Protocols - Hemorio

HODGKIN’S LYMPHOMA
LABORATORIAL TESTS:
- tumor histopathology, with immunohistochemistry
- hemogram, VHS
- biochemistry
- hepatic and renal function proofs
- LDH and reactive C-protein
- chest X-ray
- chest, abdomen, and pelvis CT
- cervical area CT, if applicable
- serology (hepatitis B, hepatitis C, HTLV1, HIV, EVB)
- bone marrow biopsy
- echocardiogram
- β-HCG for women with a child-bearing potential.
CLASSIFICATION: WHO
- Nodular lymphocytic predominance:CD3, CD15, CD20, CD21, CD30, CD57, with no association to EBV.
- Classic Hodgkin’s lymphoma (including nodular sclerosis, mix cellularity, lymphocytic depletion, and rich
in lymphocytes): CD3, CD15, CD20, CD30, CD45 with EBV association.
- nodular sclerosis
- Mix Cellularity
- Lymphocytic depletion
- Rich in lymphocytes
STAGING: ANN ARBOR / COTSWOLD INCLUSIONS
I- involvement of an only extralymphatic site or a lymph node.
II- one or more regional lymph nodes in the same side of diaphragm and extralymphatic in the same side.
(E)
III- attack in both sides of the diaphragm, it may include the spleen (S)
IV- extralymphatic diffuse involvement.
A - Absence of symptoms
B - Symptoms: weight loss > 10% in 6 months, fever >38, recurrent nocturnal sweating.
“Bulky” tumor - nodal mass >10 cm of diameter or 1/3 of the chest transversal diameter.
PROGNOSTIC FACTORS:
- serum albumin