Lymphomas Flashcards
Functions of the Lymphatic System
Maintain fluid levels
Houses immune system
Absorb digestive tract fats
Removing cellular waste
Protect against microbes
Lymphatic Vessels
Low pressure, one-way, valved, w/collecting ducts that empty lymph into thoracic duct subclavian vein blood stream
Lymphatic Fluid
Contains extracellular fluid, nutrients, damaged cells, foreign invaders, WBCs…
Lymph Nodes
> 600
Monitor and Cleanse lymph fluid
Lymphatic System: Spleen
-Largest lymphatic organ
-Filters and stores blood and produces WBC
-B- and T-cell
Lymphatic System: Thymus
-Matures T-cell
Lymphatic System: Tonsils and adenoids
Trap pathogens from food and air
Lymphatic System: Bone Marrow
Hematopoiesis: produce WBC, platelets, RBCs
Lymphatic System: Peyer’s Patches
-Patches of lymphoid tissue in mucous membranes of small intestine
Lymphatic System: Appendix
Protects intestines from bacteria prior to absorption and housing “good bacteria”
Lymphedema
-Fluid accumulation from block due to scar tissue or removal via surgery/radiation
-Can be painful or disfiguring and risk infection
Lymphadenopathy
-Any abnormal lymph node
-Anything >1cm or palpable
-Persistent x 2 weeks
Lymphoma
-Rubbery, conglomerate, non-tender, fixed nodes
-Lymphadenopathy, hepatosplenomegaly
-B symptoms
-Symptoms related to organ involvement
-Most common blood cancer
B Symptoms
-Sign of Lymphoma
-Cyclical, nocturnal fevers
-Drenching night sweats
-Weight loss > 10%
-Fatigue
Lymphatic System Workup
-CBC (anemia, thrombocytopenia, leukocytosis-smear, flow, cytometry)
-CMP (hypercalcemia)
-LDH increased
-ESR increased
-PET-CT
-Biopsy
-Bone Marrow Biopsy
Hodgkin Lymphoma
-Reed Sternberg Cells
-EBV infection-risk factor
-Painless LAD (neck and chest), B-symptoms, Pruritis
Pain with EtOH.
-
B cells
mature in marrow, but remain antigen naïve; then diversify further when exposed to antigens in lymph tissue (nodes, spleen, MALT)
T cells
move to thymus to mature before moving to lymph tissue to function in inflammatory response, mediate direct cytotoxicity against virus or cancer infected cells, or assist B-cells;
Non-Hodgkins Lymphomas (NHL)
-100 subtypes
-B cell & T cell
-Risk Factors-Viral infections, bacterial infections (ex. H. pylori), immunocompromise, exposures (herbicides, pesticides)
NHL-T cell Lymphomas
-Generally aggressive, difficult to treat, poor prognosis
-Types (7)
NHL B cell Lymphomas
—>90 subtypes
-Aggressive
Acute, treatable (curable?)
Indolent
-Chronic, slow growing, non-curable
Burkitt Lymphoma
-Endemic to African children
-Sporadic in western world, especially children and young adults
-Bulky abdominal mass (sporadic), neck mass (endemic)
-B-symptoms
-Bone marrow involvement
-CNS disease
Follicular NHL
-2nd most common, 20-30% of all NHLs
-Graded based on centroblasts
-Risk factors-potentially cigarette use, excess EtOH, increased BMI
-Painless, increasing LAD
Tumor Lysis Syndrome
-Massive and abrupt release of cellular contents into blood stream after rapid tumor cell lysis (spontaneous or treatment)
-Clinically can cause weakness, arrhythmias, paralysis, ARF, tetany, AMS
-Treat with IVF, electrolyte management, rasburicase, allopurinol, HD
