Question

Chapter 11: Lymphatic System Disorders Case Studies Case Study 1 Ms. Y is a 31-year-old woman who reported to her physician that she has recently lost weight, always seems tired, and has experienced night sweats. A few months ago, she had noticed a small firm lump on her neck that was painless and not tender, so she ignored it. Closer physical examination revealed a swelling of several lymph nodes in the neck and throat region. A blood test indicated a decreased lymphocyte count and a lymph node biopsy revealed the presence of Reed-Sternberg cells, confirming the diagnosis of Hodgkin's lymphoma. Discussion Questions 1. Relate the pathophysiologic changes to the manifestations and lab results. (See Hodgkin's Disease/Lymphoma Pathophysiology, Signs and Symptoms.) 2. Discuss the four stages of the disease based on the Ann Arbor staging system, and determine which stage the patient is probably in. Discuss the prognosis. (See Pathophysiology-Staging Systems.) 3. Discuss the treatment options for this patient. (See Treatment.) 4. Discuss the differences between Hodgkin's and non-Hodgkin's Lymphomas. (See Non-Hodgkin's Lymphoma.)

Answer 1

1. Pathophysiologic changes to the manifestations and lab results:

The main cause of the disease is unknown, but factors like genetic and environmental pattern play a vital role in getting this disease. Due to various exposure, the patient develop a slowly progressive defect in cell-mediated immunity or in the T-cells contributes to the occurence of viral, bacterial, fungal and other infections. After that, the antibody production get reduced whiich leading to death due to infections.

The signs and symptoms as Ms. Y experienced

1. Painless cervical or axillary adenopathy
2. Fever
3. Night sweats
4. loss of appetite
5. Weight loss (due to loss of appetite)
6. Splenomegaly and
7. Cachexia

2. The different stages of Ann Arbor staging are:

• Stage 1 : Represents that the cancer is located at any one of the lymph node and the surrounding area and not have anyother symptoms ( only one region got affected)
• Stage 2 : Represent the cancer is located in an affected lymph node and one side of the diaphragm ( two separate regions got affected)
• Stage 3 : the cancer has spread to both the sides of diaphragm which includes an organ, area near the lymph nodes and the spleen.
• Stage 4 : Involvement of one or more extralymphatic organs including liver, bone marrow or lung nodules.   

From the classification above mentioned, it has revealed that Ms. Y is on stage 2. Because the cancer has spread from one lymph nodes to several other lymph nodes and throat area is also affected (the disease is spreading to other regions).

3. The different treatment method that Ms. Y can be preferred are

• Chemotherapy
• Radiation therapy
• Transplantation using peripheral system cell products.

Difference between hodgkin's and non-hodgkin's lymphoma:

• Hodgkin's disease and non-hodgkin's lymphoma are cancers that typically originates from the which blood cells know as the lymphocyte.
• Hodgkin's lymphoma are less common and accounts only for 1% of all cancers in the US but non-hodgkin's are more common and estimated 5% of death in US were related to this cancer.
• Hodgkin's occurs at the age of 15 to 40 years whereas the other are being diagnosed at their age of 60 and above.
• Because of less among males and females, the incidence rate of hodgkin's disease are lower compared to non-hodgkin's disease.
• Hodgkin's disease can be confirmed by visualizing tissue samples under a microscope whereas non-hodgkin's are associated with different types of cancers with differences in the microscopic as well as biological traits.
• When biopsy done, a certain type of cell called a Reed-Sternberg cell is identified then it is hodgkin's lymphoma and is curable. In non-hodgkin's lymphoma the prognosis depends up on the type and to what extent the disease had spread.