CHAPTER 3 Immune System^153
Lymphoma
WHAT WENT WRONG?
Functionless and damaged cells of the lymphatic system undergo overgrowth,
decreasing the effectiveness of the lymphatic system. There are two main types of
lymphoma, characterized by painless lymph node swelling:
- Hodgkin’s disease is malignant lymphoma characterized by presence of
Reed-Sternberg cells. There are four stages of Hodgkin’s disease:- Stage I—Reed-Sternberg cells appear in one lymph node region.
- Stage II—Reed-Sternberg cells appear in multiple lymph node regions on
the same side of the diaphragm. - Stage III—Reed-Sternberg cells appear in multiple lymph node regions
on both sides of the diaphragm. - Stage IV—Reed-Sternberg cells appear throughout the body.
- Non-Hodgkin’s lymphoma (NHL) are cancers of the B-lymphocytes and are
characterized by the absence of Reed-Sternberg cells.
The lymphomas are caused by a disruption of cells during differentiation. Diag-
nosis is made on lymph node biopsy.
PROGNOSIS
Prognosis depends on what stage the patient was in upon diagnosis, and on response
to treatment. Survival is generally <10 years for non-Hodgkins; may be more for
Hodgkins, with an optimistic staging.
HALLMARK SIGNS AND SYMPTOMS
- B symptoms (night sweats, fever, and weight loss)
- Enlarged, painless lymph nodes in cervical region, mesentery, abdomen, and
pelvis.
INTERPRETING TEST RESULTS
- Lymph node biopsy contains Reed-Sternberg cells, whichtypify Hodgkin’s disease.
- Bone marrow biopsy contains follicular type cells (Non-Hodgkin’s lymphoma).
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