Lymphoma

Description

Mind Map on Lymphoma, created by Fatima Alkhateeb on 24/03/2019.
Fatima Alkhateeb
Mind Map by Fatima Alkhateeb, updated more than 1 year ago
Fatima Alkhateeb
Created by Fatima Alkhateeb over 5 years ago
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Resource summary

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