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The lack of clear manifestation of a type of lymphoma might have been the reason for the earlier inaccurate diagnosis of pharyngitis in Mr. H.D., before a tissue sample was taken. However Hodgkin's lymphoma does 'peak' during early adulthood, and then in later adulthood, so the patient was within a likely threshold period for manifesting the illness.
Mr. H.D. did manifest "the major clinical manifestation of malignant lymphoma" of painless lymph node enlargement, "usually firm or rubbery, often multiple and fixed in place" (Introduction to lymphoma, 2010, University of Virginia). During Stage III, patients are more likely to exhibit symptoms such as "fever, malaise, night-sweats, weight loss, and pruritis. As lymphoma progresses, spread may occur to spleen, liver, bone marrow, and other organs" including the "gastrointestinal tract, CNS, skin, spleen, bone marrow, pharyngeal tissues, salivary glands, thymus, and lung among others" (Introduction to lymphoma, 2010, University of Virginia). Partially because he was asymptomatic other than the presence of the nodes,...
H.D. was assumed to be in a less advanced stage than further exploration revealed. But based on identification of disease below the diaphragm, Mr. H.D.'s staging was changed to Stage III Hodgkin's disease, and after the removal of his spleen and appendix, he was given further radiation and drug treatment before being pronounced symptom-free.
References
Hemopathology. (2010). University of Utah. Retrieved December 6, 2010 at http://library.med.utah.edu/WebPath/HEMEHTML/HEME067.html
Introduction to lymphoma. (2010). University of Virginia. Retrieved December 6, 2010 at http://www.med-ed.virginia.edu/courses/path/innes/wcd/lymphoma.cfmLymphoma
Lymphoma: Hodgkin's Lymphoma (Part 1). (2010). University of Virginia.
Retrieved December 6, 2010 at http://www.med-ed.virginia.edu/courses/path/innes/wcd/Hodgkin's.cfm
Retrieved December 6, 2010 at http://www.med-ed.virginia.edu/courses/path/innes/wcd/hodgkin1.cfm
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