Recognizing Unusual Manifestations of Hodgkin Lymphoma
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Hodgkin lymphoma (HL) is a rare malignancy of the lymphatic system that is curable in at least 80 % of patients. Although patients usually present with painless lymphadenopathy, a variety of systemic and organ-specific syndromes may also exist in relation to HL. These syndromes may develop before, during, or after the diagnosis of HL and may also indicate disease relapse. Most of these unusual disorders resolve with successful HL treatment but some may require adjunctive supportive therapies before a response is achieved. Oncologists should be familiar with these syndromes because early recognition may result in a more timely diagnosis of HL which may lead to improved outcomes.
KeywordsHodgkin lymphoma Paraneoplastic Constitutional B-symptoms Cytokines Cutaneous Glomerulonephropathy Encephalitis Cytopenias Cholestasis
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- 1.• Bierman PJ, Cavalli F, Armitage JO. Unusual syndromes in Hodgkin Lymphoma. In: Hoppe RT, Mauch PT, Armitage JO, et al., editors. Hodgkin lymphoma. 2nd ed. Philadelphia: Lippincott Williams and Wilkins; 2007. p. 411–8. A thorough review of less-common manifestations of HL.Google Scholar
- 3.Tubiana M, Attie E, Flamant R, et al. Prognostic factors in 454 cases of Hodgkin’s disease. Cancer Res. 1801;1971:31.Google Scholar
- 4.National Comprehensive Cancer Network: Hodgkin Lymphoma Guidelines. Available at: www.nccn.org.
- 12.Mukesh M, Shuttleworth D, Murray P. Primary cutaneous Hodgkin’s lymphoma. Clin Derm. 2009, 673–5.Google Scholar
- 15.• Grimm S, Chamberlain M. Hodgkin’s lymphoma: a review of neurologic complications. Adv Hem. 2011, Article ID 624578. A thorough review of paraneoplastic as well as non-paraneoplastic neurologic manifestations of HL. Google Scholar
- 25.• Audard V, Larousserie F, Grimbert P, et al. Minimal change nephrotic syndrome and classical Hodgkin’s lymphoma: report of 21 cases and review of the literature. Kidney Int. 2006;69:2251–60. A very descriptive and large case series that explains clinical features and outcomes of patients with HL and MCNS.PubMedCrossRefGoogle Scholar
- 26.• Audard V, Zhang S, Copie-Bergman C, et al. Occurance of minimal change nephrotic syndrome in classical Hodgkin lymphoma is closely related to the induction of c-mip in Hodgkin-Reed Sternberg cells and podocytes. Blood. 2010;115:3756–62. An experimental explanation of the pathophysiology of MCNS in HL.PubMedCrossRefGoogle Scholar
- 32.Von Wasielewski R, Seth S, Franklin J, et al. Tissue eosinophilia correlates strongly with poor prognosis nodular sclerosing Hodgkin’s disease, allowing for known prognostic factors. Blood. 2000;95:1207–13.Google Scholar
- 36.Fahey JL, Rahbar S, Farbstein MJ, et al. Microcytosis in Hodgkin disease associated with unbalanced globin chain synthesis. 2006;23:123–9.Google Scholar
- 40.Banerjee D. Recent advances in the pathobiology of Hodkin’s lymphoma: potential impact on diagnostic, predictive, and therapeutic strategies. Adv Hem. 2011, Article ID 439456.Google Scholar