15. Diffuse large B-cell lymphoma: pathogenesis, clinical manifestation, diagnosis, differential diagnosis, treatment.

Question 1

what is diffuse large b cell lymphoma ?

Answer 1

the most common non hodgkin b cell lymphoma

of the gagressive type

Question 2

what is the etiology of specifically diffuse large b cell lymphoma

Answer 2

diffuse large b cell lymphoma
HHV8 = human heres virus 8
from indolent lymphoma
HIV

Question 3

what is the classification of non hodgkin lymphoma ?

Answer 3

b cell most preodminant 
indolent = occuring in older , with watch an weight 
folicluar lymphoma 
maltoma 
hairy cell leuemia 
chronic lymphoblastic leukemia 

agrresive = most often occuring in younger
most aggresive is burkitt lymphoma and lymphoblastic lymphoma
agrresive - difusse large b cell lymphoma
mantle lymphoma

Question 4

what is the chareteristic of non hodgskin lymphoma ?

Answer 4

they can be extranodoal which can affect any organs

Question 5

whatare teh signs and symptoms of large b cell lymphoma ?

Answer 5

b symptoms = fever , weight loss and night sweats

extranodoal symptoms 
lung = coughing , breathing difficultings etc 
liver = jaundice etc 
testicles 
brain including the eeys 
gastroinetsinal = vomitting

Question 6

what is the staging of non hodgskin lymphomas ?

Answer 6

stage 1 = single lymph node or organ affected

stage 2 = two or more lymph node
or one lymph node region and nearby organs

stage 3 = bothe sides of the diaphrgm is affecetd
by either lymph node
or organ

stage 4 = spread to one or more organs

Question 7

what is the complication of diffuse large b cell lymphoma ?

Answer 7

it can become chronic lymphocytic leukemia - richter sydnrome
bad prog

Question 8

how do we diagnose doffuse large b cells lymphoma ?

Answer 8

excisional biopsy = large cells , with vesicular chomatin and prominent nucleoli

CT scan

pancyopenea = do bone marrow biopsy

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serum portein electropheoreisi there is an M spike

hyperuremia
hypercalcemia

high LDH

immunohistochemistery = cd20 positive cells

Question 9

how do we treat diffuse large b cell lymphoma ?

Answer 9

stage 1 and 2 
potentially curable CHOP 
6 CYCLES 
CHOP 3 CYCLES FOLLOWED BY RADIOTHERAPY if localised 
(cyclophosphamide , adriyamyicn 
 , oncovicin , 
prednisone ) 

advanced
R-CHOP

we can have prophylaxis of CSF = intrathecal therapy of methotrextae

in young = autologous stem cells transplant