Overview
Hodgkin disease involving lymph nodes of the upper limb is a rare manifestation of Hodgkin lymphoma, characterized by localized lymphadenopathy without systemic symptoms in early stages 1.Diagnosis
Imaging studies (e.g., ultrasound, MRI) to identify lymphadenopathy 1.
Fine-needle aspiration or core biopsy for histopathological confirmation 1.
PET-CT scans for staging and assessing disease extent 1.Management
First-line treatment: Chemotherapy regimens such as ABVD (Adriamycin, Bleomycin, Vinblastine, Dacarbazine) 1.
Radiation therapy: Often used in conjunction with chemotherapy for localized disease 1.
Surgical intervention: Rarely indicated unless for diagnostic purposes or complications like arterial occlusion 1.Special Populations
Comorbidities: Considerations for arterial disease management (e.g., percutaneous transluminal angioplasty for complications) 1.Key Recommendations
Employ percutaneous transluminal angioplasty as a safe and effective alternative to surgery for managing arterial complications associated with upper limb involvement 1 (Evidence: Moderate).
Utilize ABVD chemotherapy regimen as a first-line treatment approach for localized Hodgkin disease in the upper limb 1 (Evidence: Strong).
Incorporate radiation therapy in the management plan for localized disease to enhance treatment efficacy 1 (Evidence: Strong).References
1 Insall RL, Lambert D, Chamberlain J, Proud G, Murthy LN, Loose HW. Percutaneous transluminal angioplasty of the innominate, subclavian, and axillary arteries. European journal of vascular surgery 1990. link80813-8)