Lymphoma non-hodgkinien

The Lymphome S non-hodgkiniens are Néoplasie S developed starting from lymphoid fabrics.

A lymphoma is a cancer of the lymphatic system. The lymphatic system includes/understands osseous marrow, the lymphatic spleen, thymus, ganglia and the blood-vessels and ensures the defense of the organization.

Form lymphoma and classification

One distinguishes the ganglionic and extra-ganglionic malignant lymphomas

Histology

*Lymphomes malignant aggressive (ganglionic or extra-ganglionic lymphomas having an aggressive presentation)
    • Phenotype B
      • lymphoma with large cells:
        • lymphoma centroblastic
        • lymphoma immunoblastic
        • lymphoma with cells B rich in cells T
        • lymphoma with cells B rich in histiocytes
        • lymphoma with large anaplasic cells B
        • lymphoma Burkitt-like
          • granulomatose lymphomatoïde
        • lymphoma associated with a pyothorax
        • lymphoma with the médiastin
        • intravascular lymphoma
        • lymphoma with séreuses the
      • lymphoma with Burkitt
    • Phenotype T
      • lymphoma with large anaplasic cells
      • lymphoma T peripheral
          • angio-immunoblastic
        • lymphoma with the zones T without precision

*Lymphomes not hodgkiniens indolent (ganglionic or extra-ganglionic lymphomas having a indolente presentation)

    • Lymphomas with cells of the marginal zone
        • lymphomas of the M.A.L.T. (Mucosa Associated Lymphoid Tissue: lymphomas of lymphoid fabric associated with the mucous membranes)
        • splenic lymphomas (of spleen) with or without villous lymphocytes
        • ganglionic lymphomas with or without cells B monocytoïdes
        • disseminated forms
    • follicular Lymphomas
        • grade 1 (< 50% of centroblastes)
        • rank 2 (> 50% of centroblastes)
        • cutaneous
        • digestive
    • Lymphomas with cells of the coat
        • traditional form
        • with round cells
        • blastic form
        • with large cells
    • Lymphomas lymphoplasmocytoïdes (or immunocytomes)

Classification of Ass Arbor

  • Stage I: Attack of only one ganglionic group or only one body.
  • Stage II: Attack of more than one ganglionic surface on the same side of the diaphragm. (lower part or upper part of the body)
  • Stage III: Multiple adenopathies on the two sides of the diaphragm. (lower part and upper part of the body)
  • Stage IV: Attack diffuses one or more internal organs and osseous marrow.

to Which one adds:

    • E at the stages I II III: if presence of a contiguous visceral attack
    • a: if no sign of B
    • b: - unexplained Slimming of more than 10% of the weight of the body in less than 6 months or unexplained Fever >38°C of more than 8 night days or Sweats profuses.

Classification of the general state of the patient

  • 0: There is no attack of the general state of health, the patient carries out a normal life.
  • 1: There exists a tiredness, but the patient can be occupied with his daily occupations.
  • 2: A strong tiredness obliges the patient to lie down in the course of the day.
  • 3: The patient remains confined to bed more half of the day.
  • 4: The patient cannot rise any more.

Etiologies

Viral chronic hepatitis C (Gastroenterology. 2006 DEC; 131 (6): 1879-86.2006 Sep 20. Hepatitis C and risk off lymphoma: results off the European multicenter box-control study EPILYMPH. Nieters has and Al )

Symptomatology

In addition to a deterioration of the general state, one finds a fébricule (38°C), a slimming, night sweats (++)…

Ganglionic forms

Presence of Adenopathy S surface palpable and deep visible in imageries.

Extra-ganglionic forms

There is no specific symptom but the expression of the invasion of the target body: the Stomach, the Thyroid , the Brain, the Testicle, the Parotid , the eye, the osseous Marrow

Prognostic indices

international prognostic Index of the lymphomas with large cells (IPI)
  • According to the Classification of Ass Arbor
  • According to the Histology of the malignant lymphoma
  • According to the rates of LDH (Lactate déshydrogénase)
  • According to the age of the patient (about 60 years)
  • Depending on his general state (0,1, 2,3,4)

international prognostic Index of the follicular lymphomas (FLIPI)

  • According to the Classification of Ass Arbor
  • According to the Histology of the malignant lymphoma
  • According to the rates of LDH (Lactate déshydrogénase)
  • According to the age of the patient (about 60 years)
  • According to the rate of Hemoglobin

Diagnosis

  • biological Examinations of blood
  • Biopsy of osseous marrow
  • Tomodensitométrie (Scanner) of the thorax and the abdomen

with Which are sometimes associated:

Treatment

Method of treatment intended to modify the natural means of defense of the organization, is by injection of serum or of immunoglobulin which brings the specific antibodies (immunothérapie passivates), are by vaccinotherapy which causes the production of these antibodies (immunothérapie active).

External bonds

  • France Lymphoma Hope: The association of patients of the lymphoma
  • FROZE: Group study of the lymphomas of the adult
  • Fondation lymphoma Canada
  • old teaching Moulage (of wax), presenting a lymphoma. (Museum of the mouldings of the Saint-Louis hospital)

See too

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