Affecting lymphnodes and spleen/liver lymphoreticular and mucosal related lymph nodes (tonsils...mucosa associated lmphoid tissues..peyes patches...) must consider these areas and see.
painless enlargement of lymphnodes
painful ⇒ reactive
Continous extension between lymphnode and
pathognomic histology ⇒ r.S cell
Boys > girls
Rare before 5. Occur after 11.
peak incidence 15 to 35
excision biospy of lymphonodes to diagnose. for real.
Not incision or fnac.
area where infections or inflammations are common like cervical/axillary/iguinal
Hodgkin's Lymphoma
30% of all lymphomas
painless...extra nodal non uncommon. Mediatinal too.
true cut biosy can check prognosus and response
FNAC for cytology
Toxoplasmosis, TB ⇒ DD for hodskin lymphoma
bone amrrow for late staging stage high stage
chemo =/- radiotherapy depends on the stage
ABDV + steriod
chemotherapy targets the stages of the cell cycle ...thats there main mechanism of action
And chemotherapy side effects?
prognosis over 90% for stage 1/2
70% - 80% stage 3/4
histolpatholog grading
Non Hodgkin's Lymphoma
older, hetegenous and not conitnues, extra nodal, cant be cured easily, more sub types, no RS cells
Males more likely. Burkitt in africa.
few days to week
can go for months if undiagnosed
Non specific - anorexia, maliase, loss of weight
On the localisation - abdomen, mesentery, retroperitonum and ovaries
interssusuption, apendix, ileus
Mediatinal widening, increased intrathoraxic pressure, lump, swelling of face
DD
lymph node enlarge metn of infections
Autoimmune
Hodgkins
Metastasis of sarcomas and neuroblastomas
ALL - 25% of blasts. if less 25% ⇒ nhs (another source?
Stuff can come for OSCEs. So be mindful!
ultrasound
Induction needs to be started as soon as possible
Tumor lysis syndrome will occur ⇒ prophlaxis or treatment
Chemotherapy, surgical
Lmphoma in the lympahtic cells
5-10% of all neoplasia in children
Ratio of males higher
Chromosomal alterations
Predisposal factors
AIDS
Autoimmune disorder
HIV
EBV
Congeital T cell and B cell defecrs
Thymoplysia
Blooms syndromw
Exposure to radiation
etc
Types
Burkitss 50% - adbodmen
Large B cell 7.8% abdomen , peripheral lymphnodes, skin and bones
Lymphoblastic 30% thorax
Anaplastuc 7.8% lymphnose, skin , soft tissue and bone
50% ⇒ lymphatic abdoemn localisation
80% 8 2
20 8
40% p53 mutatiosn
Burkitts lymphoma
Comparison
Summary
