the Describe differences between a Lymphoma and Leukemia. The lymphoid neoplasms encompass a group of entities that vary widely in their clinical presentation and behavior. As tumors of the immune system, lymphoid neoplasms often disrupt normal immune regulatory mechanisms. These neoplasms can either be characterized as lymphomas or leukemias. Leukemias are tumors that primarily involve the bone marrow with spillage of neoplastic cells into the peripheral blood. Lymphomas are tumors that produce masses in involved lymph nodes or other tissues. All lymphoid systems have the potential to spread to lymph nodes and various tissues throughout the body, especially the liver, spleen, and bone marrow. Lymphomas can spill over into the peripheral blood, creating a leukemia-like picture. Conversely, leukemias of lymphoid cells, originating in the bone marrow, can infiltrate lymph nodes and other tissues, creating a histologic picture of lymphoma. The various lymphoid neoplasms can only be distinguished based on the appearance and molecular characteristics of the tumor cells, not on the location within patients' bodies. There are two recognized lymphomas: Hodgkin and Non-Hodgkin lymphomas. In the United States, there has been a general decline in HD rates over the past 20 years, so that this disease now accounts for only 1% of all cancers. By contrast, non-Hodgkin's lymphoma has increased by more than 70% during this period and now represents 4% of all American cancers. It is the fifth most common malignancy in this country. Hodgkin Lymphomas: Hodgkin's lymphoma is characterized clinically by the orderly spread of disease from one lymph node group to another and by the development of systemic symptoms with advanced disease. Pathologically, the disease is characterized by the presence of Reed-Sternberg cells. The cure rate is about 93%, making it one of the most curable forms of cancer. Unlike some other lymphomas, whose incidence increases with age, Hodgkin's lymphoma has a bimodal incidence curve; that is, it occurs most frequently in two separate age groups, the first being young adulthood (age 1535) and the second being in those over 55 years old. Also, Hodgkin's lymphoma is more predominant in men. Symptoms may include swollen but painless lymph nodes occurring in the neck, splenomegaly (30% of cases), and hepatomegaly (5% of cases). About one-third of people with Hodgkin's disease may also notice some systemic symptoms, such as lowgrade fever, night sweats, weight loss, itchy skin, or fatigue. Stage I is involvement of a single lymph node region or single extralymphatic site Stage II is involvement of two or more lymph node regions on the same side of the diaphragm or of one lymph node region and a contiguous extralymphatic site Stage III is involvement of lymph node regions on both sides of the diaphragm, which may include the spleen and limited contiguous extralymphatic organ or site Stage IV is disseminated involvement of one or more extralymphatic organs
Non-Hodgkin Lymphomas: The etiology, or cause, is unknown. Non-Hodgkin lymphoma may develop in any organ associated with the lymphatic system, such as the spleen, lymph nodes, or tonsils. Most cases start with infiltration of lymph nodes, but some subtypes may be restricted to other lymphatic organs. The diagnosis of non-Hodgkin lymphoma requires a biopsy of involved tissue. The numerous subtypes of non-Hodgkin lymphoma are typically grouped into three distinct categories based on their aggressiveness, or histologic grade. These categories are indolent, aggressive, and highly aggressive. The treatment of indolent lymphoma may initially involve a period of observation, while aggressive or highly aggressive non-Hodgkin lymphoma is typically treated with chemotherapy and radiation therapy. The most significant factor in overall prognosis is the grade, or aggressiveness, of the lymphoma. Indolent Non-Hodgkin's lymphoma is generally not curable, but is typically slowly progressive and responds temporarily to therapy. Aggressive and aggressive highly are potentially curable with combination chemotherapy. Long-term survival or cure rates for these diseases vary with a number of prognostic factors. The most common symptom of Non-Hodgkins lymphoma is a painless swelling of the lymph nodes in the neck, underarm, or groin. Other symptoms may include unexplained fever, weight loss, poor appetite, fatigue, itchy skin, and reddened patches on the skin. Stage I - the cancer is located in a single region, usually one lymph node and the surrounding area. Stage I often will not have outward symptoms. Stage II - the cancer is located in two separate regions, an affected lymph node or organ within the lymphatic system and a second affected area, and that both affected areas are confined to one side of the diaphragm - that is, both are above the diaphragm, or both are below the diaphragm. Stage III - the cancer has spread to both sides of the diaphragm, including one organ or area near the lymph nodes or the spleen. Stage IV - the cancer has spread beyond the lymphatic system and involves one or more major organs, possibly including the bone marrow or skin. Leukemia causes damage to the bone marrow, by way of displacing the normal bone marrow cells with higher numbers of immature white blood cells, which results in a lack of blood platelets, which are important in the blood clotting process. This means people with leukemia may become bruised, bleed excessively, or develop pinprick bleeds. White blood cells, which are involved in fighting pathogens, may be suppressed or dysfunctional. This could cause the patient's immune system to start attacking other body cells. Finally, the red blood cell deficiency leads to anemia, which may cause dyspnea. Some other related symptoms include: * Fever, chills, night sweats * Fatigue * Loss of appetite and weight * Easy bruising * Frequent infection * Bone pain
* * * *
Swollen or bleeding gums Excess bleeding from minor cuts Neurological symptoms (headaches) Enlarged liver and spleen
* Joint pain * Dizziness * Swollen tonsils
The word leukemia is derived from the disease's namesake high white blood cell counts that most leukemia patients have before treatment. The high number of white blood cells is apparent when a blood sample is viewed under a microscope. Frequently, these extra white blood cells are immature or dysfunctional. The excessive number of cells can also interfere with the normal function of other cells. Some leukemia patients do not have high white blood cell counts visible during a regular blood count. This less-common condition is called "aleukemia". The bone marrow still contains cancerous white blood cells which disrupt the normal production of blood cells. However, the leukemic cells are staying in the marrow instead of entering the bloodstream, where they would be visible in a blood test. For an aleukemic patient, the white blood cell counts in the bloodstream can be normal or low. There is no single known cause for all of the different types of leukemia. The different leukemias likely have different causes, and very little is certain about what causes them. Researchers have strong suspicions about four possible causes: natural or artificial ionizing radiation certain kinds of chemicals some viruses genetic predispositions Leukemias Acute Acute lymphocytic leukemia (also known as Acute Lymphoblastic Leukemia, or ALL) is the most common type of leukemia in young children. This disease also affects adults, especially those 65 and older. Acute myelogenous leukemia (also known as Acute Myeloid Leukemia, or AML) occurs more commonly in adults than in children. This type of leukemia was previously called "acute nonlymphocytic leukemia".
Type Lymphocytic
Chronic Chronic lymphocytic leukemia (CLL) most often affects adults over the age of 55. It sometimes occurs in younger adults, but it almost never affects children.
Myeloid
Chronic myelogenous leukemia (CML) occurs mainly in adults. A very small number of children also develop this disease.