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A 62-YEAR-OLD MALE WITH SWELLING IN NECK

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Mind Map on A 62-YEAR-OLD MALE WITH SWELLING IN NECK, created by Zainab Kamal on 03/24/2019.
Zainab Kamal
Mind Map by Zainab Kamal, updated more than 1 year ago
Zainab Kamal
Created by Zainab Kamal about 7 years ago
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A 62-YEAR-OLD MALE WITH SWELLING IN NECK
  1. Rt.sided neck swelling
    1. noted it after sore throat & was prescribed antibiotics
      1. felt small swelling in Lt. inguinal region, dropped around 7-8kg
        1. cervical lymph node biopsy were ordered.
          1. sections show diffuse effacement of lymph node architecture by large lymphoid cells
            1. diagnosis: Non-Hodgkin lymphoma
              1. confirmed the final diagnosis of Diffuse Large B cell NHL
                1. immunohistochemistry: +ve for CD19, CD20, and CD45 and -ve for CD5, CD3. Variable expression of CD10 and BCL6 was noted.
                  1. CT: Rt. cervical & Lt. inguinal with diffuse involvement of retroperitoneal nodes, high LDH
                    1. stage IIIB Diffuse large B cell Non-Hodgkin lymphoma.
                      1. treated with six cycles of rituximab + CHOP chemotherapy
                        1. R-CHOP
                          1. R-CVP
                            1. FCR
                              1. DA-EPOCH
                              2. low
                                1. small lymphocytes, flollicular
                                2. intermediate
                                  1. diffuse small, diffuse large, diffue mixed
                                  2. high
                                    1. large cell, immunoblastic, lymphoblastic
                                    2. miscellaneous
                                    3. diagnosis
                                      1. biopsy
                                        1. Contrast CT
                                          1. X-ray
                                            1. PET
                                              1. CBC
                                                1. immunohistochemstry
                                                  1. flow cytometry
                                                2. B cell lymphoma
                                                  1. CD19, CD20
                                                  2. T cell lymphoma
                                                    1. CD3, CD4, CD8
                                                3. hodgkin
                                                  1. reed stirnberg cells
                                                    1. Ass. EBV
                                                      1. localized, single
                                                      2. non hodgkin
                                                        1. multiple, spread
                                                          1. majority B cells
                                                            1. Ass. HIV
                                                        2. Core needle biopsy
                                                          1. Fine needle aspiration
                                                            1. Excisional biopsy
                                                              1. permits the hematopathologist to evaluate the architecture of the lymph node.
                                                            2. signs & symptoms
                                                              1. swollen lymph nodes
                                                                1. Abdominal pain
                                                                  1. Night sweats
                                                                    1. weight loss
                                                                  2. risk factors
                                                                    1. low immunity
                                                                      1. infections
                                                                        1. HIV
                                                                          1. EBV
                                                                            1. H.pyori
                                                                              1. HCV
                                                                                1. HTLV-1
                                                                                2. age above 60
                                                                              2. lymph node distribution

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