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1、HodgkinDiseaseDefinition:neoplasticdisorderwithdevelopmentofspecificinfiltratecontainingpathologicReed-Sternbergcells.Itusuallyarisesinlymphnodesandspreadstocontiguousgroups.Extranodalpresentationarerare.Diseaseisassociatedwithdefectivecellularimmunity.HodgkinDiseaseInciden
2、ce:-2-4casesper100000population/year-bimodalagedistribution:15-35yearsandabove50years-malepredominanceM:F=1,7:1ClinicalPresentationNontenderlymphnodesenlargement(localised)neckandsupraclaviculararea60-80%mediastinaladenopathy50%other(abdominal,extranodaldisease)systemicsymp
3、toms(Bsymptoms)30%fevernightsweatsunexplainedweightloss(10%per6months)othersymptomsfatigue,weakness,prurituscough,chestpain,shortnessofbreath,venacavasyndromeabdominalpain,boweldisturbances,ascitesbonepainDiagnosisofHodgkinDiseaseisbasedonmicroscopicexaminationoflymphnodeor
4、otherinvolvedtissueitrequiresidentificationofdiagnosticReed-SternbergcellsPathologicClassificationWHOClassicalHodgkindiseaselymphocyterich(LR)nodularsclerosis1and2(NS)mixedcellularity(MC)lymphocytedepletion(LD)Hodgkinlymphomawithlymphocytepredominance(LP)StagingClassificati
5、onAnnArbormodifiedbyCotswoldsStageI:involvementofsinglelymphnoderegionorlymphoidstructureStageII:involvementoftwoormorelymphnoderegionsonsamesideofdiaphragmStageIII:involvementoflymphnoderegionsorstructuresonbothsidesofdiaphragmIII1:withsplenichilar,celiac,portalnodesIII2:w
6、ithpara-aortic,iliac,mesentericnodesStageIV:involvementofextranodalsite(s)A.AsymptomaticB.Symptomatic(Bsymptoms)X.Bulkydisease(>1/3wideningofmediastinum,>10cmmax.dimensionofnodalmass)E.Involvementofasingle,localised,extranodalsiteStagingevaluationforHodgkin’sDisease(1)Essen
7、tialpathologicdocumentationbyhemopathologistphysicalexaminationdocumentationofBsymptomslaboratoryevaluationcompletebloodcount,ESRliverfunctiontestsrenalfunctiontestslactatedehydrogenasechestradiographultrasonographyCTscanofchest,abdomenandpelvisbonemarrowaspiration/biopsy(b
8、ilateral)StagingevaluationforHodgkin’sDisease(2)Essentialundercertaincircumstances
