复旦大学：《内科学》课程教学资源（PPT课件讲稿）Lymphoma

Lymphoma Zhongshan Hospital Fudan University Zou shanhua

Lymphoma Zhongshan Hospital ,Fudan University Zou Shanhua

General considerations Definition: A group of neoplastic diseases of lymphoid tissues Classification: Hodgkin′ s Disease,HD ( Hodgkin′ s Lymphoma) Non Hodgkin 's Lymphoma, NHL)

Definition：A group of neoplastic diseases of lymphoid tissues Classification： Hodgkin′s Disease, HD (Hodgkin′s Lymphoma) Non Hodgkin ′s Lymphoma,NHL) General considerations

General Considerations Clinical Features Painless, progressive lymphadenectasis Fever wasting, night seat; cachexia Splenohepatomegalia epidemiology: Incidence: urban /rural: male/female: age HD8~11%;NHL90%

Clinical Features： Painless,progressive lymphadenectasis Fever,wasting,night seat；cachexia Splenohepatomegalia Epidemiology： Incidence： urban / rural;male/female;age HD 8～11％；NHL 90% General Considerations

Etiology and Pathogenesis Virology: EB virus→ Burkitt lymphoma、HD HTLV.I→→ATL HTLV-- Mycosis fungoides

Virulogy: EB virus→Burkitt lymphoma、HD HTLV-Ⅰ→ATL HTLV-Ⅱ→Mycosis fungoides Etiology and Pathogenesis

Etiology and Pathogenesis Immune States of host Immune deficiency/immune suppression Mechanism: Antigenic stimulction-y lymphadenosis(modulation+) -,infinite proliferation → ymphoma

Immune States of Host： Immune deficiency/immune suppression Mechanism：Antigenic stimulction → lymphadenosis(modulation↓ ) → infinite proliferation →lymphoma Etiology and Pathogenesis

Classification of Lymphoma HD: Reed-Sternberg(r-s) Cell Rye classification, 1966 Lymphocyte predominance Nodular sclerosis Mixed cellularity Lymphocyte depletion

HD：Reed-Sternberg(R-S) Cell Rye Classification ，1966 Lymphocyte predominance Nodular sclerosis Mixed cellularity Lymphocyte depletion Classification of Lymphoma

Classification of Lymphoma NHLE IwF,1982 REAL, 1994 wHO,2000

NHL： IWF，1982 REAL，1994 WHO，2000 Classification of Lymphoma

Working formulation Low-grade lymphoma A. small lymphocytic, consistent with chronic lymphocytic leukemia plasmacytoid B follicular, predominantly small cleaved cell diffuse areas sclerosis C follicular, mixed small cleaved and large cell diffuse areas sclerosis

Working formulation Low-grade lymphoma A. small lymphocytic, consistent with chronic lymphocytic leukemia plasmacytoid B. follicular, predominantly small cleaved cell diffuse areas sclerosis C. follicular, mixed small cleaved and large cell diffuse areas sclerosis

Working formulation Intermediate-grad lymphoma D follicular, predominantly large cell diffuse areas sclerosis Ediffuse, small cleaved cell sclerosis F diffuse, mixed small and large cell sclerosis epithelioid cell com ponent G. diffuse, large cell cleaved celll noncleaved cell sclerosis

Working formulation Intermediate-grad lymphoma D. follicular, predominantly large cell diffuse areas sclerosis E. diffuse, small cleaved cell sclerosis F. diffuse, mixed small and large cell sclerosis epithelioid cell component G. diffuse, large cell cleaved cell noncleaved cell sclerosis

Working formulation High-grade lymphoma H. mmunoblastic, large cell plasmacytoid clear cell polymorphous epithelioid cell component lymphoblastic, convoluted or nonconvoluted cell J. small noncleaved cell. burkitts or non -Burkitts

Working formulation High-grade lymphoma H. mmunoblastic, large cell plasmacytoid clear cell polymorphous epithelioid cell component I. lymphoblastic, convoluted or nonconvoluted cell J. small noncleaved cell, Burkitt's or non-Burkitt's