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Hodgkin Lymphoma: Painless Lymphadenopathy and the Role of Lymph Node Biopsy in Diagnosis

A middle-aged Hispanic patient in a light blue hospital gown attentively listens to a Hispanic doctor holding a medical history. On the desk, a model of the lymphatic system highlights the lymph nodes, emphasizing the importance of communication in diagnosing Hodgkin lymphoma, particularly in cases presenting with painless lymphadenopathy and B symptoms like night sweats.

Hodgkin lymphoma is a malignant neoplasm of the lymphatic system characterized by the presence of Reed-Sternberg cells. One of the most common clinical manifestations is painless lymphadenopathy, which frequently occurs in the neck, axillae, or groin region. Additionally, patients may experience B symptoms such as fever, night sweats, and unexplained weight loss. Although these symptoms are nonspecific, they are crucial for the differential diagnosis of this disease.

The diagnosis of Hodgkin lymphoma can be challenging due to symptom overlap with other pathologies. An interesting case involves a patient with Kimura's disease, where painless lymphadenopathy initially raised suspicion for Hodgkin lymphoma, but a more thorough diagnosis revealed the true nature of the disease. This example underscores the importance of a comprehensive and accurate diagnostic evaluation.

Lymph node biopsy is the gold standard for diagnosing Hodgkin lymphoma. Through histological and immunophenotypic evaluation, the presence of Reed-Sternberg cells can be confirmed. In a reported case, a patient with nodular lymphocyte predominant Hodgkin lymphoma presented features overlapping with histiocytic-rich large B-cell lymphoma, highlighting the need for detailed analysis for an accurate diagnosis.

In patients with HIV, the risk of developing Hodgkin lymphoma is higher, and the clinical presentation may be atypical. A documented case describes a patient with HIV who presented with chronic diarrhea as the initial symptom, which ultimately led to the diagnosis of Hodgkin lymphoma following a lymph node biopsy.

In conclusion, painless lymphadenopathy is a key clinical sign in Hodgkin lymphoma, but it is not exclusive to this disease. Lymph node biopsy remains essential for definitive diagnosis, allowing differentiation between various pathologies that may present with similar symptoms. Early and accurate identification of Hodgkin lymphoma is crucial for initiating appropriate treatment and improving patient prognosis.

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Created 13/1/2025