lymphomas

lymphomas

1. malignancies of immune sys cells

   • divided into
     • Hodgkin
       • seen more often in adolescence
     • non-Hodgkin
       • more common in childhood

2. Hodgkin lymphoma

   • presentation
     • painless lymphadenopathy
       • most often in neck
       • lymph nodes larger & firmer than benign lymphadenopathy often seen in kids
       • lymph nodes cause airways obstruction
     • long hx (several months)
     • systemic sx (aka B sx) uncommon, even in more advanced
       • sweating
       • pruritus
       • weight loss
       • fever
   • Ix- to stage disease & determine Rx
     • lymph node biopsy
     • radiological assessment of all lymph node sites
     • bone marrow biopsy
   • Mx
     • combo chemo w/ or w/o radiotherapy
     • PET scanning
       • used in UK to monitor Rx response & guide further mx
     • about 80% of all pts can be cured
       • 60% of pts w/ disseminated disease can be cured

3. Non-Hodgkin lymphoma

   • T cell malignancy- characteristic mediastinal mass
     • + varying degrees of bone marrow infiltration
     • may cause SVC obstruction
   • B cell
     • more commonly NHL
       • localised lymph node disease
         • head & neck
         • abdo
   • abdo disease
     • pain from intestinal obstruction
     • palpable mass
     • intussusception w/ involvement of ileum
   • Ix
     • biopsy
     • radiological assessment of nodal sites
       • CT
       • MRI
     • examination
       • bone marrow
       • CSF
   • Mx
     • multiagent chemo
     • prognosis
       • most do well
         • survival rates of 80% expected for B & T cell disease