1. Made by: reham Talal Khalil Asmaa Mohamed alghefari
Case 8 : -
Made by:
reham Talal Khalil
Asmaa Mohamed alghefari

3. a 64-y.o o comes to your office of pain in the chest & coughing you ordered a roentgenogram showed a “mass” in the mediastinum. an excisional biopsy was performed diffuse large b-cell lymphoma on farther investigation multiple inguinal & iliac lymphadenopathy

4. Non Hodgkin Lymphoma Aggressive Indolent B cell Follicular
Burkitt Hairy cell leukemia/lymphoma
Mantle cell Waldenestrom Macroglobulinemia
Precursor T lymphoblastic
B lymphoblastic

5. Aggressive Can Be Trait By Chemotherapy
* Aggressive Can Be Trait By Chemotherapy * Non Aggressive Can Be Trait By Observe (Watch, Wait).

6. - B cell lymphoma The most common aggressive lymphoma - Could Be:-
- B cell lymphoma The most common aggressive lymphoma   - Could Be:- * De novo * From abreviously indolent lymphoma   Some are Associated EBV - Can be nodel and extranodel   - Median age 65 Y.O

7. When CLL becomes DLBCL Richter syndrome due to rapid cell turnover in DLBCL can have tumor lysis syndrome high ka , ureic acid in the blood but, low ca, LDH usually high .

8. How diagnose LDBCL   -excisional biopsy the architecture of the node and cell appearance -CBC and blood chemistry (LDH) will be high uric acid will be high > high grade NHL -HIV testing -staging physical exam and CT scan - pet scan . help diagnose and follow up -if use immunobiological stain.cd 20

9. Thank you