Ms. Y is a 31-year-old woman who reported to her physician that she has recently
ID: 139142 • Letter: M
Question
Ms. Y is a 31-year-old woman who reported to her physician that she has recently lost weight, always seems tired, and has experienced night sweats. A few months ago, she had noticed a small firm lump on her neck that was painless and not tender, so she ignored it. Closer physical examination revealed a swelling of several lymph nodes in the neck and throat region. A blood test indicated a decreased lymphocyte count and a lymph node biopsy revealed the presence of Reed-Sternberg cells, confirming the diagnosis of Hodgkin's lymphoma. Discussion Questions Relate the pathophysiologic changes to the manifestations and lab results. (See Hodgkin's Disease/Lymphoma—Pathophysiology, Signs and Symptoms.) Discuss the four stages of the disease based on the Ann Arbor staging system, and determine which stage the patient is probably in. Discuss the prognosis. (See Pathophysiology—Staging Systems.) Discuss the treatment options for this patient. (See Treatment.) Discuss the differences between Hodgkin's and non-Hodgkin's Lymphomas. (See Non-Hodgkin's Lymphoma.)
Explanation / Answer
Stages of lymphoma:
Stage 1 : one lymph node involved
Stage 2: Multiple lymph node on same side of diaphragm
Stage 3: Multiple lymph node on both sides of diaphragm
Stage: 4: Multiple extra nodal side of lymph nods.
II. This patient is having multiple extra nodal involvement. So patient is on stage 4.
III. Prognosis:
Above case scenario patient is in 4 th stage lymphoma, so prognosis is poor.
IV. Treatment:
Combination of chemotherapy includes DBVD like Doxorubicin, Vinblastin, Bleomycin, Dacarbazine.
V. difference between both:
Hodgkin's Non Hodgkin's Most often localized single axial involved. Involvement of multiple peripheral nodded involved. Contagious Non contagious Mesentric node rarely involved. Mesentric node commonly involved. Extra nodal involvement uncommon. Extra nodal involvement common.Related Questions
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