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lymphoma
Presented by
Dr FERMIZET RUDY SpPD-FINASIM
FK UNILA -2010
A 25 year old lady
? Infection EBV
? Environmental factors
REAL* Classification
Classic:
Nodular Sclerosis
Lymhocyte rich
Mixed Cellularity
Lymhocyte depleted
Non-Classic
Nodular Lymphocyte predominant
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
Indications for 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
ABVD:
Adriamycin,
Bleomycin,
Vinblastine,
Dacarbazine
Staging
Similar to HD
Etiology
Cannot be attributed a single cause
Chromosomal translocations: t
(14, 18)
Infection:
Virus:EBV, HTLV,HHV-8, HIV
Bacteria: H.Pylori - Gastric lymphoma
Immunology:
Congenital immunodeficiency,
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.
Monoclonal antibody