Resident’s Conference. Cynthia Lan, MD June 21, 2005. Case presentation. CC: “I have a knot under my chin”
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Cynthia Lan, MDJune 21, 2005
CC: “I have a knot under my chin”
HPI: 29 AAF who c/o “knot” under her chin x 1 week. About 2 weeks ago, she had some upper respiratory symptoms (nasal congestion, rhinorrhea, sore throat). She went to see her doctor and was given amoxicillin. Her respiratory symptoms resolved, but the mass under her chin remained. The patient does not feel the mass has grown in size, but it has not decreased in size either so she was concerned.
She denies fevers, chills, or weight loss. ROS otherwise negative.
PMH: 1) Asthma
2) C sxn x 2
Soc Hx: Married. Has 3 healthy children, ranging from ages 9 to 13. Works as store manager at Albertson’s. Occasional ETOH use. Quit smoking 5 years ago. Denies IV drug abuse.
FH: Negative for cancer
CD30 + Hodgkin’s lymphoma, nodular sclerosing type. Immunohistochemical studies were positive for CD15 and CD30, and are negative for CD45 and CD 20.
CD15 + Hodgkin’s lymphoma, nodular sclerosing type. Immunohistochemical studies were positive for CD15 and CD30, and are negative for CD45 and CD 20.
CD20 Hodgkin’s lymphoma, nodular sclerosing type. Immunohistochemical studies were positive for CD15 and CD30, and are negative for CD45 and CD 20.-
in incidence, age of onset, or genotype
of Epstein-Barr virus infection;
crowding during childhood as a result of
lower socioeconomic status, or intrinsic
genetic differences in susceptibility.
Dr. William Osler, and in 1901 she won a
pathology fellowship with Dr. William Welch.
Working in the Hopkins laboratories, she
first clearly separated tuberculosis from
Hodgkin's disease, and maintained that the
term Hodgkin disease should be limited to
histological findings in which "her"
giant cells were present. She later won
international recognition for her work.
I Involvement of single LN region or lymphoid structure (spleen)
II Involvement of 2 or more LN regions on the same side of the diaphram
III Involvement of LN regions on both sides of the diaphram
III1 Limited to spleen, splenic hilar nodes, celiac nodes, or portal nodes
III2 Includes para-aortic, iliac, or mesenteric nodes plus those in stage III1
IV Involvement of extranodal sites beyond that designated as “E” (see next slide); more than one extranodal deposit at any location, any involvement of liver or bone marrow.
A No B symtoms
B Unexplained weight loss greater than 10% in the last 6 months, unexplained fever >100.4 F in the past month, recurrent drenching night sweats in the past month
X Bulky disease, mass greater than 10 cm, mediastinal mass greater than 1/3 the chest diameter at T5-6
E Localized solitary involvement of extralymphatic tissue, except liver and bone marrow
(ABVD = doxorubicin, bleomycin, vinblastine, dacarbazine)
Randomized Comparison of ABVD Chemotherapy With a Strategy that includes radiation therapy in patients with limited-stage Hodgkin’s lymphoma: National Cancer Institute of Canada Clinical Trials Group and the Eastern Cooperative Oncology Group (Meyer, et al. J of Clinical Oncology, vol 23, no 21) Published ahead of print on April 18, 2005 (Original date July 20, 2005)
MOPP = (nitrogen mustard/mechlorethamine, vincristine, procarbazine, prednisone)