Hodgkin's Lymphoma

Bharat R Agarwal
Hodgkin's Lymphoma - Diagnosis
Any peripheral lymph node > 1 cm in size that does not regress after 6 weeks of observation should be biopsied. (Care should be taken not to biopsy the edge of the lymph node as it as it may appear as "reactive" on histopathology, but central nodes should be biopsied.) Once, the diagnosis is confirmed, it is necessary to determine the stage of the disease for prognosis and treatment evaluation. Staging is based on a combination of history, physical examination, and x-rays (including CT Scan of chest, abdomen and pelvis), gallium scan, bone marrow biopsy and laboratory biochemical profile. In patients with mediastinal mass, if pleural effusion is present, a thoracocentesis should be done as cytological diagnosis is possible. Mediastinoscopy, anterior mediastinotomy and thoracoscopy are procedures of choice when other methods fail to establish the diagnosis.

Pathologic staging requires laparotomy with splenectomy, retroperitoneal lymph node biopsy and liver biopsy. However in children, chemotherapy alone, has been used increasingly for treatment. Hence, staging laparotomy is rarely required.

Hodgkin's Lymphoma Hodgkin's Lymphoma 01/04/2001
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