Malignant Lymphoma: cancerous tumor composed of uncontrollably growing peripheral lymphoid tissue cells. Both Hodgkin’s and Non-Hodgkin lymphomas are characterized by uncontrolled neoplastic growth of lymph tissue and in lymph nodes.
Hodgkin Lymphoma or Hodgkin Disease:
- a group of cancers characterized by the presence of Reed-Sternberg cells.
- This unicentric cancerous line spreads from a single lymph node by continuous extension along the lymphatic system.
- Spread of cancerous cells is often along predictable lines
- localization is common.
- Epstein-Barr Virus Infection which has been linked to Hodgkin’s Lymphoma.
- a heterogenous group of cancers that originate from neoplastic B or T cell lymphoid tissue, cells of this cancer type may vary morphologically.
- This multicentric cancer line metastasizes unpredictably.
- Localization of disease is uncommon.
- Epstein-Barr Virus has been linked to Burkitt Lymphoma
- Human T cell lymphotrophic virus has been linked to adult T cell leukemia-lymphoma
- Helicobactor pylori infection linked with MALT stomach lymphoma
- has been linked to environmental toxins, viral infection and immunosuppressant states such as HIV/AIDS and immunosuppressant drug therapies such as those used in organ transplantation.
Reed-Sternberg cells: the malignant cell line of Hodgkin’s disease. Morphologically large cell thought to be of immature lymphoid cellular origin. When fewer Reed-Sternberg cells are present the cancerous spread is limited to fewer lymph nodes.
Risk Factors: with links to previous infection with Epstein-Barr Virus, immunosuppressant states such as HIV/AIDS and or organ transplantation. Research has indicated genetic predisposition for developing Hodgkin Lymphoma.
- disseminate via lymphatic system and blood vessel infiltration
Manifestation signs and symptoms:
- painless lymphadenopathy (due to pressure or obstruction)
- enlarged lymph nodes may be evident in the supraclavicular, cervical regions
- Involvement of extremities may manifest in pain, nerve irritation and obliteration of pulse
- Systemic B symptoms = fever, night sweats, weight loss, pruritis, hepatomegaly and splenomegaly
- non-productive cough (mediastinal mass)
Treatment – medical management:
- Radiation is the primary treatment strategy in localized disease, stage 1 (single lymph node involvement) and stage 2 (involvement of 2 or more lymph nodes on the same side of the diaphragm).
- Stage 3 treated with a combination of radiation and chemotherapeutic agents
correlations with environmental toxins, viral infections (EBV, human herpes virus 8), bacterial infections (Helicobactor pylori) and immunosuppressive states (HIV/AIDS and immunosuppressant drug therapies for organ transplants) have been implicated.
Pathophysiology: abnormal proliferation of neoplastic lymphocytic lineage.
Manifestations: Painless enlargement of lymph nodes. Symptoms arise as neoplasms impair and obstruct lymph nodes.
May include extranodal site metastasis to:
- GI tract
Systemic B symptoms may occur:
- night sweats
- weight loss
- hepatomegaly or splenomegaly may also occur
- depends on histological type, stage of disease and clinical status of the person
- radiation may be most effective for localized, early stages and non-aggressive forms
- stages 1 and 2 may be effectively treated with chemotherapy and radiation
- cranial radiation or intrathecal chemotherapy, in addition to systemic radiation may be used to treat more advanced stages
- Monoclonal antibody therapy may also be used to specifically target antigens present on most B cell lymphoma cell surface
Martin, Glenn and Porth, Carol, Mattson. 2009. Pathophysiology Concepts of Altered Health States. 8th ed. Lippincott Williams and Wilkins. Philadelphia