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Lymphomas Notes

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This is an extract of our Lymphomas document, which we sell as part of our Haematology Notes collection written by the top tier of University Of Leicester students.

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Lymphomas Malignant disorder of lymphoid tissue

Hodgkin's Lymphoma Reed-Sternberg cells present Epidemiology
- Two peaks in incidence o 20-30yrs o > 50yrs Clinical features
- Asymmetrical painless lymphadenopathy
- Most often cervical lymph nodes (feel rubbery)
- Hepatosplenomegaly
- 20-30% also have systemic features o Fever o Night sweats o Weight loss o Pruritis o Fatigue o Alcohol-induced pain

Aetiology
- EBV may be involved Pathology
- The malignant cells o Reed-sternberg cells o From B lymphocytes
- Tumour also made up of o T-lymphocytes o Granulocytes o Fibroblasts o Plasma cells

Staging
- Ann Arbor system o 1 = nodal involvement restricted to 1 region o II - 2 or more lymph nodes regions on the same side of diaphragm o III - nodal involvement on both sides of diaphragm or splenic involvement o IVa - extra-nodal disease - liver/bone no systemic symptoms o IVb - extra-nodal disease - liver/bone plus systemic symptoms
? Unexplained fever > 38 degrees
? Drenching night sweats
? Loss of >10% body weight in 6 months Investigations
- Blood count (FBC, LDH, ESR/PV) o Mild normochromic anaemia o Eosinophilia
- BM aspirate and trephine o Can show infiltration
- FNA of lymph nodes (excision biopsy of node preferred)
- CXR
- CT (of neck,chest, abdo, pelvis) Management
- In early stages, can be cured by radiotherapy
- In advanced stages the main treatment is chemotherapy

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