HEMATOLOGY - alterations in lymphoid function: malignant lymphoma Flashcards
EXAM 2 content
what are lymphomas?
a diverse group of neoplasms that develop from malignant lymphocytes in the lymphoid system
what are the 3 major groups of lymphomas? what can they be?
- b cell neoplasms
- t cell neoplasms
- natural killer (NK) cell neoplasms
they can be indolent (slow grow) or aggressive (fast grow)
what are the two basic groups of lymphomas?
- hodgkin lymphoma
- non hodgkin lymphoma
what is the pathophysiology of lymphomas?
malignant transformation (normal tissue become cancer) –> produce cell with uncontrolled & excessive growth –> accumulates in lymph nodes & other sites
- starts in lymph nodes/lymphoid tissues of stomach or intestines
what are the risk factors of lymphomas?
- genetic mutation
- viral infection: epstein bar, HIV
- immune deficiencies: AIDs & organ transplant
what is hodgkin lymphoma (HL)?
where a B cell is malignantly transformed into the Reed-Sternberg cell (RS)
- progresses from one group of lymph nodes to another
- RS cells secrete & release cytokines –> accumulation of inflammatory cells (local & systemic effects)
what are the clinical manifestations of Hodgkins Lymphoma? why is the 1st sign of HL important to note? which body systems are affected?
biggest manifestation, 1st sign: enlarged painless lymph node in the neck
- this is important bc usually large lymphs cause pain – differentiating factor
- asymptomatic mediastinal mass seen in chest x-ray
- cervical, axillary, inguinal lymphadenopathy (swelling)
systemic symptoms: intermittent fever, night sweats, pruritus, fatigue
respiratory, cardic, GI & urinary system affected
what kinds of lab data would we see in someone with HL? what occurs during early & late HL
- anemia of chronic disease due to inflammation! –> elevated erythrocyte sedimentation rate (high lvls = more inflam)
- low serum iron level!
- early HL –> leukocytosis & eosinophilia
- late HL –> leukopenia
what do we use to diagnose HL?
lymph node biopsy
- looking for RS cells on pathology report
what does the disease trajectory look like in a pt with HL? what is the treatment? what risks are there with the treatment?
- HL is usually localized = better prognosis than non HL
- in adults – they can be cured with EARLY diagnosis + treatment
- treatment: chemotherapy + radiation therapy –> increase risk of second cancers & cardiovascular disease
what is NON Hodgkin lymphoma (NHLs)? how are they different from HL?
a heterogenous group of lymphoid tissue neoplasms
- these cancers are different from HL by LACK OF RS cells
what are the categories of NHLs? which category is the most common?
NHLs can arise from any – most common is B cell neoplasms
- B cell neoplasms
- T cell neoplasms
- NK cell neoplasms
what are the clinical manifestations of NHLs? what manifestations are uncommon?
- multiple peripheral lymph node enlargement
- uncommon: fever, weight loss, & nighsweat (all systemic) – they spread randomly + widely early in the course of the disease
what are the diagnostic procedures for NHLs? What is the definitive test?
- definitive test: lymph node biopsy
- CBC
- blood cchem study
- ESR (erythrocyte sedimentary rate)
what is the disease trajectory of NHLs? what treatments will we use? what does treatment depend on?
NHLs are NOT localizes – spreads widely
- partial remission is possible
- treatment depends on type (B or T cells), tumor characteristics, symptoms, age & presence of comorbidities
treatments:
- chemotherapy
- chemotherapy + radiation
- stem cell transplant
