Hodgkin Lymphoma Differential Diagnoses

  • Author: Scott K Dessain, MD, PhD; Chief Editor: Emmanuel C Besa, MD   more...
 
Updated: May 24, 2012
 
 

Diagnostic Considerations

Other diseases to be considered in the differential diagnosis of Hodgkin lymphoma include the following:

  • Any disease presenting with lymphadenopathy and constitutional symptoms
  • HIV infection
  • Hypersensitivity reaction
  • Other solid tumors

Because Hodgkin lymphoma is considered a curable malignancy and the differential diagnosis is broad, medicolegal problems may arise from failure to diagnose the disease in a timely manner, possibly due to the following factors:

  • The misinterpretation of B symptoms
  • A lack of follow-up for abnormal chest radiographs or physical examination findings
  • A missed pathologic diagnosis because a needle biopsy was obtained rather than an excisional lymph node biopsy

Occasionally, Hodgkin lymphoma can present as hemophagocytic syndrome (hemophagocytic lymphohistiocytosis).[9] Hemophagocytic syndrome is associated with Epstein-Barr virus antigen expression by Reed-Sternberg cells and has the following clinical and laboratory characteristics:

  • Pancytopenia
  • Fever
  • Hepatosplenomegaly with liver function test abnormalities
  • Elevated serum levels of ferritin and triglycerides
  • Phagocytosis of hematopoietic lineage cells by benign macrophages

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Scott K Dessain, MD, PhD  Associate Professor, Lankenau Institute for Medical Research

Disclosure: Nothing to disclose.

Coauthor(s)

Bradley W Lash, MD  Fellow in Hematology/Oncology, The Lankenau Medical Center

Bradley W Lash, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society of Clinical Oncology, and American Society of Hematology

Disclosure: Nothing to disclose.

James L Spears, MD  Consulting Staff, Bux-Mont Hematology Oncology Medical Associates

James L Spears, MD is a member of the following medical societies: American Society of Clinical Oncology

Disclosure: Nothing to disclose.

Athanassios Argiris, MD  Professor, Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine

Athanassios Argiris, MD is a member of the following medical societies: American Association for Cancer Research, American College of Physicians, and American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Koyamangalath Krishnan, MD, FRCP, FACP  Paul Dishner Endowed Chair of Excellence in Medicine, Professor of Medicine and Chief of Hematology-Oncology, James H Quillen College of Medicine at East Tennessee State University

Koyamangalath Krishnan, MD, FRCP, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, American Society of Hematology, and Royal College of Physicians

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Chief Editor

Emmanuel C Besa, MD  Professor, Department of Medicine, Division of Hematologic Malignancies, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University

Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Clinical Oncology, American Society of Hematology, and New York Academy of Sciences

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Virginia Kaklamani, MD, and Christine Wasilewski, MD, MPH,to the development and writing of the source article.

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Mixed cellularity Hodgkin lymphoma showing both mononucleate and binucleate Reed-Sternberg cells in a background of inflammatory cells (hematoxylin and eosin, original magnification X200).
A positron emission tomography (PET) scan obtained with fluorodeoxyglucose (FDG) that shows increased FDG uptake in a mediastinal lymph node.
A CT scan showing bulk disease.
Hodgkin Lymphoma
Hodgkin Lymphoma PET
 
 
 
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