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Question

not sure how to answer these ?'s

MAKE THE CONNECTION 1. Explain the role that the lymphatic system plays in the metastasis of cancer. A 16-year-old female patient with a history of tonsillitis 4 weeks before coming to the clinic presents to a physician with arthritis that has been moving from joint to joint (migratory polyarthritis). An echocardiogram reveals that the mitral valve is damaged and a sedimentation rate indicates the patient has acute inflammation which is later traced to the heart muscle. 2. Follow the sequence of events which explains how tonsillitis led to polyarthritis and damage of the heart.

Explanation / Answer

1. Metastasis of cancer is the spreading of cancer cells to form daughter tumors in vital orhans like lungs and lever. Lymphatic system is the route frequently used by the cancerous cells to spread into the different organs. The cancer cells enter to the lymphatic vessels and migrate to the lymph nodes which causes swelling of lymph nodes. From lymph nodes these cancerous cells move to different organs through the blood. An inflammation factor TGF-beta (transforming growth factor-beta) is possibly involved in the spreading of cancer cells by supplying the surface of the cancer cell with a receptor that normally only exists on the white blood cells that travel through the lymphatic system. After binding with these receptor, cancer cells recognise and migrate towards a substance that is secreted from the lymphatic vessels and binds to the receptor. In this way the cancerous cells effectively uses lymphatic system for metastasis.

2. Tonsilitis caused by infection with a group A streptococus. When infection with group A streptococcus occurs then immune system produces antibodies against streptococcus bacteria. These antibodies fight against streptococcus as well as these antibodies exhibit cross reactivity with host tissues which leads to damage of the normal tissues, especially with repeated infections. Most common tissues that exhibit cross-reactivity are cardiac tissue, joints, nervous tissue and the skin. This damge to the joint tisues causes polyarthiritis and damage to the heart muscle causes acute inflammation in heart muscles. The valves of heart most affected in this condition, in order, are the mitral, aortic, tricuspid, and pulmonary valves.

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