Hodgkin Lymphoma: The Daily PANCE Blueprint

Home Hodgkin Lymphoma: The Daily PANCE Blueprint

Hodgkin Lymphoma: The Daily PANCE Blueprint

A 28-year-old HIV-negative woman presents to the clinic with a painless neck mass she noticed 3 weeks ago. She denies any other symptoms. Physical examination reveals an enlarged, firm, non-tender, and mobile lymph node in the left anterior cervical region. No other abnormalities are noted on physical examination. Laboratory studies, including complete blood count and comprehensive metabolic panel, are within normal limits. A lymph node biopsy confirms the diagnosis of classic Hodgkin lymphoma. What is the next best step in the management of this patient?

A. Initiate chemotherapy immediately
B. Schedule for radiation therapy
C. Perform a PET/CT scan for staging
D. Refer for bone marrow biopsy
E. Begin corticosteroid treatment

Answer and topic summary

The answer is C. Perform a PET/CT scan for staging

Classic Hodgkin lymphoma (HL) typically presents with painless enlargement of lymph nodes, often in the neck or mediastinal region. Some patients may experience systemic symptoms like fever, weight loss, and night sweats, known as B symptoms, or generalized itching. The diagnosis is confirmed through a biopsy showing Reed-Sternberg cells. The treatment plan for HL depends on the specific tissue subtype, the stage of the disease, and the patient’s overall health and performance status. Before initiating treatment, a comprehensive evaluation is essential. This includes blood tests such as a complete blood count, erythrocyte sedimentation rate, and liver function tests. Imaging studies, particularly a PET/CT scan of the chest, abdomen, and pelvis, are critical for staging the disease. This imaging helps differentiate between benign masses and persistent lymphoma, especially in cases of suspected recurrence.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Hematology ⇒ Neoplasms, premalignancies, and malignancies  ⇒ Lymphoma

Also covered on the PAEA EOR topic blueprint for Internal Medicine, Family Medicine, and Emergency Medicine

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