A male patient 59 year old complains of multiple swellings in the neck, fever, and weight loss. He gives a history of hypertension treatment. General examination reveals painless lymph nodal enlargement in the neck and on blood investigation, anaemia is revealed. Lymph node biopsy shows typical owl eye-shaped appearance cells. What can be the most probable diagnosis for this patient?
Correct Answer: Hodgkin’s lymphoma
Description: Hodgkin lymphoma, like NHL, usually manifests as painless lymphadenopathy. Although a definitive distinction from NHL can be made only by examination of a tissue biopsy, several clinical features favor the diagnosis of Hodgkin lymphoma. After the diagnosis is established, staging is used to guide therapy and determine prognosis.
Younger patients with more favorable subtypes tend to present with stage I or stage II disease and usually are free of so-called “B symptoms” (fever, weight loss, night sweats). Patients with advanced disease (stages III and IV) are more likely to exhibit B symptoms as well as pruritus and anemia.
The sine qua non of Hodgkin lymphoma is the Reed-Sternberg (RS) cell, a very large cell (15 to 45 µm in diameter) with an enormous multilobate nucleus, exceptionally prominent nucleoli, and abundant, usually slightly eosinophilic cytoplasm. Particularly characteristic are cells with two mirror-image nuclei or nuclear lobes, each containing a large (inclusion-like) acidophilic nucleolus surrounded by a clear zone, features that impart an owl-eye appearance.
Difference between Hodgkin Lymphoma and Non-Hodgkin Lymphoma
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Pathology
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