Mbah Dukun Bagong the modern shaman from Medical and Health Information, explain how to diagnose Hodgkin's Lymphoma. how many ways to diagnose this disease?
1. CLINICAL (anamnesis)
Most patient complaints are enlarged lymph nodes in the neck, axilla or groin, weight loss decreases and sometimes accompanied by fever, sweating and itching
2. PHYSICAL EXAMINATION
Palpation of enlarged lymph nodes in the neck especially supraclavicular, axillary and inguinal. Maybe palpable enlarged spleen and liver. Examination ENT (ear, nose, throat) needs to be done to determine the possibility of ring waldeyer involved. If this area looks to be examined because of gastrointestinal often seen together.
3. LABORATORY EXAMINATION
Routine blood tests, liver function tests and kidney function tests are an important part in medical examinations, but did not provide information about the extent of disease. or specific organ involvement. In patients with Hodgkin's disease as well as in neoplastic disease or other chronic normochromic normocytic anemia may be found in the degree is related to decreased levels of iron and iron bind capacity, but with normal iron stores or increased in the bone marrow leukomoid frequent moderate to severe reactions, especially in patients with symptoms and usually disappear with treatment.
Absolute mild peripheral eosinophilia is not uncommon, especially in patients suffering from pruritus. Also found monositosis absolute limfositopenia absoluit (<1000 cells per cubic millimeter) usually occurs in patients with advanced-stage disease. Has done an evaluation of many examinations as an indicator of disease severity.
Until now, the erythrocyte sedimentation rate is still the best monitors, but the examination is not specific and can return to normal although there are still residual disease. Another test is abnormal elevated levels of copper, calcium, lactic acid, alkaline phosphatase, lysozyme, globulin, C-reactive protein and other acute phase reactants in serum.
4. Cytology ASPIRATION BIOPSY
Fine Needle Aspiration Biopsy (FNAB) is often used in preliminary diagnosis of lymphadenopathy to identify the causes of disorders such as reaction hyperplastic lymph nodes, metastatic carcinoma and lymphoma malignum.
Another complicating aspiration biopsy cytology in the diagnosis of Hodgkin's Lymphoma or Non-Hodgkin's lymphoma is the presence of false negative aspiration biopsy is recommended to do multiple holes in some places the surface of the tumor. If found negative and cytology is also not in accordance with the clinical picture, then the best option is the incision or excision biopsy.
Biopsy of the tumor is very important, in addition to histopathological subtype diagnosis also identified although clear aspiration biopsy cytology Hodgkin's Lymphoma or Non-Hodgkin's Lymphoma. Biopsy was done not just take the network, but must be considered whether the tissue biopsy can provide adequate information. Biopsies are usually selected on the chain nodes in the neck. Lymph nodes in the groin, back of neck and submandibular not selected due to inflammatory processes, it is recommended that biopsy done under general anesthesia to prevent the influence of local injections of liquid drug which can disrupt the network architecture for a network
1. chest X-ray to determine the involvement of mediastinal lymph nodes
2. Limfangiografi to determine the involvement of iliac lymph nodes and post-aortal area
3.USG widely used to see an enlarged lymph nodes in paraaortal and simultaneously guided fine needle aspiration biopsy for cytologic confirmation.
4. CT-scans are often used for diagnosis and evaluation of growth Hodgkin's Lymphoma
Abdominal laparotomy is often performed to see the condition lympha nodule in the para-aortic and iliac mesentery with the aim of determining the stage. Thanks to technological advances such as ultrasound radiology and CT scan plus a fine needle aspiration biopsy cytology, action laparotomy can be avoided or at least minimized.