Info

PHYSICAL EXAMINATION. During advanced phases of the disease, the patient may have edema of the face and neck, weight loss, and jaundice. Palpate all lymph node chains, including the submental, infraclavicular, epitrochlear, iliac, femoral, and popliteal nodes. Involved nodes are characteristically painless, firm, rubbery in consistency (unlike the rock-hard nodes of carcinoma), freely movable, and of varying size. Palpate the liver and spleen, which may be enlarged.

PSYCHOSOCIAL. The diagnosis of a neoplastic disorder in young adulthood is a devastating event for the patient and significant others. Rather than pursuing educational goals, job obligations, social interactions, or parenting responsibilities, the young adult is suddenly managing a potentially terminal disease. Although the disease is treatable in most cases, the patient needs to manage short- and long-term complications of therapy that may profoundly alter the patient's body image. Infertility in young adults after treatment may affect the patient's view of herself or himself and the long-term potential for the desired role of parenthood.

Diagnostic Highlights

Test

Normal Result

Abnormality with Condition

Explanation

Lymph node biopsy or bone marrow biopsy

Normal cells

Positive for Hodgkin's lymphoma cells (ReedSternberg giant cells)

Determines extent of disease and allows for staging of disease; bone marrow biopsy is generally done only for patients with anemia or fever and night sweats

Computed tomography (CT) scan or magnetic resonance imaging (MRI) of chest, abdomen, and pelvis

Normal structures

Spread of Hodgkin's lymphoma into organs and body cavities

Assists with staging; common sites of extralymphatic involvement include spleen, stomach, small intestine; combined with lymphangiography, can predict nodal involvement in 90% of cases

Diagnostic Highlights (continued)

Test

Normal Result

Abnormality with Condition

Explanation

Lymphangiography, a radiographic test of lymphatic vessels and nodes; radiopaque iodine contrast medium is injected into lymphatics of foot or hand

Normal lymphatic system

Identification of structural abnormalities or tumor involvement

Test has been replaced in many situations by CT scanning but may still be used for staging; not usually performed in children

Other Tests: Complete blood cell count, chest x-ray, erythrocyte sedimentation rate; tests for liver and renal function, including lactate dehydrogenase, alkaline phosphatase, blood urea nitrogen, and creatinine.

Single Parentings Guide

Single Parentings Guide

Finally! You Can Put All Your Worries To Rest! You Can Now Instantly Learn Some Little-Known But Highly Effective Tips For Successful Single Parenting! Understand Your Role As A Single Motherfather, And Learn How To Give Your Child The Love Of Both Parents Single Handedly.

Get My Free Ebook


Post a comment