Case Studies
Expert physicians provide insight on managing oncology-based patient cases that highlight the use of novel agents in clinical practice.
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Classical Hodgkin Lymphoma: Is There a Cure?
Classical Hodgkin Lymphoma: Is There a Cure?
A 22-Year-Old Woman With Stage IV Classical Hodgkin Lymphoma
History & Physical
- A 22-year-old female presented with right cervical nodes developing over several months
- Initially evaluated by her OB/GYN who recommended observation. She subsequently developed neck pain while drinking wine
- Referred for lymph node biopsy -> classical Hodgkin lymphoma
- Past medical history: unremarkable
- Social history: No tobacco use; occasional ETOH; Division 1 swimmer, NKDA
- Family History:
- Maternal grandfather – Squamous cell cancer
- Maternal grandmother – Melanoma
- Aunt – Breast Cancer
- 2 healthy siblings
Laboratory Values
- WBC 19.8 (85% PMN’s)
- Hgb 12.0
- Plts 571
- ESR 30
- Cr 0.76
- Albumin 4.2
- HIV/Hepatitis Negative
Staging PET/CT
- Intrathoracic adenopathy
- R cervical 2.3 x 1.9 (SUV 9.3)
- L cervical 2.2 x 1.8 (SUV 8.8)
- Ant Mediastinum 4.8 x 2.9 (SUV 21.3)
- R axillary 2.8 x 2.8 (SUV 12.2)
- Spleen SUV 2.9 with normal size
- Diffuse uptake in the axial skeleton (SUVs 4.9-5.5)
- Mediastinum SUV 1.8 / Liver 2.4
Pathology
- Nodular sclerosis classical Hodgkin Lymphoma
- Per IHC, Hodgkin cells express CD30, CD15, PAX5 (weak); negative for CD3, CD20, CD45
Treatment: A(BV)VD x 6
- Interim PET/CT with Deauville 3
- Tolerated well with GCSF support
