17424458
A 62 year old male with
swelling in neck
- Swelling in neck diffrential diagnosis
- Cingenital
- Thyroglossal cysts
- Thyroglossal cysts
- Developmental
- Branchial cysts
- Branchial cysts
- Skin and
subcutaneous
tissue
- Lipooma
- Lipooma
- Thyroid swellings
- solitary thyroid nodule
- solitary thyroid nodule
- Salivary glands
tumors
- Pleomorphic adenoma
- Pleomorphic adenoma
- Tumors of
parapharyngeal
space
- deep lobe parotid
- deep lobe parotid
- Reactive neck
lymphadenopathy
- Tonsilitis
- Tonsilitis
- Malignant neck node
- metastases
- Lymphoma
- Neoplastic proliferation oflymphoid
cells that forms a mass; may arise in a
lymph node or in extra nodal tissue
- Lymphnode
- Lymph Node
Development
- The lymph sacs are transformed
into groups of lymph nodes in
early fetal life, at about the third
month, except the upper portion
of the cisterna chyli, which
persists.
- The mesenchymal
cells will give rise
to the lymph node
capsule and the
connective tissue
framework of the
node.
- The lymph sacs are transformed
into groups of lymph nodes in
early fetal life, at about the third
month, except the upper portion
of the cisterna chyli, which
persists.
- Lymph Node distribution
- Lymph Nodes of the Neck
- major site of B and T lymphocytes
- Histology of the Thymus
- Site of T-cell differentiation and maturation
- Located in the anterosuperior mediastinum
- Encapsulated
- Cortex dense with immature cells
- Medulla pale with Mature Tcells and Hassal corpuscles (Reticular cells)
- Site of T-cell differentiation and maturation
- Lymphocytes Functions
- Histology of the Thymus
- Lymphadenopathy
- Acute infections
- Chronic infections (Cat Scratch Disease).
- Primary or secondary tumors
- Autoimmune Diseases.
- Acute infections
- Lymph Node
Development
- Lymphnode
- Risk Factors
- Epstein-Barr virus
infection/mononucleosis
- Age & Gender
- Family history
- Weakened immune system
- Exposure to certain
chemicals and drugs
- Infections that directly transform lymphocytes
- HTLV-1
- EBV
- HHV-8
- HTLV-1
- Epstein-Barr virus
infection/mononucleosis
- Hodgkin vs. Non-Hodgkin
Lymphoma
- Classification
- Hodgkins Lymphoma
- Classic
Hodgkins
Lymphoma
- Nodular Sclerosis type\ Mixed
cellularity\ Lymphocyte Rich\
Lymphocyte Depleted
- Nodular Sclerosis type\ Mixed
cellularity\ Lymphocyte Rich\
Lymphocyte Depleted
- Nodular Lymphocyte
predominant
Hodgkins lymphoma
- Classic
Hodgkins
Lymphoma
- Non-Hodgkin Lymphoma
- Relation Between
Non-Hodgkin Lymphoma
and Leukemia
- Chronic
lymphocytic
leukemia
- Similar to small-cell
lymphocytic lymphoma
- Transform into diffuse large B
cell lymphoma by Richter
transformation
- Richter transformation is
common in chronic
lymphocytic leukemia with
deletion 17p, or trisomy21 or
NOTCH1 mutations.
- Richter transformation is
common in chronic
lymphocytic leukemia with
deletion 17p, or trisomy21 or
NOTCH1 mutations.
- Similar to small-cell
lymphocytic lymphoma
- Adult T cell
leukemia\lymphoma
- It is T cell non-Hodgkin
lymphoma that is
caused by HTLV1
- there is
lymphocytosis
in blood.
- there is
lymphocytosis
in blood.
- It is T cell non-Hodgkin
lymphoma that is
caused by HTLV1
- Chronic
lymphocytic
leukemia
- Aggressive non-Hodgkin lymphomas
- Account for 60 % of all non-Hodgkin lymphomas
- Younger patents
- More B symptoms
- Short natural history
- Median survival rate (1-2 years).
- Account for 60 % of all non-Hodgkin lymphomas
- Indolent non-Hodgkin lymphomas
- Account for 40 % of all non-Hodgkin lymphomas.
- Older patients.
- Few B symptoms.
- Long natural history.
- Median survival rate (7 to 10 years).
- Account for 40 % of all non-Hodgkin lymphomas.
- Hodgkins Lymphoma
- Classification
- Diagnosis
- Excisional biopsy
- Immunohistochemistry
- Flow cytometry
- CD 19, CD20 for B
cell lymphomas
- CD 3, CD 4, CD8 for T
cell lymphomas
- CD 19, CD20 for B
cell lymphomas
- Chromosome changes
- 4;18 translocation in follicular lymphoma (bcl-2 oncogene)
- t(8;14), t(2;8), t(8;22) in Burkitt lymphoma (c-myc oncogene)
- t(11;14) in mantle cell lymphoma (cyclin D1 gene)
- 4;18 translocation in follicular lymphoma (bcl-2 oncogene)
- Excisional biopsy
- Staging
- Blood tests
- Bilateral bone
biopsy & aspirate
- Lactic dehydrogenase, beta-2
microglobulin levels
- Chest x-ray, CT scan
- PET
- Lumbar puncture in case of : AIDS NHL
- Blood tests
- Management
- First-line treatment for stages I & II
- First-line treatment for stages III & IV
- Follow-up care
- First-line treatment for stages I & II
- Neoplastic proliferation oflymphoid
cells that forms a mass; may arise in a
lymph node or in extra nodal tissue
- metastases
- Cingenital
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