淋巴瘤医学专业知识宣讲讲义.ppt

淋巴瘤医学专业知识宣讲;2009年6月5日，央视《新闻联播》主持人，人称“第一国嘴”的罗京因患有淋巴瘤出现心脏衰竭在北京逝世，年仅48岁。;The lymphomas are a heterogenous group of clonal (neoplastic) diseases that share the single characteristic of arising as the result of a somatic mutation(s) in a lymphocyte progenitor. The progeny of the affected cell usually carry the phenotype of a B, T, or NK cell as judged by immunophenotyping or gene rearrangement studies. Any site of the lymphatic system may be the primary site of origin of the disorder including lymph nodes, gut-associated lymphatic tissue, skin, or spleen. Any organ, e.g., thyroid, lung, bone, brain, gonads, etc. may be involved either by spread from lymphatic sites or as a manifestation of primary extranodal disease. The classification of the subtypes of disease has been difficult but newer systems couple immunologic phenotype with histopathologic and cytologic features to arrive at definition of subtypes. By historical convention, lymphocytic malignancies originating in the marrow are referred to as lymphocytic leukemia, whereas those originating in any other lymphoid site are referred to as lymphoma. In the former case, lymphoid sites may be involved and in the latter case the marrow may be involved. Diagnosis is usually made by histological examination of a biopsy specimen, supplemented by immunophenotyping and molecular analysis for clonal origin. Patients are often put through staging procedures that may involve imaging studies, other biopsies, and blood chemical studies. Treatment depends on the type of lymphoma and the distribution of clinically evident disease. Combinations of drugs are often required. Radiotherapy may be useful for localized disease. ;教学目的;;概述;组织病理学上淋巴瘤分为霍奇金淋巴瘤（Hodgkin lymphoma, HL）和非霍奇金淋巴瘤（Non-Hodgkin lymphoma, NHL）两大类。二者的发病率、生物学特性及临床经过方面均有显著差异。;流行病学;病因和发病机制;致病因素; (3) 免疫因素 恶性淋巴瘤是免疫系统恶性肿瘤，免疫缺陷是恶性淋巴瘤的重要原因之一。正常情况下，人体的免疫系统具有免疫监视功能，对体内发生突变或癌变的细胞能起到清除的作用。免疫缺陷病人容易发生机会感染，特别是病毒感染。 (4) 遗传因素 遗传因素与恶性淋巴瘤的病因相???有许多方面的报道，有时可见明显的家族聚集性，如兄