The first symptom is usually enlarged lymph nodes, and the diagnosis is made by a lymph node biopsy.
NSHL occurs most commonly between the ages of 15 and 35 and affects equal numbers of males and females.
The prognosis is very good, in general, with roughly 90 percent 5-year survival.
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That said, the treatment can be challenging.
Support, as well as long-term management, are important.
Types of Lymphomas
There are two main categories of lymphoma, includingHodgkin and Non-Hodgkinlymphoma.
Lymph nodes are like outposts that occur at various points along thelymphatic channelsthat run throughout the body.
Of these sites, over 50% occur in the chest.
Pathology
The abnormal B lymphocytes found in NSHL are referred to asReed Sternberg cells.
Enlarged Lymph Nodes
The most common symptom with NSHL ispainless,enlarged lymph nodes.
When these occur in the neck or armpits, they are often detected by feeling the nodes.
It’s most common in the lower legs and may begin even before the diagnosis is made.
However, itching is not one of the B symptoms.
Rates of NSHL do not appear to be different based on sex or ethnic background.
Diagnosis
The diagnosis of lymphoma is made with alymph node biopsy.
Immunohistochemistry tests may be done to tell the difference as the two diseases are treated in different ways.
There are different options for preserving fertility for those who are interested.
For those who are pregnant when diagnosed, the management of Hodgkins during pregnancy also requires special consideration.
Chemotherapy
Chemotherapy is the mainstay of treatment for NSHL.
Radiation Therapy
Radiation may be given to areas of lymph node involvement after chemotherapy.
Adcentris may also be used along with chemotherapy (ABVD) with advanced stage lymphomas.
Immunotherapy
A throw in ofimmunotherapyreferred to as immune checkpoint inhibitors may be used.
Fortunately, advances have made these side effects much more tolerable than in the past.
Side effects of radiation therapyinclude skin redness and fatigue.
When radiation is delivered to the chest, inflammation of the lungs and esophagus may occur.
One of the greatest concerns is the risk ofsecondary cancers in Hodgkin lymphoma survivors.
The internet provides an opportunity for people to connect with others with their subtype of Hodgkin lymphoma.
Recurrence
NSHL may recur.
For everyone who has been treated for NSHL, the risk of secondary cancers is present.
A Word From Verywell
Nodular sclerosing Hodgkin lymphoma is often curable, but the treatment is challenging.
In addition, late side effects may occur, and lifelong monitoring is needed.
What this means is that support is crucial throughout the journey.
NCCN Clinical Practice Guidelines in Oncology.
April 14, 2018.
