Zusammenfassung der Ressource
Lymphoma
- Lymphatic system
- Lymphatic vessels absorb excess
interstitial fluid and transport this fluid
(LYMPH) to ducts that drain it to the veins
- Lymph nodes and lymphoid tissues in the thymus, spleen,
and tonsils produce lymphocytes involved in immunity
- Lymph
node
histology
- Types
- Hodgkin's
- Non-Hodgkin's
- Burkitt lymphoma
- t(8;14)—translocation, “Starry sky” appearance, sheets of lymphocytes
with interspersed “tingible body” macrophages, associated with EBV. Jaw
lesion in endemic form in Africa; pelvis or abdomen in sporadic form.
- Diffuse large B-cell lymphoma
- Alterations in Bcl-2,
Bcl-6, Most common
type of non-Hodgkin
lymphoma in adults.
- Follicular lymphoma
- t(14;18)—translocation,
Indolent course; Bcl-2
inhibits apoptosis. Presents
with painless “waxing and
waning” lymphadenopathy.
- Mantle cell lymphoma
- t(11;14)—translocation,
Very aggressive,
patients typically
present with
late-stage disease.
- Marginal zone lymphoma
- t(11;18), Associated
with chronic
inflammation (eg,
Sjögren syndrome,
chronic gastritis
[MALT lymphoma]).
- Derived from a specific lineage
of B cells(Reed-Sternberg cells).
- Manifestations are similar to
Non-Hodgkin’s Lymphoma(fever,
chills, wt. loss, & night sweats).
- Presents at single site(rarely
extranodal), in young adults or elderly
- Spread is contiguous, Associated
with Epstein-Barr virus
- CD15+ and CD30+
- Classification
- Nodular sclerosis
- Most common[70%], enlarging cervical
or mediastinal lymph node, bands of
sclerosis, lacunar appearance
- Lymphocyte-rich (best prognosis)
- Mixed cellularity
- Associated with abundant
eosinophils, IL-5
- Lymphocyte-depleted
- Most aggressive
of all types
- Neoplastic proliferation of
lymphoid cells arising in a lymph
node or in extra-nodal tissue
- Stages
- Stage 1
- Stage 2
- Stage 3
- Stage 4
- Investigations
- CBC, ESR, LFT
- Chest radiograph
- CT SCAN
- PET SCAN
- STAGING
LAPAROTOMY
- Treatment
- R-CHOP
- Rituximab
- Cyclophosphamide
- Doxorubicin
- Prednisolone
- Vincristine
- Prognosis
- IPI score
- 0-1 risk factors - 75%
- 2-3 risk factors - 50%
- 4-5 risk factors - 25%