[Cervical adenopathies of malignant lymphomas and especially Hodgkin's disease]

Cervical lymph nodes are frequently involved in malignant lymphomas, especially in Hodgkin's disease. The surgeon who performs a lymph node biopsy should be aware of the technical problems concerning fixation, conservation, and transport of the surgical specimen in order to allow special immunologic and histochemical techniques, if there is a high degree of suspicion of malignant lymphoma. Staging laparotomy should be considered only if non invasive diagnostic methods have been non contributory and if the potential change in staging involves a change in treatment. Radiotherapy is the main part of the therapeutic strategy in stage I/II whereas chemotherapy is primarily considered for stage III/IV. Stage I/II, with B symptoms, with massive mediastinal involvement, and/or with a large number of nodal sites, may benefit from the combination of chemotherapy and radiotherapy. On the other hand, irradiation of residual disease after chemotherapy should be considered in disseminated disease.