TAILIEUCHUNG - Chapter 105. Malignancies of Lymphoid Cells (Part 24)

A number of other late side effects from the treatment of Hodgkin's disease are well known. Patients who receive thoracic radiotherapy are at very high risk for the eventual development of hypothyroidism and should be observed for this complication; intermittent measurement of thyrotropin should be made to identify the condition before it becomes symptomatic. Lhermitte's syndrome occurs in ~15% of patients who receive thoracic radiotherapy. This syndrome is manifested by an "electric shock" sensation into the lower extremities on flexion of the neck. Infertility is a concern for all patients undergoing treatment for Hodgkin's disease. In both women and. | Chapter 105. Malignancies of Lymphoid Cells Part 24 A number of other late side effects from the treatment of Hodgkin s disease are well known. Patients who receive thoracic radiotherapy are at very high risk for the eventual development of hypothyroidism and should be observed for this complication intermittent measurement of thyrotropin should be made to identify the condition before it becomes symptomatic. Lhermitte s syndrome occurs in 15 of patients who receive thoracic radiotherapy. This syndrome is manifested by an electric shock sensation into the lower extremities on flexion of the neck. Infertility is a concern for all patients undergoing treatment for Hodgkin s disease. In both women and men the risk of permanent infertility is age-related with younger patients more likely to recover fertility. In addition treatment with ABVD rather than MOPP increases the chances to retain fertility. Nodular Lymphocyte-Predominant Hodgkin s Disease Nodular lymphocyte-predominant Hodgkin s disease is now recognized as an entity distinct from classical Hodgkin s disease. Previous classification systems recognized that biopsies from a subset of patients diagnosed as having Hodgkin s disease contained a predominance of small lymphocytes and rare Reed-Sternberg cells. A subset of these patients have tumors with nodular growth pattern and a clinical course that varied from that of patients with classical Hodgkin s disease. This is an unusual clinical entity and represents 5 of cases of Hodgkin s disease. Nodular lymphocyte-predominant Hodgkin s disease has a number of characteristics that suggest its relationship to non-Hodgkin s lymphoma. These include a clonal proliferation of B cells and a distinctive immunophenotype tumor cells express J chain and display CD45 and epithelial membrane antigen ema and do not express two markers normally found on Sternberg-Reed cells CD30 and CD15. This lymphoma tends to have a chronic relapsing course and sometimes transforms to diffuse .

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