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Late Recurrence In Hodgkin's Disease: A Report Of Two Cases

Green et al., 1984Lymphoma

Green, J. A., Arnold, A. M., Macbeth, F. R., Mead, G. M., Williams, C. J., Wright, D. H., & Whitehouse, J. M. (1984). Late recurrence in Hodgkin's disease: a report of two cases. Medical and pediatric oncology, 12(2), 148–149. https://doi.org/10.1002/mpo.2950120218

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Abstract

Two cases of Hodgkin's disease are described who relapsed 22 and 19 years after regional radiation therapy. One of the patients also developed a carcinoma of the large bowel soon after first relapse. The importance of long follow‐up and documentation of cause of death in Hodgkin's disease is stressed.

Case Details

Disease Location

Bilateral cervical and axillary, mediastinal nodes

Personal Characteristics

48 -year-old female

Clinical Characteristics

Presented in april 1952 with bilateral cervical and axillary lymphadenopathy, and enlarged mediastinal nodes shown on a chest xray a biopsy of a left cervical node mass was shown to be infiltrated by hodgkin's disease when initially stable, her condition deteriorated over the next year with fever, sweating and weight loss. Local radiotherapy was given to her neck, axilla and mediastinum in 7 fractions over 10 days. In 1975 she noted increasing right cervical adenopathy becoming painful and later associated with generalized pruritus but not other symptoms by september 1979, the mass had extended over the right upper anterior chest wall to the level of the 4th rib and infiltrated the overlying skin. Nodes were present in the right axilla and chest xray showed widening of the mediastinum a biopsy was taken and compared with the biopsy obtained in 1952; both showed the features of nudular sclerosing hodgkin's disease she was considered to be stage iib as the relapse was within a previously irradiated area, chemo with chlorambucil, vinblastine, procarbazine and prednisolone was given with good response in february 1981, she developed a large bowel obstruction, laparotomy found a carcinoma of the ascending colon with hepatic metastases but no evidence of hodgkin's she died a months later relapse occured at 22 years later

Remission Characteristics

After local radiotherapy, she remained well until 1975 chemo in 1979 resulted in a good response and she remained in complete remission until february 1981

Treatment & Mechanisms

Proposed Remission Mechanisms

No major mechanism proposed

Clinical Treatment

Local radiotherapy chemo (chlorambucil, vinblastine, procarbazine, and prednisolone)

Non-Clinical Treatment

None reported