Haem: Hodgkin's Lymphoma: Free MSRA Podcast

🧪 FREE MSRA PODCAST – Hodgkin’s Lymphoma: Reed-Sternberg, B Symptoms & High-Yield Pearls 🎧If Hodgkin’s lymphoma is on your MSRA radar (and it should be!), this episode is your go-to deep dive. We'll break down this curable but complex condition with a clear, high-yield summary. Learn how to spot it, stage it, and treat it – with memory tips built in. 🧠💡🧠 Key Learning Points📌 DefinitionA cancer of the lymphatic system, defined by the presence of Reed-Sternberg cells – large, abnormal B cells seen on lymph node biopsy.📌 Subtypes🔹 Classical Hodgkin’s Lymphoma (cHL) – 4 types:– Nodular sclerosis (most common)– Mixed cellularity– Lymphocyte-rich– Lymphocyte-depleted🔹 Nodular Lymphocyte Predominant HL (NLPHL) – lacks classic Reed-Sternberg cells (instead has “popcorn cells”); carries risk of transforming into non-Hodgkin's lymphoma📌 Aetiology & Risk Factors• Multifactorial: immune dysregulation, genetics, viruses• Epstein-Barr virus (EBV) – found in ~50% of cHL• Risk factors: – Past EBV infection (glandular fever) – Family history – Immunosuppression (HIV, post-transplant) – Smoking – Down syndrome (mild increase)📌 Pathophysiology• Malignant B cells (Reed-Sternberg) evade immune destruction• Release cytokines → inflammation + immune cell recruitment• Result: swollen lymph nodes (lymphadenopathy) + systemic symptoms📌 Epidemiology• ~1,800 UK cases/year• Bimodal distribution: peak at 20–34 yrs and again >75 yrs• Slight male predominance• Incidence ≈ 2.7 per 100,000 annually📌 Clinical Features🎯 BFIT Mnemonic + more:– B symptoms: Fever (>38°C), Night sweats, ≥10% weight loss in 6 months– Fatigue– Itching (pruritus)– Tender lymph nodes (rare: pain after alcohol)• Painless, rubbery lymphadenopathy: cervical, supraclavicular, mediastinal• Hepatosplenomegaly, mediastinal mass, cough, breathlessness• Rare: paraneoplastic syndromes (e.g. cerebellar degeneration)📌 Investigations🧪 Diagnosis• Excisional lymph node biopsy – gold standard• Histology: Reed-Sternberg cells (large, bi/multinucleated)• Immunophenotyping confirms HL subtype📸 Staging• PET-CT scan – gold standard• Ann Arbor staging I–IV + A/B for symptoms + E for local spread• Bone marrow biopsy only if PET suggests marrow involvement🧪 Blood tests• FBC: anaemia, neutrophilia, eosinophilia, low lymphocytes• ESR, LDH, albumin: prognostic markers• LFTs, U&Es, HIV testing📌 Management🎯 ABVD = Adriamycin, Bleomycin, Vinblastine, Dacarbazine• Standard first-line for most stages• Combined with radiotherapy for early-stage bulky disease• BEACOPP used for high-risk cases (more toxic)• Stem cell transplant for relapsed/refractory cases (autologous preferred)• Radiotherapy targeted to minimise long-term risks• Pretreatment checks: cardiac echo, lung function, fertility counselling• Irradiated blood products required lifelong post-radiotherapy📌 Complications• Relapse• Secondary malignancies (AML, breast, thyroid, lung, colon, melanoma)• Cardiopulmonary toxicity• Infertility• Hypothyroidism (neck radiation)• Late mortality from treatment-related effects📎 More MSRA Resources for Hodgkin’s Lymphoma📝 Revision Notes:https://www.passthemsra.com/topic/hodgkins-lymphoma-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/hodgkins-lymphoma-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/hodgkins-lymphoma-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/hodgkins-lymphoma-rapid-quiz/🎓 Haematology Course:https://www.passthemsra.com/courses/haematology-for-the-msra/#MSRA #HodgkinsLymphoma #MSRAFlashcards #MSRAQuiz #HaematologyMSRA #PassTheMSRA #FreeMSRA #MSRARevisionNotes #MSRAQandA #MSRAPodcast