125. Lymphomas: definition, classification, pathological anatomy, immunohistochemical diagnosis, complications, causes of death.

1) Lymphomas are malignant neoplasms of lymphoid tissue that can primarily occur in the lymph nodes or extranodal.

Classification of malignant lymphomas:

1. Morphology:

Hodgkin's lymphoma (CL)

non-Hodgkin's lymphomas (NHL)

2. By prevalence:

localized – lesion of L.U. or some one organ (stomach, lungs)

generalized – lesion of L.U., spleen, liver, CM, etc.

General morphological characteristics of lymphomas:

a) have a monoclonal origin

b) an increase in LV. (especially characteristic is an increase in cervical lv.)

c) MiSk: the erasure of the L.U. pattern, the lack of division into zones, the appearance of atypical cells

d) general symptoms of intoxication: fever above 38 ° C, profuse night sweats, weight loss

e) may leukemize (more than 25% of blasts per KM)

The diagnosis of lymphoma is established on the basis of morphological and immunohistochemical examination of biopsy or surgical material. In some cases, it is necessary to conduct molecular biological and genetic tests. Cytological examination of punctures or smear prints of lymph nodes or other tumor foci is an additional method of investigation and cannot serve as a sufficient basis for the diagnosis of lymphoma and its nosological verification.

Complications and causes of death:

1. Compression of vital organs with enlarged LV.

2. Joining the infection

3. Cachexia

5. Dysfunction of organs with the proliferation of lymphoma cells in them

126. Rheumatic diseases: definition of the concept, classification, general characteristics. Stages of disorganization of connective tissue.

Rheumatic diseases are a group of diseases characterized by primary systemic damage to connective tissue and blood vessels caused by immune disorders. Common features of rheumatic diseases: - The absence of a clearly established etiological origin; - Disorders of immune homeostasis in the form of hypersensitivity reactions of immediate and delayed types - Continuous chronic clinical course with periods of exacerbations and remissions; - Systemic progressive disorganization of the intercellular structures of connective tissue and blood vessels, Classification. - Rheumatism - Rheumatoid arthritis (RA), - Systemic lupus erythematosus (SLE), - Systemic scleroderma (SS), - Nodular polyarteritis (periarteritis) Morphogenesis: Systemic progressive disorganization of connective tissue, vascular damage, especially of the microcirculatory type, and immunopathological processes are most pronounced in the connective tissue of the heart. Phases of disorganization:

- Mucoid swelling: reversible phase, characterized by hydration of the base substance

- Fibrinoid changes: (swelling and necrosis) deep irreversible disorganization, the impregnation of collagen fibers by plasma proteins occurs

- Cellular inflammatory reactions: the formation of specific rheumatic granuloma. Initially, macrophages accumulate, which transform into large cells with hyperchromic nuclei, they begin to accumulate around the masses of fibrinoid forming a "blooming" granuloma. Later, when the cells are stretched and fibroblasts appear in them, fibrinoid masses become smaller, this is a "fading" granuloma. As a result, fibroblasts displace granuloma cells and it acquires the character of scarring. The development cycle is 3-4 months. Rheumatic granulomas are most often formed in the connective tissue of the valvular and parietal endocardium, myocardium, epicardium, and vascular adventitia.

-Sclerosis is the final phase of connective tissue disorganization.