Question

Mr. J, aged 38 years, presents to the clinic today for his routine physical. During the review of systems, he offhandedly mentions that he has a “knot” in his neck, but he figures it is no big deal since it does not hurt. He also reports occasional fever and chills, and the last several weeks, he has awakened drenched in sweat. He attributes this to the fact that he was around his niece and nephew who were both recovering from the flu. (Learning Objectives: 4, 13, 14, and 15)

1. What other questions would be helpful to determine the source of these symptoms?
2. The health care provider (HCP) has ordered a chest x-ray because he is suspicious of Hodgkin lymphoma. What is the rationale for this order?

The health care provider (HCP) tells Mr. J that he would like to biopsy the “knot” in his neck to rule out Hodgkin lymphoma. After the HCP leaves the room, Mr. J immediately starts wringing his hands and says, “Oh my goodness. I know I am going to die. My friend had something like this, and he was dead in 6 months. Who will take care of my family?”

3. How will the nurse respond to Mr. J’s concerns?
4. What constitutes a definitive diagnosis of Hodgkin lymphoma?
5. What are some manifestations associated with non-Hodgkin lymphoma?
6. The lymph node biopsy is positive for the Reed-Sternberg cell. What type of treatment is indicated?

Answer 1

Mr J has symptoms related to Hodgkin’s disease such as painless swelling of lymph node in neck , fever , night sweats etc . So he is suspected to have Hodgkin’s disease. Inorder to conform the diagnosis health care provider ordered for chest X-ray .

Hodgkin’s disease is a treatable form of cancer if detected in the early stage.Patient will be worried about his condition but need to give support, there is lot of treatments to cure disease. Having positive attitude can help to cope up with any situation. Always stay active , take proper rest , relaxation exercise and music therapy can also help to relieve from stress .

Diagnosis of Hodgkin’s disease include ;

1)Imaging test like X-ray or CT scan

2) Lymph node biopsy to test any abnormal cells are present or not

3) Blood test such as complete blood count to measure red blood cells, white blood cells and platelets

4) echocardiogram to check whether heart is working properly

5) Bone marrow biopsy to examine marrow inside your bone to determine cancer has spread

Non Hodgkin’s disease;

The symptoms of these disease include swollen lymph nodes , fever , stomach ache , night sweats , weight loss, chest pain and loss of appetite.

Reed stern berg cells are essential to the diagnosis of Hodgkin’s disease. These abnormal cells are found within the lymph nodes . The treatment provided are ;

chemotherapy

Radiation therapy

Bone marrow transplant

other alternative therapies such as ;

music therapy

relaxation techniques

exercises

meditation

art therapy

These may help to cope with stress of cancer diagnosis and side effects of cancer treatment.