in HL

Answer 5

PEL EBSTEIN FEVER

days–weeks of fever – afebrile interval – recurrence

Question 6

STANDARD FOR STAGING

more sensitive than bone marrow biopsy

bone marrow involvement is patchy in cHL

Answer 6

PET/CT scan

Question 7

Tumor features of HL

Answer 7

rare malignant B cells (Reed-Sternberg cells)

immunoglobulin genes rearranged but not expressed

background of polyclonal inflammatory infiltrate

Question 8

Treatment of HL

Answer 8

HIGHLY CURABLE
chemotherapy alone or chemotherapy + radiotherapy

ADVANCED-stage disease:
No benefit from routine radiotherapy

Question 9

EARLY-STAGE cHL (Stage I–II)

Answer 9

ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine)

given every 2 weeks
1 cycle = 2 treatments

Question 10

ADVANCED-STAGE cHL (Stage III–IV)

Answer 10

ABVD ×6 cycles

NO ROUTINE RADIOTHERAPY AFTER COMPLETE RESPONSE

RADIOTHERAPY INCREASES RISK OF:
secondary malignancies
thyroid disease
premature cardiovascular disease and stroke

Question 11

RELAPSED cHL

Answer 11

Salvage chemotherapy → autologous stem cell transplant (ASCT)

Cure rate: >50% if chemo-sensitive

Question 12

COMMON SALVAGE REGIMENS

Answer 12

ICE (ifosfamide, carboplatin, etoposide)

GND (gemcitabine, vinorelbine, doxorubicin)

Question 13

MC presentation of HL

Answer 13

FEVER