西安交通大学医学院血液系统疾病课件 Lymphoma.pptVIP

Lymphoma Classification and Feature Malignant tumor of immunologic system. Divided into NHL and HD Originate in the lymph nodes or extranodal lymphatic tissues Close relationship with monocyte-macrophage system Infiltrate to all of tissues and systems in the body Clinic features: hepatomegly, splenomegly, enlargement of lymph nodes and systemic symptom . Incidence 1.5/100000 with increasing tendence Much lower in China than other countries Much higher in NHL than HD More in male than female Origin of malignant cells in lymphoma NHL lymph node B 60%, T30%, NK HL lymph tissues not sure Histocyte---Hodgkin cell RS B or T cell HL causes and mechanism virus EB virus HTLV-1 virus disorder of immunity function auto-immune diseases, SLE imi immunosuppressant immunodeficiency Pathology and classification HD Hodgkin cell—characteristic diagnosis Reed-Sternberg: double-nucleus single- nuclear multi- nuclear close relationship between prognosis and clinical stages Clinic staging of lymphoma（Ann Arbor） Stage I: node involvement in one area Stage II: two or more areas confined to one side of diaphragm Stage III: areas above and below diaphragm Stage IV: extranodal areas including bone marrow and liver Period A: without B symptom Period B: with B symptom B symptom：fever，lose weight，night sweat Clinic manifestation HD: painless, aggressive lymph node enlargement or lymphadenopathy (particularly cervical, axillary) with or without ‘B symptoms’ local or systemic skin itch Laboratory examination HD BRT: RBC and Hb , WBC and N , Eo COOMB test + BM:R-S cell node biopsy:R-S cell biochemistry: ESR , LDH