Painless enlargement of lymphnode -medicine-hematological malignancies-clinical feature of hodgkin disease patient characterstically presents with painless enlargement of lymph nodes (most common left cervical and left supraclavicular nodes). most common extra nodal are liver, bone marrow and lung. nodes are discrete and freely movable. mediastinal involvement is discovered on chest x-ray bone marrow infiltration is seen in advanced cases and is suggested by leukopenia, anaemia, thrombocytopenia and elevated alkaline phosphate. occasionally hd presen with fever of unknown origin particularly in mixed cellularity type. rarely the fever persist for days to weeks followed by afebrile interval and then recurrence. this pattern is called pel-