内科学 淋巴瘤-邹善华

内科学 淋巴瘤-邹善华

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1、LymphomaZhongshanHospital,FudanUniversityZouShanhuaDefinition:AgroupofneoplasticdiseasesoflymphoidtissuesClassification:Hodgkin′sDisease,HD(Hodgkin′sLymphoma)NonHodgkin′sLymphoma,NHL)GeneralConsiderationsClinicalFeatures:Painless,progressivelymphadenectasisFev

2、er,weightloss,nightsweat;cachexiaHepatosplenomegalyEpidemiology:Incidence:incities/inthecountry;male/female;ageHD8~11%;NHL90%GeneralConsiderationsVirulogy:EBvirus→Burkittlymphoma,HDHumanT-cellLymphotropicVirustype1,HTLV-1→AdultT-celllymphoma/leukemia,ATLHTLV-2

3、→MycosisFungoidesHelicobacterPylori→MALTlymphomaKaposisarcoma-associatedherpesvirus→primarybodycavitylymphomaEtiologyandPathogenesisImmuneStatesofHost:Immunodeficiency/immunosuppressionMechanism:Antigenicstimulation→lymphadenosis(modulation↓)→infiniteprolifera

4、tion→lymphomaEtiologyandPathogenesisClassificationofLymphomaHD:Reed-Sternberg(R-S)CellClassificationofLymphomaRyeClassification,1966LymphocytepredominanceNodularsclerosisMixedcellularityLymphocytedepletionClassificationofLymphomaWHOClassification,2001Nodularly

5、mphocytepredominanceHodgkin'slymphomaClassicalHodgkin'slymphomaLymphocyte-richclassicalHodgkin'slymphomaNodularsclerosisHodgkin'slymphomaMixedcellularityHodgkin'slymphomaLymphocytedepletionHodgkin'slymphomaClassificationofLymphomaNHL:ClassificationofLymphomaNH

6、L:IWF,1982REAL,1994WHO,2001WorkingFormulationLow-gradelymphomaA.smalllymphocytic,consistentwithchroniclymphocyticleukemiaplasmacytoidB.follicular,predominantlysmallcleavedcelldiffuseareassclerosisC.follicular,mixedsmallcleavedandlargecelldiffuseareassclerosisW

7、orkingFormulationIntermediate-gradlymphomaD.follicular,predominantlylargecelldiffuseareassclerosisE.diffuse,smallcleavedcellsclerosisF.diffuse,mixedsmallandlargecellsclerosisepithelioidcellcomponentG.diffuse,largecellcleavedcellnoncleavedcellsclerosisWorkingFo

8、rmulationHigh-gradelymphomaH.mmunoblastic,largecellplasmacytoidclearcellpolymorphousepithelioidcellcomponentI.lymphoblastic,convolutedornonconvolutedcellJ.smallnoncleavedcell,Burki

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