VII. TEACHING POINTS

1. Fever, night sweats, and weight loss are systemic symptoms that may be associated with infectious, inflammatory, and malignant etiologies.
2. Persistently enlarged lymph nodes should be evaluated; in particular, one or more lymph nodes at least 1 cm in diameter persistent for at least 1 month, or lymphadenopathy that is associated with systemic symptoms.
3. Hodgkin lymphoma is a relatively uncommon type of lymphoma that has bimodal incidence, occurring most commonly in individuals 15 to 30 years old, and then in individuals over 55 years of age. HIV is associated with an increased incidence of Hodgkin lymphoma.
4. Hodgkin lymphoma is divided into classical Hodgkin lymphoma (95%) and nodular lymphocyte-predominant Hodgkin lymphoma (5%). There are four sub-types of classical Hodgkin lymphoma, and the most common of these in the United States is nodular sclerosis Hodgkin lymphoma.
5. Though accompanied by other cell types, including lymphocytes and histiocytes, the malignant cell in classical Hodgkin lymphoma is the Reed-Sternberg cell, a large binucleate cell with prominent nucleoli.
6. Hodgkin lymphoma is staged according to the number of sites of disease and their locations (Stages I-IV), as well as by whether or not systemic symptoms such as fever, night sweats and weight loss are absent (A) or present (B).
7. Stage IA and IIA Hodgkin disease may be treated with radiation therapy alone or with chemotherapy. More advanced disease is generally treated with systemic chemotherapy, sometimes with the addition of radiotherapy to areas of bulky disease.
8. With modern treatment modalities, there is an overall 5-year survival for this disease of about 85%.

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