Normally the lymph nodes are composed of connective tissues that surround a

Normally the lymph nodes are composed of connective

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Normally, the lymph nodes are composed of connective tissues that surround a fine mesh of reticular fibers and cells. In Hodgkin's lymphoma the normal structure of lymph nodes is destroyed by hyperplasia of monocytes and macrophages. The main diagnostic feature of Hodgkin's lymphoma is the presence of Reed-Sternberg cells in lymph node biopsy specimens. s/s o enlargement of cervical, axillary, or inguinal lymph nodes o mediastinal node second most common location o nodes are not painful unless they exert pressure on nerves o weight loss o fatigue o fever o chills o tachycardia o night sweats o A group of initial findings including fever (in excess of 100.4° F [38° C]), drenching night sweats, and weight loss (exceeding 10% in 6 months) are termed B symptoms and correlate with a worse prognosis o Pain when drinking alcohol o Skin lesions o Advanced: hepatomegaly and splenomegaly, anemia 7
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Amanda Sacca Care o standard for chemotherapy is the ABVD regimen: doxorubicin (Adriamycin), bleomycin, vinblastine, and dacarbazine o more severe BEACOPP (bleomycin, etoposide, doxorubicin (Adriamycin), cyclophosphamide, vincristine (Oncovin), procarbazine, and prednisone) Non-Hodgkin’s Lymphoma heterogeneous group of malignant neoplasms of primarily B-, T-, or natural killer (NK) cell origin affecting all ages B-Cell lymphomas T cell and NKcell lymphomas patho o cause unknown; possible chromosomal translocations, environmental factors, immunodeficiency states o no hallmark feature like reed-sternberg cells o mimic leukemia o Diffuse large B-cell lymphoma, the most common aggressive lymphoma, is a neoplasm that originates in the lymph nodes, usually in the neck or abdomen. o Burkitt's lymphoma is the most highly aggressive disease and is thought to originate from B-cell blasts in the lymph nodes. s/s o NHLs can originate OUTSIDE the lymph nodes o Method of spread unpredictable o Primary clinical manifestation: painless lymph node enlargement o Usually disseminated when diagnosed Other symptoms present depending where the disease has spread o Patients with high-grade lymphomas may have lymphadenopathy and constitutional symptoms (B symptoms) such as fever, night sweats, and weight loss. Care o chemo and radiation o Weird --- more aggressive lymphomas (diffuse large B cell) are more responsive to tx and more likely to be cured than indolent lymphomas that have naturally long course but are difficult to treat 8
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Amanda Sacca Rituximab, a monoclonal antibody against the CD20 antigen on the surface of normal and malignant B cells, is used to treat NHL. Once bound to the cells, rituximab causes lysis and cell death. Numerous chemotherapy combinations have been used to try to overcome the resistant nature of this disease (Table 30-29). Complete remissions are uncommon, but the majority of patients respond with improvement in symptoms.
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