This document discusses Hodgkin lymphoma, a type of lymphoma that arises in lymph nodes, most commonly in the cervical nodes. It describes the stages of Hodgkin lymphoma from Stage 1 involving a single site to Stage 4 with extensive extranodal involvement. It also discusses the classical and non-classical varieties based on markers and the different histological subtypes including nodular sclerosis, mixed cellularity, lymphocyte rich and lymphocyte depletion. Risk stratification is described based on factors like albumin and it outlines the standard ABVD chemotherapy regimen used to treat Hodgkin lymphoma.

1. - Dr. Akif A.B
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2. -Arises in Lymph nodes
-MC LN to involved is - Cervical
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3. -Pel Ebstein fever
-Asymptomatic lymphadenopathy
-Constitutional symptoms (unexplained weight loss [>10% of total
body weight] within the past 6 months, unexplained fever >38º C, or
drenching night sweats) collectively, these are known as "B symptoms
B symptoms
1) unexplained fever >38º C
2) unexplained weight loss
3) drenching night sweats
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4. (high fever for 1-2 wk, followed by an afebrile period of 1-2 wk)
- Observed only in 35% of patients
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5. STAGE 1 Only a single lymph node site or extranodal site is
involved
STAGE 2 Two or more lymph node sites on one side of the
diaphragm are involved, -, or limited contiguous
extranodal site involvement
STAGE 3 Lymph node sites on both sides of the diaphragm are
involved, with splenic or limited contiguous
extradodal site involvement
STAGE 4 Extensive involvement of extranodal sites, with or
without lymph node involvement
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6. Classical Variety
CD15+, CD30+
Non classical variety
CD15- , CD30- , CD20+
Nodular sclerosis Lymphocyte predominant
Mixed cellularity
Lymphocyte rich
Lymphocyte depletion
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7. Nodular
Sclerosis
Lacunar
cells,
Bands of
fibrosis
CD15+ ,
CD30+
Usually
EBV-
M=F Good
Prognosis
MC in
world
Mixed
cellularity
Mononucle
ar cells
CD15+ ,
CD30+
70% EBV+ M>F Good
prognosis
MC in
India
Lymphocy
te rich
Reed-
Sternberg
cell
CD15+ ,
CD30+
40% EBV+ M>F Good
prognosis
Lymphocy
te
Reed
sternberg
CD15+ ,
CD30+
90% EBV+ M>F Poorest
prognosis
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8. Bands of
fibrosis
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9. Bands of
fibrosis
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10. In this lymph node, there
are numerous scattered
large cells with a
surrounding prominent
clear space surrounding
the nucleus, an artefact of
formalin fixation.
These are the lacunar
cells characteristic for the
nodular sclerosis type of
Hodgkin lymphoma.
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12. Mixed cellularity Hodgkin lymphoma showing both
mononucleate and binucleate Reed-Sternberg cells in
a background of inflammatory cells
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13. Nodular Lymphoctye Predominant
Hodgkin lymphoma (NLPHL), with a
popcorn-shaped Reed-Sternberg cel
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14. Albumin <4 g/dL
Hemoglobin <10.5 g/dL
Male
Age ≥45 y
Stage IV disease
Leukocytosis: white blood cell count (WBC)
>15,000/Μl
Lymphopenia: Lymphocyte count <8% of WBC and/or
absolute lymphocyte count <600 cells/μL
Good risk : 0-1
Fair risk : 2-3
Poor risk : 4-7
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15. A -Adriamycin
B -Bleomycin
V - Vinblastine
D - Dacarbazine
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