Hodgkin disease

Clinical presentations
Enlarged, painless, rubbery, nonerythematous, nonotender lymph nodes
Cervical, supraclavicular, and axillary lymphoadenopathy are the most common initial signs.
B symptoms: drenching night sweats, 10% weight loss, fever
Extralymphatic sites are usually enlarged spleen, skin, gastric, lung, and CNS.
Extralymphatic involvements are more common in non-Hodgkinn lymphoma

Pathology
Reed-Sternberg cell

Staging
Stage I: one lymphatic group
Stage II: 2 lymphatic groups on the same side of the diaphragm
Stage III: Involvement on both sides of the diaphragm or involvement of any extralymphatic organ contiguous to the primary nodal site
Stage IV: Widespread disease with involvement of diffuse extralymphatic sites such as the bone marrow or liver

Workup

1. confirm the diagnosis: excisional lymph node biopsy
   
2. determine the extend of the disease: CXR, chest CT, abdominal CT, or MRI=> to determine if the disease is localized to supraclavicular region
3. If all the tests are not revealing and local radiotherapy is done, a staging laparotomy is used to definitely to exclude more widespread disease
   
4. Bone marrow biopsy
   

CXR, chest Ct