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This term refers to the science of diseases of the blood system. It has been an area of rapid progress in medicine over the past 30 years for two reasons: the human diseases which are the subject of study are in general highly treatable, and scientific advances in the fields of immunology and genetics have very direct application to these diseases. Blood is the only fluid organ system.
The lymphatic circulatory system is normally invisible; it consists of delicate tiny vessels which circulate the clear plasma of the blood, which is constantly leaking into our tissues, back into the blood. Deficiency in the lymphatic circulation produces swelling of our soft tissues, such as swollen feet at the end of a long day of standing. Although some cells of our immune system are present in the bloodstream (granulocytes), the greatest number and those with the most specific immune activity (lymphocytes) are concentrated in lymph nodes, nodules at the crossroads of our lymphatic vessels (e.g. in the groin and armpit areas and in the neck beneath the jaw). Other concentrations are found in the tonsils, the small intestine, the airways and the spleen. Deficient function of the hemic (blood) and immune (lymphoid) systems,
Depending on the patient's history of illness and the findings from physical examination, the managing physician who is concerned about a hematologic disorder will select which tissue samples should be submitted for testing. Drawing blood is often a preliminary step, allowing a broad battery of tests to be run. If serious questions are raised by the blood studies, a bone marrow or lymph node biopsy may be indicated. From such tissue samples the pathologist can usually establish a definite diagnosis. Such tissue samples are preserved in fixative solutions and then embedded in wax, allowing their storage for years. These preparations (tissue blocks) are durable and can be sent from one laboratory to another, allowing consultative efforts among pathologists at different institutions. Most disorders of the hemic-immune system are not malignant, such as iron-deficiency anemia or autoimmune thrombocytopenia (a deficiency of circulating platelets causing easy bruising).
Because the cells of the normal hemic-immune system are designed to grow rapidly in response to challenges such as infections, it is sometimes difficult for both the managing physician and the pathologist to distinguish between inflammatory responses and malignancies. Although the majority of cases can be answered with conventional microscopic appearances, as interpreted by a fully trained pathologist, in some instances it is necessary to utilize additional highly specific immunologic methods and, in some cases even genetic probe techniques, in order to arrive at a definite final diagnosis. Malignancies of the hemic-immune system differ markedly in their treatability. Some are slowly advancing processes easily controlled by medications, while others are rapidly advancing, life-threatening illnesses requiring intensive, highly toxic drugs. Precise classification of these leukemias and lymphomas is necessary to permit appropriate therapeutic management. An advance in the classification of lymphomas was represented by the Revised European-American Lymphoma ("REAL") Classification of 1994 (See Dr Banks' medical papers, ref. 123...*click*). A more comprehensive update in the classification of leukemias and lymphomas has appeared in the World Health Organization's book of 2001 on the classification of hemic and lymphoid malignancies ( Publications, Projects and Presentations page...*click*). For more information the reader is recommended the following sources:
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Its functions relate to metabolism (delivering oxygen to all body tissues and removing carbon dioxide and other by-products of active cells), hemostasis (clotting off defects or disruption of the blood vessels as with injuries), and immunity (protection against all types of infectious agents).
whether of benign or malignant nature, cause manifestations such as anemia (paleness, weakness, shortness of breath), hemorrhage (bleeding from the nose, gums, gastrointestinal tract; easy bruising or tiny bleeding spots on the surfaces of the eyes or lining of the cheeks, tongue and lips) and infections (sore throat, pneumonia, fever ).
