¨Os linfomas são neoplasias do sistema imunitário com procedência em linfócitos que envolvem os tecidos linfoides com desenvolvimento de massas tumorais. Estão distribuídos em dois grupos principais: linfomas de Hodgkin (LH) e linfomas não Hodgkin. O LH é uma neoplasia linfoproliferativa caracterizada histopatologicamente pela presença de células neoplásicas com variada morfologia denominadas Reed-Sternberg, em meio a infiltrdo de linfócitos pequenos (não-neoplásicos). Geralmente, o paciente tem adenopatia cervical, que pode evoluir com acometimento de outras cadeias. O estadiamento segue o sistema de Ann Arbor. Parte do estadiamento inclui a avaliação da medula óssea, sendo a biópsia mandatória. O linfoma de Hodgkin (LH) é considerado uma doença curável em aproximadamente 75% dos casos. O papel da radioterapia na abordagem do linfoma de Hodgkin é bem definido. O regime quimioterápico mais utilizado é o chamado ABVD, associado ou não a radioterapia para massas originalmente maiores que 10 cm e nos estágios mais iniciais em associação ao esquema ABVD. Para os raros pacientes com doença refratária ou recidivada, existem diversos regimes de salvamento e pode lançar-se mão de quimioterapia de altas doses com resgate de células-tronco autólogas (transplante autólogo) ou até transplante alogênico de células-tronco. São vários os efeitos tardios do tratamento da doença de Hodgkin: leucemias secundárias ao uso de medicamentos quimioterápicos e/ou radioterapia, câncer de mama secundário, a radioterapia do tórax, a doença coronariana precoce, pericardite constrictiva, hipotireoidismo e aumento da incidência de diversos tumores sólidos durante a evolução clínica nos anos subsequentes ao tratamento. ¨
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■ Dr Paulo Fernando Leite
Cardiologia/Prevenção Cardiovascular
Estratificação de Risco Cardiovascular
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