Hire Writer What will you tell him? I would tell him that it is cancer of the lymphocytes, which leads to an enlargement of he lymph nodes. A patient will usually have a swollen lymph node and its usually painless. To diagnose Hodgkin Lymphoma, there must be a biopsy.
MF has received honoraria from Cephalon; SL reports no conflicts of interest. The treatment of patients with non-Hodgkin's lymphoma NHL is often the treatment of elderly patients, as most patients are older than 65 years at diagnosis. These elderly patients present particular therapeutic challenges, because they may be more frail and at greater risk of treatment-related toxicity, especially anthracycline-related cardiotoxicity, than younger patients.
The following two case studies illustrate the challenges and therapeutic decision-making in managing Lymphoma case study patients with an aggressive and an indolent form of lymphoma.
Case 1 - Elderly woman with existing cardiopathy History This woman was aged 79 years at presentation. She had a history of congestive cardiopathy and myocardial ischemia, and had undergone angioplasty 10 years earlier.
Her recent history included a hospital admission due to abdominal pain. The patient was referred for diagnostic procedures. Diagnosis and staging Clinical examination showed no systemic signs or symptoms. Laboratory investigations showed that complete blood count, hemoglobin, albumin, hepatorenal function, lactate dehydrogenase LDHbeta-2 microglobulin, and serum electrophoresis were all within the normal range.
A computed tomography CT scan revealed a dishomogeneous mass with rounded margins and a longest transverse diameter of 10 cm in Lymphoma case study left flank region of the abdomen. The mass included the superior mesenteric artery, with no signs of compression.
A 2-dimensional echocardiogram showed signs of pre-existing ischemic cardiopathy with moderate reduction of ventricular function and moderate valvular incontinence. Final diagnosis The final diagnosis was therefore: Assessment for treatment According to data from epidemiological studies, the median age of patients with DLBCL at the time of diagnosis is around 65 years, and one fifth of them are, like the reported case, within the age range of 75—80 years.
In such cases, median overall survival increases to 36 months, compared with 6 months for patients in this age range who are treated with only palliative intent. The main issue in elderly DLBCL patients is then to properly decide who is suitable for a full course of therapy.
The rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone R-CHOP regimen appears to be a good option for elderly patients with aggressive lymphoma.
The addition of rituximab to the standard CHOP regimen has been shown to increase its efficacy, in both young and elderly patients. As this patient had existing cardiopathy and a low LVEF, she would be at increased risk of cardiotoxicity during anthracycline treatment. However, her disease, due to the limited stage and favorable prognostic features, may be cured, with a high chance of success, if the standard approach was adopted.
She would therefore probably benefit from the use of a standard regimen adapted to her concomitant disorders. Among the different strategies adaptable for this patient, there is the possibility of reducing the drug doses, using treatment regimens specifically designed for elderly patients, or using different formulations of the active drugs, allowing reduced toxicity.
For this last strategy, the availability of the non-pegylated liposomal doxorubicin NPLD formulation makes it feasible to substitute conventional doxorubicin in the R-CHOP regimen, defining a different, potentially more tolerable, therapy, namely the R-COMP regimen.
She also received pro-phylactic granulocyte colony-stimulating factor and erythropoietin, and prednisone was lowered to half dose in cycles 3 and 4 in order to reduce steroid-related toxicity. She was diagnosed with a pulmonary embolism at the end of chemotherapy, which resolved during treatment with low-molecular-weight heparin.
This patient remains in complete remission after 7 years. Case 2 - Elderly man with a history of cardiovascular disease History This year-old man was admitted to hospital due to abdominal pain and the presence of a palpable mass. The patient had a history of myocardial infarction 2 years before admission, which had been treated with coronary stenting.
He had persistent arterial hypertension. Diagnosis and staging The patient underwent laparoscopic biopsy, and the histologic diagnosis was grade 2 follicular lymphoma FL.
CT and positron emission tomography scans confirmed the presence of an abdominal mesenteric mass with pathologic adenopathies in the mediastinum and neck.
Laboratory tests showed normal values for white blood count, hemoglobin, platelets, and erythrocyte sedimentation rate, but elevated LDH and beta-2 microglobulin. Bone marrow biopsy revealed several perivascular and paratrabecular lymphoid aggregates, comprising B-lymphocytes expressing CD20 and CD However, if the patient has an indolent lymphoma and is in his eighth decade, he may experience a significant reduction in life expectancy if not properly cured of his disease.
It is not currently clear what the optimal chemotherapy is for FL. Some study data were obtained before the widespread use of rituximab, and others before the availability of the REAL classification of lymphomas, 16 when FL was less strictly defined and was included among other indolent lymphomas.
Based on the most recent data, a large proportion of patients are treated with R-CHOP, although rituximab, cyclophosphamide, vincristine, and prednisone R-CVP and fludarabine-based regimens such as rituximab, fludarabine, and mitoxantrone R-FM are also used.Case History: This year old female presented with bilateral ingulnal adenopathy and a subsequent right groin biopsy demonstrated a non-Hodgkin's lymphoma.
Advanced Studies inNursing 13 portive documentation. Additionally, the healthcare practice has found in the past that many people with Medicare cannot afford the out-of-. Oct 28, · The treatment of patients with non-Hodgkin's lymphoma (NHL) is often the treatment of elderly patients, as most patients are older than 65 years at diagnosis.
These elderly patients present particular therapeutic challenges, because they may be more frail .
Case Studies in Rare Lymphomas: Hodgkin Lymphoma and Systemic Anaplastic Large Cell Lymphoma 3 Multiple-choice Questions 1. . Lymphoma Case Study. Topics: Cancer, Case Study Case study methods involve Systematically gathering enough information about a particular person, social setting, event, or group to permit the researcher to effectively understand how it .
Case Study of a Newly Diagnosed HL Patient: The Role of CD30 from Diagnosis to Treatment Case Study of a Newly Diagnosed HL Patient: The Role of CD30 from Diagnosis to Treatment. Introduction.
Hodgkin lymphoma is a lymphoid malignancy that typically affects young adults; the median age at diagnosis is 34 years in our database (GHSG ).