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The optimal management of localized or regional histologically proved Hodgkin's disease (stages I and II, respectively7) is a difficult therapeutic problem because of uncertainty concerning the extent of the disease. If Hodgkin's disease can begin unifocally and then spread with varying rapidity from its site of origin to adjacent areas, it is reasonable to apply vigorous measures to try to cure the disease during its localized phase. Before undertaking a therapeutic program, it is essential to determine, as far as present techniques permit, if the disease is confined to a single area. This requires, as a minimum, a careful symptomatic history, a complete physical examination, necessary laboratory studies, which include a complete blood count, kidney and liver function tests, and certain roentgenographic procedures—chest, skeletal survey, lymphangiography of pelvic and lower abdominal areas, intravenous pyelography, and inferior vena cavography. The lymphangiogram has been particularly useful; Lee, Nelson, and Schwarz13
Karnofsky DA. Chemotherapy. JAMA. 1965;191(1):30–31. doi:10.1001/jama.1965.03080010036009
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