Our patient has been referred to the haematology team.
He presented with a left sided inguinal node which he noticed around 4 weeks ago, this had been enlarging and was around 2x3cm when he initially presented.
He has been feeling generally tired for the last few months, and has had drenching night sweats for 2 weeks and generalised itching for 3 weeks. Weight has been stable.
He drinks very occasional alcohol and smokes around 20/day.
Bloods have shown
Fbc – normal
U&E – normal
LFT -normal
HIV – negative
ESR 55
EBV IgG positive, IgM negative
A ct scan has shown enlarged nodes in the left inguinal and left iliac area with a maximum diameter of 6cm.
The surgical team have performed an excisional biopsy of one of the left inguinal nodes.
The report has come through showing a classical Hodgkin’s lymphoma.
What other investigations would you do?
How would you stage the disease?
What things do we need to consider for this patient?
Join us on Twitter @TeamHaem and let us know what your thoughts are, what questions you have and what you want to do as we see this case evolve over the next week. Remember to use #teamhaem on all your posts to help us follow the case! Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality. TeamHaem are not a position of authority. It is an educational platform to allow discussion and learning.
To complete stagin esp he has B symptoms to do bone marrow biopsy
PET scan proved to be effective in staging for early stage hodgkin disease
Echo heart and pulmonary function test esp DLCO
Thanks for the comment. We do most of the discussion via Twitter using #teamhaem 🙂