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Lymphomas (Non-Hodgkin's Lymphoma (Aetiology (HTLV-1 - human T cell…
Lymphomas
Non-Hodgkin's Lymphoma
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Aetiology
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Immunodeficiency - drugs, HIV
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Signs
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Extra nodal involvement is more common than in Hodgkin's e.g in gut, skin, oropharynx
Investigations
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Grading
Low grade lymphomas = indolent, incurable, widely disseminated
High grade lymphomas = more aggressive, systemic symptoms but often curable
Treatment
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If low grade, give no treatment if symptomless. Give radiotherapy for localized disease
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5 year survival for treated patients, 30% for high grade, 50% for low grade
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Hodgkin's Lymphoma
Definition
The characteristic cells of Hodgkin's lymphoma are Reed-Sternberg cells which have two mirror image nuclei
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Symptoms
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Enlarged, non-tender rubbery lymph nodes
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Investigations
Staging
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Done via CT/PET of neck, abdomen + pelvis - Ann Arbor system
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A = no systemic symptoms, other than pruritus
B = presence of B symptoms (systemic symptoms) i.e. weight loss >10% over last 6 months, fever >38 degrees, night sweats
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Treatment
In relapsed disease, there is high dose chemotherapy followed by autologous stem cell transplantation
Radiotherapy. This may increase the risk of second malignancies in the breast and lung, IHD and hypothyroidism
Chemotherapy - curative intent, varied according to stage of disease and sites involved. Intensive regimens for poor prognosis
Definition
Lymphomas are neoplastic transformations of B and T cells which accumulate in lymph nodes (aka lymphadenopathy)
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