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Hodgkin's Lymphoma Assessment

Hog-king with Lime-foam and Assess-man
Picmonic
Hodgkin's lymphoma is a malignant condition caused by the proliferation of Reed-Sternberg cells in lymph node tissue. Causes include lymph node cancer which may spread along adjacent lymph nodes. Symptoms include painless lymphadenopathy and B symptoms including fever, night sweats, and weight loss. Hodgkin's lymphoma occurs most frequently in teenagers and individuals over 50 years old.
9 KEY FACTS
CAUSE
Lymph Node Cancer
Lime-nose and Tumor-guy

Lymph node cancer may lead to the development of Hodgkin's lymphoma, a type of blood cancer that affects lymphocytes. Cancerous lymph nodes cause DNA mutation and lead to the dysfunctional production of B cells that spread across the lymphatic system.

Contiguous Spread
Contiguous Trail

In a large percentage of patients with Hodgkin's lymphoma, the disease arises in the cervical lymph nodes. The disease contiguously spreads along adjacent lymph nodes and affects other areas. Hodgkin's lymphoma eventually infiltrates other organs including the lungs, liver, and spleen. Patients with recurrent disease may experience more diffuse, instead of contiguous, spread of Hodgkin's lymphoma.

ASSESSMENT
Painless Lymphadenopathy
No Pain-bolt sign with Lymph-lime-add (+)

Painless lymphadenopathy is a characteristic symptom of Hodgkin's lymphoma. Swollen lymph nodes remain movable and may indicate malignancy. Commonly affected lymph nodes include cervical, axillary, or inguinal lymph nodes.  Drinking alcohol may cause rapid onset of pain at the lymph nodes.

Constitutional B Signs
Constitution Bee

The patient with Hodgkin's lymphoma may experience a group of distinct symptoms known as B symptoms. Symptoms include fever, night sweats, weight loss, chills, and tachycardia. The presence of B symptoms indicate poor prognosis (refer to the Picmonic on “Hodgkin’s Lymphoma Interventions”).

Night Sweats
Moon Sweat

Night sweats are characteristic of Hodgkin's lymphoma and may indicate acute infection. Since the patient may wake up drenched in sweat, teach the patient comfort measures, such as wearing loose cotton clothing to absorb sweat and installing fans to circulate air.

Fever
Fever-beaver

Since Hodgkin's lymphoma greatly impairs the immune response, the patient has an increased risk of developing infection. Elevated levels of eosinophils, a type of white blood cell responsible for engulfing antigen-antibody complexes, are found in patients with Hodgkin's lymphoma . Fever in excess of 100.4°F (38°C) is a characteristic symptom of acute infection that may be caused by Hodgkin's lymphoma. Severe viral or fungal infections may lead to death.

Weight Loss
Skinny-with-baggy-pants

Unexplained weight loss exceeding 10% of the patient's body weight within 6 months is a characteristic symptom of Hodgkin's lymphoma. Weight loss is a part of the B symptoms found in patients diagnosed with Hodgkin's lymphoma.

CONSIDERATIONS
Bimodal Age Distribution
Graph with Bimodal-peaks

Hodgkin's lymphoma has a bimodal age distribution with a higher incidence in certain age populations. The condition more commonly affects individuals between 15 to 35 years old and over 50 years old.

Reed-Sternberg Cells
Red-stone-bird

Reed-Sternberg cells are abnormally large multinucleated cells that are found during lymph node biopsy. The presence of Reed-Sternberg cells is the main diagnostic finding in Hodgkin's lymphoma.

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