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Pediatric_Oncology_A_Comprehensive_Guide.pdf
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P. Imbach

 

 

7.6.1.2 Lungs

Pulmonary involvement in patients with mediastinal enlargement; in about 20%, also pulmonary involvement as solitary peribronchial or subpleural lesion

Intraparenchymal:

Nodular form: similar to lung abscess, tuberculosis, or fungal infection

Alveolar form: similar to pneumonia

Pleural manifestation when obstruction of lymphatic channels is present (rarely)

7.6.1.3 Bone Marrow

Bone marrow involvement in patients with B symptoms and with anemia; low WBC and/or thrombocytopenia

Multiple bone marrow biopsies necessary, because involvement is mostly focal

Bone scintigraphy may indicate biopsy location

7.6.1.4 Bone

Involvement via hematogenous spread

Vertebral involvement with spinal compression or with vertebral body collapse, as well as involvement of epidural area, is known

Bone involvement indicates poor prognosis

7.6.1.5 Liver

Involvement mostly together with concomitant splenic disease

Histologically diffuse or nodular pattern

Hodgkin involvement of the liver is prognostically unfavorable

Nonspecific hepatomegaly with or without abnormal liver-function tests is often described in Hodgkin disease

Differential diagnosis: hemolysis, hepatitis due to virus toxoplasmosis, cytomegalovirus infection, cholestasis, periportal infiltration of lymph nodes

7.7Laboratory Analyses

7.7.1Blood

Anemia indicates an advanced stage of disease or an autoimmune phenomena of hemolysis with or without thrombocytopenia and neutropenia

Neutrophilia and eosinophilia occur in 15–20% of patients

Occasionally thrombocytosis

Lymphocytopenia indicates an advanced stage of the disease

High erythrocyte sedimentation rate in active Hodgkin disease; normal during remission

Bone marrow involvement (see above)

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