Essay on Non-Hodgkin’s Lymphoma Pathophysiology
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University of Salford Manchester
Added on 2020-02-24
Essay on Non-Hodgkin’s Lymphoma Pathophysiology
University of Salford Manchester
Added on 2020-02-24
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NON-HODKIN’S LYMPHOMA 1Non-Hodgkin’s LymphomaNameName of the ClassInstructorInstitutionState and CityDate
NON-HODKIN’S LYMPHOMA 21.0 IntroductionNon-Hodgkin’s Lymphoma (NHL) is a heterogeneous group of malignancies originating from lymphoid tissues, with various clinical and biological features (Armitage 2009). The purpose of this essay is to discuss the Non-Hodgkin’s Lymphoma pathophysiology, cancer care pathway, the role of the relevant diagnostic imaging modalities and the significance of a multidisciplinary team approach care for a symptomatic. 2.0 Pathophysiology Non-Hodgkin’s Lymphoma represents a clonal expansion of the B, T or natural killer cells arising from the accumulation of lesions which affect the tumour suppressor genes leading to cell immortalisation (Lennert 2013). The oncogenes are activated by tumour suppressor or inactivated by either mutation or chromosomal deletion. Moreover, the genome of other lymphoma subtypes can be changed due to the introduction of exogenous genes from different oncogenic viruses. Leonard (2006) asserts that several cytogenetic lesions are thus connected with certain NHL, showing the presence of certain markers of diagnostic importance when it comes to classifying different NHL subtypes. Statistically, over 80% of NHLs are from B cells, while the remainder is derived from T or natural killer cells (Leonard, 2006). The tumours are characterised by several factors such as the histologic pattern of growth, cell’s origin size, the rate of proliferation of the origin cell and the differentiation level.In many of the B cell NHL subtypes, the cell size, as well as pattern of growth can be crucial determinants of tumour aggressiveness. However, it should be noted that a tumour that grows in a nodular pattern is less aggressive compared to lymphomas which proliferate in the diffusion manner (Lemone et al. 2013). Lymphomas of tiny lymphocytes have an extra indolent course compared to those of large lymphocytes with high-grade aggressiveness. NHL Risk FactorsLeonard (2006) asserts that adults have a high prevalence of contracting NHL than youngpeople. Although some lymphomas like endemic Burkitt’s occur among young people, those aged over 60 years are at high risk of getting NHL. However, diseases such as HIV and Epstein-Barr viruses (EBV) increase risks of contracting NHL. According to Baum (2014), EBV causes mononucleosis and is implicated in the aetiology of Burkitt’s lymphoma occurring following an
NON-HODKIN’S LYMPHOMA 3organ transplant while HIV weakens immune system predisposing the body to NH. Moreover, immunosuppressant’s increase the chances of contracting NHL. The drugs weaken the immune system thus increasing the susceptibility of the body to infections (Wiernik 2013).Signs and Symptoms of NHLNon-Hodgkin’s Lymphoma has various signs and symptoms which depend on the affected body part. According to Dehghani et al. (2015), NHL patients commonly exhibit constitutional signs and symptoms such as enlarged lymph nodes, losing weight, fever, unexplained fatigue and itchy skin. 3.0 Patients Care PathwayPatients’ care pathway forms part of the larger integrated care pathways, which are a multidisciplinary care plan that detail essential phases in caring for patients with the unique clinical problem and describing the expected clinical course of patients (Acton 2012). Patient care pathways include primary, secondary, and tertiary care.a) Primary CareAn NHL patient comes into contact for the first time with a healthcare provider. In this case, the General Practitioner (GP) endeavours to know the patient as an individual, tailoring healthcare services to him. The GP after listening to the patients’ symptoms, eliciting signs and suspecting NHL as possible diagnosis proceeds to undertake initial work up at establishing the diagnosis and ruling out differential diagnoses (Brown and Edward 2013). It is required of the healthcare provider to give detailed information to the patient and his/her relatives on the nature and purpose of the diagnostic and staging tests. However, with a high index of suspicion for NHL from clinical findings and test results, the GP can refer a patient to an oncologist within thehospital for secondary care (National Cancer Intelligence 2010). b) Secondary CareSecondary involves specialist care with a haemato-oncologist as the primary care provider. At secondary stage, a multidisciplinary team approach facilitates in having a holistic
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