1
Q
What are some characteristics of Hodgkin’s Lymphoma?
A
- A malignant lymphoma first characterized by Thomas Hodgkin in 1832
- HL progresses from one (1) group of LNs to another and includes the development of systemic symptoms and the presence of B cells called Reed-Sternberg (RS) cells
- Incidence of HL is higher in males with median age of 64 at diagnosis
- Incidence greater in Caucasians
- HL peaks at two (2) different ages: early in life (2nd & 3rd decade) and later in life (6th & 7th decade)
2
Q
Describe the pathophysiology associated with Hodgkin’s Lymphoma
A
- Reed-Sternberg (RS) cells represent the malignant transformed lymphocytes and are the HALLMARK of HL and are necessary for the diagnosis of HL
- The triggering mechanism for malignant transformation of cells remains unknown.
- Classic HL appears to be derived from a B cell in the germinal center that has not undergone successful immunoglobulin gene rearrangement and would normally be induced to undergo apoptosis.
- Survival of this cell may be linked to infection with EBV.
- Studies have linked HL with EBV infection and EBV DNA.
- The RS cells secrete and release cytokines that result in the accumulation of inflammatory cells that produces local and systemic effects.
HL is subcategorized into two (2) main types:
- Classic Hodgkin’s – which is further subcategorized into four (4) types
- Nodular lymphocyte predominant Hodgkin’s
3
Q
What are the Symptoms/Physical Exam findings associated with Hodgkin’s Lymphoma?
A
- Enlarged, painless LN in neck(classic presenting sign)
- Discovering of mediastinal mass on routine chest x-ray- asymptomatic
- Cervical, axillary, inguinal and retroperitoneal LNs commonly affected in HL
- Fever, weight loss, night sweats
- Pruritus
4
Q
What are the laboratory findings associated with Hodgkin’s Lymphoma?
A
- Presence of Reed-Sternberg (RS) cells on lymph node biopsy
- Thrombocytosis
- Leukocytosis
- Eosinophilia
- Elevated ESR
- Elevated alkaline phosphatase
- Paraneoplastic syndrome
5
Q
What is Burkitt’s Lymphoma?
A
- It is a rare but highly aggressive B-cell Non-Hodgkin’s Lymphoma.
- Translocation of a gene called MYC is a HALLMARK of Burkitt lymphoma
- In adults, Burkitt Lymphoma is often indistinguishable from diffuse Large B cell Lymphoma- another aggressive B cell lymphoma
- Endemic Burkitt lymphoma originates in Africa and is associated with the Epstein-Barr virus (ON TEST); its incidence rate is about 50 times higher in equatorial Africa and New Guinea than in the U.S.
6
Q
What are the symptoms associated with Non-Hodgkin’s Lymphoma?
A
- Lymphadenopathy- painless, widespread or isolated
- Patients may be asymptomatic
- Fever
- Night sweats
- Weight loss
- Abdominal fullness- with Burkitt lymphoma may have bowel obstruction
- Splenomegaly
- Hepatomegaly
- Extra-nodal sites of disease- skin ulcers
