Test your knowledge on Hodgkin's lymphoma

Read the haematology article on Hodgkin's lymphoma then answer these three questions to check your understanding. You may want to document your answers and any learning points to save in your CPD Organiser along with the article.


Read our clinical feature on Hodgkin's Lymphona

TEST YOUR KNOWLEDGE ON HODGKIN'S LYMPHOMA
Question 1

A young man, previously weighing 80kg, presents with approximately 10 kg weight loss in the preceding six months, and mild chest discomfort. He is found to have extensive mediastinal lymphadenopathy and tissue obtained at mediastinoscopy confirms a diagnosis of Hodgkin’s lymphoma. His bone marrow biopsy is negative and PET/CT scanning shows, in addition to mediastinal lymphadenopathy, several 1-2cm supraclavicular and axillary nodes which strongly take up the FDG tracer. Bone marrow biopsy is negative. Using the Ann-Arbor system, what stage disease does he have?

Answer

Stage 2B. Disease is present at more than one site but is confined to lymph nodes, all on the same side of the diaphragm. Weight loss of ≥ 10 per cent is a ‘B’ symptom.

Question 2

The patient is finding it hard to come to terms with the diagnosis.  He is a smoker who has recently led a sedentary lifestyle. He wants to know what caused his lymphoma.  What would you tell him?

Answer
In the vast majority of patients with Hodgkin’s lymphoma, no underlying cause is identified. There is no link with lifestyle factors such as smoking or alcohol consumption. There is very little chance of anyone in his family being similarly affected.
Question 3

The patient embarks on a course of combination chemotherapy (ABVD).  What is the approximate probability that he will ultimately die of Hodgkin’s lymphoma?

Answer

Approximately 10-15 per cent of such patients will ultimately die from relapsed or refractory disease. About 75 per cent are likely to be cured with first-line chemotherapy; about half of those who are refractory or who subsequently relapse achieve cure with further treatment.

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