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lymphoma
A 25 year old lady
? Infection EBV
? Environmental factors
REAL* Classification
Classic:
NodularSclerosis
Lymhocyte rich
Mixed Cellularity
Lymhocyte depleted
Non-Classic
Nodular Lymphocyte predominant
Reactive
background of eosinophils,
lymphocytes, plasma cells
Fibrous tissue
The operation was done on February
third, my boyfriend's birthday.
Bulky disease
Lymphangiography
Staging
Stage I : Involvement of single LN region (I) or extra
lymphatic site (IAE )
Stage II : Two or more LN regions involved (II) or an
extra lymphatic site and lymph node regions on the
same side of diaphragm
Stage III : Involvement of lymph node regions on both
sides of diaphragm, with (IIIE) or without (III) localized
extra lymphatic involvement or involvement of the
spleen (IIS) or both (IISE)
Stage IV : Involvement outside LN areas (Liver, bone
marrow)
A : Absence of B symptoms
B : B symptoms present
I had Stage IVb Hodgkin's Disease, a form of
cancer of the lymph nodes.
RT
Chemo
BMT / SCT
Antibody treatment: Rituximab target CD-20
Supportive
Treatment - Guidelines
Indicationsfor RT:
Stage I disease
Stage II disease with 3 or lesser areas involved
For Bulky disease
For pressure problems
Indications for CT
All with B symptoms
Stage II disease with >3 areas involved
Stage III and IV disease
Treatment
Stage
IA , Stage IIA with 3 or < 3 areas involved:
Radiotherapy
StageIII & IV :
Chemotherapy + Radiotherapy ( for bulky
disease or palliation of symptoms)
Irradiation fields used in Hodgkins Lymphoma
Chemotherapy
MOPP :
Nitrogen Mustard,
Vincristine
(Oncovin), Procarbazine,
Prednisolone
ABVD:
Adriamycin,
Bleomycin,
Vinblastine,
Dacarbazine
Higher
dose for relapse or younger pts with poor
prognostic features
After six cycles of chemotherapy, my
CT scans still show masses on my
chest and in my neck.
Staging
Similar to HD
Etiology
Cannotbe attributed a single cause
Chromosomal translocations: t (14, 18)
Infection:
Virus:EBV, HTLV,HHV-8, HIV
Bacteria: H.Pylori - Gastric lymphoma
Immunology:
Congenitalimmunodeficiency,
Immunocompromised patients - HIV, organ transplantation
'When I went back a couple of weeks
later, he said that the results showed I
had stage I indolent follicular non-
Hodgkin's lymphoma, which is a slow-
growing form of the disease.
Chemotherapy: mainstay
CHOP
-every 3 weeks, at least
6 cycles
Cyclophosphamide,
Doxorubicin Hydrochloride,
Vincristine,
Prednisolonone
'We talked about what treatment I
should have, and the doctor said that,
as I had radiotherapy on my neck
before, and now other lymph nodes
were involved, I couldn't have the same
treatment again.
High risk cases with poor prognostic
factors or relapse :
High dose chemotherapy
combined with autologous BMT / SCT
Monoclonal antibody