18 Questions
Nodular Sclerosing Hodgkin Lymphoma is characterized by lacunar cells in a densely fibrotic stroma.
True
Lymphocyte depletion type of Hodgkin’s lymphoma is characterized by abundant lymphocytes in the affected areas.
False
Involvement of two or more lymph node regions on the same side of the diaphragm corresponds to Stage II in the Ann Arbor Staging System for Non-Hodgkin's Lymphoma.
False
Presence of B symptoms such as fever, night sweats, and unexplained weight loss are considered adverse prognostic features in Hodgkin's Disease.
True
Stage IV in the Ann Arbor Staging System indicates localized involvement of an extralymphatic organ or site on both sides of the diaphragm.
False
Hodgkin's Disease Stage III may involve lymph node regions on both sides of the diaphragm and may be accompanied by involvement of the spleen.
True
In Hodgkin Disease/ Lymphoma, an adverse prognostic feature for stage I & II (EORTC data) includes ESR below 50.
False
According to the Ann Arbor Staging System, bulk is defined as a nodal mass greater than 5 cm.
False
Presence of more than 3 nodal sites is considered an adverse prognostic feature for B cell malignancies.
True
B symptoms include recurrent drenching night sweets and unexplained weight gain of more than 10% of body weight during the previous 6 months.
False
Non-Hodgkin's lymphoma is classified under lymphoid solid masses.
True
Critical organs invasion is considered an adverse prognostic feature for Hodgkin's Disease.
True
Lymph node involvement is more common in Hodgkin's Disease compared to Non-Hodgkin's Lymphoma.
True
B symptoms in Hodgkin's Disease include fever, weight loss, and night sweats.
True
In Hodgkin's Disease, neoplastic cells make up the majority of the cells in the affected tissue.
False
The Ann Arbor Staging System is commonly used for staging Non-Hodgkin's Lymphoma.
True
Lymphocyte-predominant Hodgkin's is the most common type of Hodgkin's Disease.
False
Untreated Hodgkin's Disease has a high cure rate of over 80% with chemotherapy.
False
Study Notes
Hodgkin's Lymphoma
- Nodular Sclerosing Hodgkin Lymphoma features lacunar cells and a densely fibrotic stroma with scanty lymphocytes.
- Lymphocyte depletion type of Hodgkin's lymphoma is characterized by numerous atypical cells in a densely fibrotic stroma with scanty lymphocytes.
Staging and Classification
- Ann Arbor Staging System for Hodgkin's Disease and Non-Hodgkin's Lymphoma has four stages:
- Stage I: Involvement of a single lymph node region or a single extralymphatic organ or site.
- Stage II: Involvement of two or more lymph node regions on the same side of the diaphragm.
- Stage III: Involvement of lymph node regions on both sides of the diaphragm.
- Stage IV: Diffuse or disseminated involvement of one or more extra lymphatic organs or tissues.
- "B" symptoms include fever > 38°C for three consecutive days, drenching night sweats, or unexplained loss of 10% or more of weight in the preceding six months.
Clinical Presentation
- Common symptoms include lymphadenopathy, mediastinal mass, "B" symptoms, and hepatosplenomegaly.
- The most commonly involved lymph nodes are the cervical and supraclavicular in 75% of cases.
- Bone marrow is involved in 5% of patients.
Pathogenesis and Prognosis
- The pathogenesis of HD is still largely unknown.
- HD nearly always arises and disseminates in lymph nodes.
- Without treatment, 90% of patients die within 2-3 years.
- With chemotherapy, >80% of patients are cured.
Subtypes of Hodgkin's Lymphoma
- "Classic" Hodgkin's Disease subtypes include:
- Nodular sclerosis
- Mixed cellularity
- Lymphocyte-depleted
- Lymphocyte-rich
- Nodular lymphocyte-predominant Hodgkin's lymphoma (LPHD) makes up ~5% of cases and has B cell markers CD20 and surface immunoglobulin.
Adverse Prognostic Features
- Adverse prognostic features for stage I & II include:
- More than three nodal sites
- Bulky adenopathy
- ESR > 50
- B symptoms
- Invasion into critical organs
- Male age > 40
- MC or LD subtype
Test your knowledge on the Modified Ann Arbor Staging criteria for Hodgkin Disease and Lymphoma. This quiz covers topics such as extranodal disease, B symptoms, bulk criteria, adverse prognostic features, and more.
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