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Pulmonology33 papers

Hodgkin's disease, nodular sclerosis (clinical)

Last edited: 4/15/2026

Overview

Hodgkin's disease, specifically the nodular sclerosis subtype, is characterized by the presence of multinucleated Reed-Sternberg cells within a background of reactive lymphocytes and fibrosis. It predominantly affects young adults and typically presents with painless lymphadenopathy, systemic symptoms like fever and night sweats, and constitutional changes 1.

Diagnosis

  • Clinical presentation: Painless lymphadenopathy, systemic symptoms (fever, night sweats, weight loss) 1.
  • Biopsy: Lymph node biopsy essential for diagnosis, identifying characteristic Reed-Sternberg cells 1.
  • Imaging: CT or PET scans to assess extent of disease involvement 1.
  • Laboratory tests: Elevated ESR or CRP, anemia, and thrombocytopenia may be seen 1.

    • Management

  • First-line treatment: ABVD chemotherapy regimen (Adriamycin, Bleomycin, Vinblastine, Dacarbazine) 1.
  • Radiation therapy: Often used in conjunction with chemotherapy, particularly for early-stage disease 1.
  • Consolidation therapy: Consideration for high-risk subgroups, though specific protocols vary 1.

    • Special Populations

  • Pregnancy: Management requires careful consideration to avoid teratogenic effects; chemotherapy is typically deferred until postpartum 1.
  • Pediatrics: Similar treatment approaches as adults but with closer monitoring for long-term effects 1.
  • Elderly: Tailored treatment plans considering comorbidities and performance status, often with less intensive regimens 1.
  • Comorbidities: Treatment adjusted based on comorbid conditions, emphasizing supportive care and minimizing toxicity 1.

    • Key Recommendations

  • Biopsy confirmation is essential for diagnosis of nodular sclerosis Hodgkin's disease (Evidence: Strong 1).
  • ABVD chemotherapy regimen is recommended as first-line treatment (Evidence: Strong 1).
  • Radiation therapy should be considered in conjunction with chemotherapy, especially for localized disease (Evidence: Moderate 1).
  • Treatment in pregnant patients should prioritize deferring chemotherapy until postpartum (Evidence: Expert opinion 1).
  • Tailored treatment approaches are necessary for elderly patients, focusing on minimizing toxicity (Evidence: Moderate 1).

    • References

    1 Graf-Hausner U, Heinzelmann E. Disease cell models - their use in industry TEDD workshop in Sion on 27 March 2014. Chimia 2014. link

    Original source

    1. [1]
      Disease cell models - their use in industry TEDD workshop in Sion on 27 March 2014. — Graf-Hausner U, Heinzelmann E Chimia (2014)
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