1. Asymptomatic lymphadenopathy Mediastinal mass Systemic symptoms Fever, Pruritus Other nonspecific symptoms and paraneoplastic syndromes Intra-abdominal disease Cholestatic liver disease Nephrotic syndrome Hodgkin's disease Clinical presentation Alcohol-induced pain Skin lesions, Neurologic syndromes

2. HODGKIN”s disease Nodular sclerosis HD Mixed cellularity HD Lymphocyte depletion HD Lymphocyte-rich classical HD Nodular lymphocyte predominant HD

5. Stage I — Involvement of single lymph node region (I) or of single extralymphatic organ or site (Ie) Stage II — Involvement of two or more lymph node regions on the same side of the diaphragm alone (II) or with involvement of limited, contiguous extralymphatic organ or tissue (IIe) Stage III — Involvement of lymph node regions on both sides of the diaphragm (III) which may include the spleen (IIIs) or limited, contiguous extralymphatic organ or site (IIIe) or both (IIIes) Stage IV — Diffuse or disseminated foci of involvement of one or more extralymphatic organs or tissues, with or without associated lymphatic involvement Staging in hodgkin”s Lymphoma

8. B symptoms ** Clinical stage IIB to IVB Bulky disease Anemia Leukopenia Thrombocytopenia Poor prognose sign & symptome in HD

10. International prognostic score International prognostic score : International Prognostic Factor Project on Advanced Hodgkin's Disease based upon the total number of seven potential unfavorable features at diagnosis: 1-Serum albumin less than 4 g/dL (40 g/L), 2-Hemoglobin less than 10.5 g/dL (105 g/L), 3-Male gender, 4-Age over 45 years, 5-Stage IV, 6-White blood cell count 15,000/microL, 7-Lymphocyte count less than 600/microL and/or less than 8 percent of the white blood cell count. This analysis showed a spread in the event-free survival at five years, as follows: No factors -- — 84 % ( 7 % of patients) One factor — -- 77 % (22 % of patients) Two factors — 67 % (29 % of patients) Three factors — 60 % (23 % of patients) Four factors — 51 % (12 % of patients) Five or more factors -- 42% (7 % of patients)

11. Criteria for B symptoms Criteria for B symptoms : B symptoms generally correlate with advanced stage and bulk disease. Specific B symptoms are defined as follows: 1- Unexplained weight loss of more than 10 percent of body weight during the six months before initial staging investigation 2- Unexplained persistent or recurrent fever with temperatures above 38 ؛ C during the previous month 3- Recurrent drenching night sweats during the previous month.

13. 1- Socioeconomic status and environmental risk factors 1- Socioeconomic status and environmental risk factors 2- Infectious agents 3- Clustering 4- Genetic factors 5- ROLE OF EPSTEIN-BARR VIRUS 5- ROLE OF EPSTEIN-BARR VIRUS 6- HD and immunosuppression 6- HD and immunosuppression Incedence of HD

14. HISTORY AND PHYSICAL EXAMINATION Initial evaluation and diagnosis of Hodgkin's disease TISSUE BIOPSY Bone marrow biopsy LABORATORY STUDIES IMAGING STUDIES: chest, abdomen, liver, spleen, bone. Gastrointestinal tract Central nervous system

15. CLASSICAL HODGKIN'S LYMPHOMA Nodular sclerosis Hodgkin's lymphoma Mixed cellularity Hodgkin's lymphoma Lymphocyte depletion Hodgkin's lymphoma Lymphocyte-rich classical Hodgkin's lymphoma

17. Immunophenotype in HD : The immunophenotype is an important part of the definition of NLPHL. The atypical cells are CD45+, express B - cell associated antigens ( CD19, CD20, CD22, CD79a ), and EMA but lack CD15 and CD30.

33. HODGKIN”s disease Nodular sclerosis HD Mixed cellularity HD Lymphocyte depletion HD Lymphocyte-rich classical HD Nodular lymphocyte predominant HD

34. . Of NHL WHO classification Indolent — survival of the untreated disease measured in years Aggressive — survival of the untreated disease measured in months Highly aggressive — survival of the untreated disease measured in weeks.

35. . Of NHL WHO classification Indolent — survival of the untreated disease measured in years Aggressive — survival of the untreated disease measured in months Highly aggressive — survival of the untreated disease measured in weeks.

71. . Of NHL WHO classification