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RNSG 1343 Lymphoma

Chapter 29 White blood cell disorders Lymphomas

Malignant Lymphoma • Proliferation of lymphocytes, histocytes, and precursors or derivatives • Hodgkin and non-Hodgkin • Malignancies of lymphoid tissue
• Hodgkin lymphoma – Develops in a single lymph node or chain of nodes, spreads to adjoining cells – Reed–Steinberg cells – Immune system impairment - Reed-Sternberg Cells
• Pathophysiology of Hodgkin lymphoma – Etiology unknown – Contributing factors • Epstein–Barr virus • Genetic factors
– Manifestations of Hodgkin lymphoma • Painlessly enlarged lymph nodes in cervical or subclavicular region • Persistent fever • Night sweats
– Classic “B” Symptoms of Hodgkin lymphoma • Fatigue, malaise • Weight loss (>10% of normal body weight) • Pruritus • Anemia • Enlarged spleen
• Non-Hodgkin lymphoma – Does not contain Reed–Steinberg cells – Etiology unknown – Viral infections can play a role
Manifestations of Non-Hodgkin lymphoma • Early, similar to Hodgkin disease – Classic “B” symptoms • Fever, night sweats, fatigue, and weight loss are less common
• Prognosis of Non-Hodgkin lymphoma determined by – Stage of disease – Presence of systemic manifestations – Factors such as age - Prognosis good when localized to one or two node regions
– Diagnostic tests for Lymphoma – CBC – Erythrocyte sedimentation rate (ESR) – Chemistry studies of major organ function – Chest x-ray– CT scans of chest, abdomen, and pelvis – PET or gallium scans – Biopsy of lymph node and bone marrow
• Staging of Lymphoma – Ann Arbor Staging System (Stage I, II, III, IV)
Stage I of Lymphoma • Involvement of a single lymph node region or lymphoid structure
Stage II of Lymphoma • Involvement of two or more lymph node regions on the same side of the diaphragm
Stage III of Lymphoma • Involvement of lymph node regions or structures on both sides of the diaphragm • III1: limited to upper abdomen • III2: involvement of lower abdominal nodes
Stage IV of Lymphoma • Involvement of an extranodal site
Nursing Diagnoses for Lymphoma • Fatigue • Nausea • Disturbed Body Image • Sexual Dysfunction • Risk for Impaired Skin Integrity
Created by: pdimple