non hodgkin's lymphoma | Non-Hodgkin's lymphoma

Non-Hodgkin's lymphoma



Definitions
Pathophysiology
Classification
Etiologies
Clinical Exams and signs
Examinations and Paraclinical Signs
Complications
Taking care

1. Definitions
1.1 Non-Hodgkin's lymphoma

Non-Hodgkin's lymphoma is a malignant tumor of the lymphatic system developing in organs containing lymphoid tissue and then invading the viscera, marrow and blood, secondary to the malignant transformation of a lymphoid cell B or a Lymphoid cell T.

1.2 Tumor
A tumor is a proliferation of abnormal cells resulting in a tissue mass that more or less resembles the homologous normal tissue and increases by escaping the biological rules of cell growth and differentiation (autonomy Biological).

The benign tumor does not spontaneously result in the patient's death.

1.3 Malignant tumor-Cancer
A malignant tumor or cancer is a proliferation of abnormal cells (tumors) resulting in a poorly constrained and irregular tissue mass; Which more or less resembles the original fabric and rapidly increases with biological autonomy, by invading and destroying the original fabric and sometimes the surrounding tissues; and can be disseminated remotely by lymphatic and blood, to form secondary tumors in other tissues: metastasis.

The malignant tumor spontaneously leads to the death of the patient in the absence of treatments.

2. pathophysiology
Abnormal lymphoid cells are derived from the malignant transformation of a lymphoid cell B or a lymphoid cell T
The proliferation of abnormal lymphoid cells occurs in any organ containing or not, lymphoid cells
Lymphoid proliferation leads to an extension of the tumor by lymphatic, blood or contiguous

3. Classification
Ann Harbor Classification in 4 stages:
Stage I: Attainment of a single ganglionic region or a single lymphocyte structure (spleen, thymus, Waldeyer ring)
Stage II: Attainment of 2 or more ganglion regions located on the same side of the diaphragm. Upper, middle and lower mediastinum is considered to be a single region but pulmonary hiles are considered independent of mediastinum
Stage III: Impairment of lymph nodes or lymphocyte structures on either side of the diaphragm
Stage III-1: Impairment under diaphragmatic limited to the spleen, to the ganglia of the hilum splenic, celiac or trunk door
Stage III-2: Attainment of lumbosacral-aortic, iliac or mesenteric regions associating or not with the invasion of III1 stage structures
Stage IV: Attainment of a viscera (not contiguous to a ganglionic attack) or of several viscera

4. Etiologies
Human immunodeficiency Virus (HIV)
Auto-immune disorder
Immunosuppression
Helicobacter pylori
Epstein-Barr Virus (EBV)
Toxic (pesticide)
Genetic factor

5. Clinical Examinations and Signs
Lymphadenopathy: Increase of the volume of a lymph node
Superficial lymphadenopathy
Lymphadenopathy Farm
Lymphadenopathy not painful
Painful lymphadenopathy by ingestion of alcohol
Asthenia
Hyperthermia
Night Sweating
Slimming
Perception of abdominal mass:
Hepatomegaly
Splenomegaly
Compression signs:
Pain
Cough
Dyspnea

6. Examinations and Paraclinical Signs
Lymph node biopsy: confirms the diagnosis
Biological Balance:
Blood count (NFS) – Platelets
Blood Ionogram
Kidney function
liver function
Extension Balance:
Electrocardiography (ECG)
Chest X-Ray
Thoraco-abdominal-pelvic Scanner (Computed tomography: TDM)
PET Scanner
Abdominal ultrasound
Ostéomédullaire biopsy

7. Complications
Immunosuppression
Recurrence

8. Taking care
Medical Management:
Chemotherapy
Radiotherapy
Immunotherapy: Monoclonal antibodies
Analgesic
Autografting of peripheral stem cells
Psychological and support management:
Psychological support for the patient and his entourage
Therapeutic Education:
Explain the disease, the treatments, the adverse effects
To accompany the patient to the acquisition of self-care and adaptation skills, necessary to improve and maintain the state of his health, his quality of life and those of his relatives

References
College of the High Authority of Health (HAS)-Chronic disease Service and patient support devices/National Cancer Institute (CNIB)-Department of Health professional recommendations. Long-term affection Guide (ALD): "Malignant tumor, malignant disease of the lymphatic or hematopoietic tissue-non-Hodgkin lymphomas of the adult". March 2012.