lymphomas

lymphomas

malignancies of immune sys cells
1. divided into
  1. Hodgkin
    1. seen more often in adolescence
  2. non-Hodgkin
    1. more common in childhood
Hodgkin lymphoma
1. presentation
  1. painless lymphadenopathy
    1. most often in neck
    2. lymph nodes larger & firmer than benign lymphadenopathy often seen in kids
    3. lymph nodes cause airways obstruction
  2. long hx (several months)
  3. systemic sx (aka B sx) uncommon, even in more advanced
    1. sweating
    2. pruritus
    3. weight loss
    4. fever
2. Ix- to stage disease & determine Rx
  1. lymph node biopsy
  2. radiological assessment of all lymph node sites
  3. bone marrow biopsy
3. Mx
  1. combo chemo w/ or w/o radiotherapy
  2. PET scanning
    1. used in UK to monitor Rx response & guide further mx
  3. about 80% of all pts can be cured
    1. 60% of pts w/ disseminated disease can be cured
Non-Hodgkin lymphoma
1. T cell malignancy- characteristic mediastinal mass
  1. + varying degrees of bone marrow infiltration
  2. may cause SVC obstruction
2. B cell
  1. more commonly NHL
    1. localised lymph node disease
      1. head & neck
      2. abdo
3. abdo disease
  1. pain from intestinal obstruction
  2. palpable mass
  3. intussusception w/ involvement of ileum
4. Ix
  1. biopsy
  2. radiological assessment of nodal sites
    1. CT
    2. MRI
  3. examination
    1. bone marrow
    2. CSF
5. Mx
  1. multiagent chemo
  2. prognosis
    1. most do well
      1. survival rates of 80% expected for B & T cell disease

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	Criado por v.djabatey quase 11 anos atrás