CHIEF COMPLAINTS Systemic complaints(B symptoms) Fever-temperature >380 s Weight loss >10 percent over the past six months Sweats- the presence of drenching night sweats Lymphadenopathy rapid and progressive or Waxing and waning The duration observed sites. and extent Peripheral lymphocytosis
CHIEF COMPLAINTS Systemic complaints (B symptoms) * Fever — temperature >38ºC * Weight loss >10 percent over the past six months * Sweats — the presence of drenching night sweats Lymphadenopathy * Rapid and progressive or Waxing and waning * The duration, observed sites, and extent * Peripheral lymphocytosis
Symptoms in gastrointestinal lymphoma according to involved site Symptom Stomach n=277 Small bowel n=32 Ileocecal n= 26 Multiple sites n=24 Pain 78 58 Loss of appetite 47 Weight loss 24 Bleeding Vomiting Night sweats‖ll 46 Diarrhea COnstipation 3 Fever Perforation leus No symptoms 4 This table shows the percent of patients with the listed symptom at each of the four major sites of disease. Data from Koch. P et al. J Clin Oncol 2001: 19: 3861
Symptoms in gastrointestinal lymphoma according to involved site Symptom Stomach n = 277 Small bowel n = 32 Ileocecal n = 26 Multiple sites n = 24 Pain 78 75 77 58 Loss of appetite 47 41 23 58 Weight loss 24 34 15 25 Bleeding 19 6 12 8 Vomiting 18 31 8 21 Night sweats 11 12 19 46 Diarrhea 4 12 19 29 Constipation 3 25 23 12 Fever 2 6 8 4 Perforation 2 9 - - Ileus - 38 19 4 No symptoms 4 - - - This table shows the percent of patients with the listed symptom at each of the four major sites of disease. Data from Koch, P, et al. J Clin Oncol 2001; 19:3861
ONCOLOGIC EMERGENCIES pinal cord compression Pericardial tamponade Hypercalcemia(adult T cell lymphoma) Superior or inferior vena cava obstruction hyperleukocytosis(lymphoblastic lymphoma) Acute airway obstruction(mediastinal lymphoma) ymphomatous meningitis and/or CNS mass Hyperuricemia and tumor lysis syndrome hyperviscosity syndrome Intestinal obstruction, intussusception Ureteral obstruction, unilateral or bilateral Severe hepatic dysfunction Venous thromboembolic disease Severe autoimmune hemolytic anemia and/or thrombocytopenia
• Spinal cord compression • Pericardial tamponade • Hypercalcemia (adult T cell lymphoma) • Superior or inferior vena cava obstruction • Hyperleukocytosis (lymphoblastic lymphoma) • Acute airway obstruction (mediastinal lymphoma) • Lymphomatous meningitis and/or CNS mass • Hyperuricemia and tumor lysis syndrome • Hyperviscosity syndrome • Intestinal obstruction, intussusception • Ureteral obstruction, unilateral or bilateral • Severe hepatic dysfunction • Venous thromboembolic disease • Severe autoimmune hemolytic anemia and/or thrombocytopenia
PHYSICAL EXAMINATION Waldeyer's ring Standard lymph node sites Liver and spleen Abdominal nodal sites(mesenteric, retroperitoneal Less commonly involved nodal sites(eg, occipital preauricular, epitrochlear, popliteal)
PHYSICAL EXAMINATION • Waldeyer's ring • Standard lymph node sites • Liver and spleen • Abdominal nodal sites (mesenteric, retroperitoneal) • Less commonly involved nodal sites (eg, occipital, preauricular, epitrochlear, popliteal)
PHYSICAL EXAMINATION: Head and Neck Superficial (Surface)Lymphatics Supraclavicular lymph nodes Epitrochlear lymph nodes lymph node Lymph node Axillary Pectoral lymph node mph nodes Inguinal lymph nodes 2008 Medicine Net, Inc
PHYSICAL EXAMINATION： Head and Neck