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Original Work Proposal

Introduction and Statement of Purpose

Through my research assessments in ISM (Independent Study and Mentorship) and my

mentor meetings with Dr.Vibha Thomas I have gained much exposure and knowledge in the

field of Oncology. After understanding the field to a great level I have taken the decision to

declassify a case study presenting a rare cancer patient at the Texas Oncology Flower Mound

location as my final product for the 2018 school year. This case was presented at a tumor board

meeting at Texas Oncology Flower Mound, in which my mentor, who is a medical oncologist,

and other doctors, such as radiologist, radiation oncologist, surgical oncologist, and other

medical oncologist, came together to review this patient, in order to get feedback from the each

other, to make sure they are treating this unique patient correctly. This patient is a woman who

has been diagnosed with plasmablastic lymphoma, which was found after she had undergone

breast implantations.

In this case study I will be focusing on the molecular level this disease. Therefore I will

be looking more into the biology of these cancer cells. I will be researching in depth about how

how the cancer cells in plasmablastic lymphoma interact with each other. With the help of my

mentor I will have to understand how plasmablastic lymphoma differs from all the other types of

lymphomas as well, since there are about 40 different types of lymphomas. Besides this I will

learn about the correlation between breast implantation and the diagnosis of different types of

lymphoma. I will also have to write about the treatment that has been chosen to give this patient,

and will have to give an explanation to why this treatment was chosen for this patient. I will be

listing all the drugs that are being given to this patient and will be explaining how they are

destroying cancer cells at the molecular level as well.


Since Dr.Thomas has declassified case studies in her years working as a medical

professional, one about a Primary cutaneous large B-cell lymphoma in a patient and another

about a Epithelial–mesenchymal transition in pulmonary carcinosarcoma in a cancer patient, she

will help guide me in writing the case study. After writing this case study our primary goal is to

get this case study published by a medical journal, which I will be doing with the help of my

mentor as well.

Review of Skills and Research

Writing a case study of this rare and aggressive type of cancer is definitely going to be

difficult being a high school student, therefore I am going to have to be up to date on on all the

research done with plasmablastic lymphoma. I am also going to have to understand the process

and the needed skills to create a quality case study, which a medical journal would want to

publish.

While shadowing Dr.Thomas I have seen multiple patients who are diagnosed with

lymphomas, these include different types of T-cell and B-cell lymphoma. I have received good

insight by asking Dr.Thomas specific questions about these patients diagnosis, while reading

their case reports. Previously I have also learned about the differences between the two main

types of lymphomas, Non-Hodgkins and Hodgkins. A lymphoma is referred to as Hodgkins if a

doctor finds a Reed Sternberg cell under the microscope while examining the cancer cells.

Hodgkin's lymphomas have also been seen to be easier to treat in patients. Plasmablastic

lymphoma unfortunately is a rare aggressive form of Non-Hodgkin's lymphoma. Since it is rare I

will have to conduct much research to find a substantial amount of information about this form

of cancer. Since my mentor will be gone during the week of March 11th, I plan to have learned

everything about plasmablastic lymphoma including, what ethnicity it is more prevalent in,
whether it has been seen more in females or males, how its effects are different from the other

types of types of lymphomas, what method of treatment has shown to successfully treat this type

of cancer, which drugs have shown much side effects in patients, etc.

Dr.Thomas gave me the idea to make the focus of my case study the molecular changes

that come with this disease. Since I have taken AP Biology it will be easier for me to look into

the biology of these cancer cells, however I still will have to go over my biology notes to go over

things that I have forgotten about that I will come across in my case study. Doing this will help

me in writing about the molecular changes that come with this form of cancer.

After looking at many example of case studies I have understood that there is a specific

way case studies are formatted. Following a certain format for a case study makes it easier for

medical professionals to comprehend the case study, as well as makes the case study look

professional. While researching online I found a couple templates for case studies I could

possibly use for my case study. Another option would be to construct a template with

Dr.Thomas, as she has had experience in creating case studies.

By learning everything to the minor details of plasmablastic lymphoma, refreshing what I

have learned in my biology classes, coming up with a template to build my case study on I will

be able to construct a quality case study. Therefore this will bring me a step closer to getting my

case study published by a medical journal.

Methodology

It is utmost of importance that work in a timely manner, therefore located below is (after

the conclusions section) is my calendar, which I will strictly follow to make sure that no time is
wasted on such important research. The first step of my original work/final product is to get

consent from the patient to use her case. Once she has consented we will be able to use any of

her reports in the case study, however her name will not be listed anywhere in this case report

because of confidentiality reasons.

The second step in this process will be actually gathering all the patient reports. While

doing a case study sometimes it is a good idea to interview the patient, however since we can

receive her medical reports interviewing her will not be necessary. After gathering all her

medical reports I will go through them with Dr.Thomas and try to deeply understand them.

Anything I am unfamiliar with or have questions about Dr.Thomas will explain to be

thoroughly.

Since I want to focus my case study about the molecularity of plasmablastic lymphoma, I

am going to have to gather books and credible sources to help me understand this rare condition.

I am going to be researching in depth about how what plasmablastic lymphoma is, and how it is

different than the other 40 types of lymphomas. I will also be researching about why it is

common to diagnosis different types of lymphomas after breast implantations.

Next I will have to go over the treatment that has been being given to the patient. I will

talk to Dr.Thomas and understand why the specific treatment was given against the many others.

Once I do all of these things, I will start to write my case study with the help of Dr.Thomas.

Again I will include the molecular changes caused in the body because of this form of cancer. I

also plan to include information about the correlation between implantation and diagnoses

lymphomas.

I am also planning on getting this case study published by a medical journal. My mentor

Dr.Thomas has written case studies, which have been published before. With her guidance I will
approach specific Medical Journals that publish case studies, and will submit my case study to

them for publication.

Materials

Materials that I am going to have to use for my original work/final product are mainly

sources for research about plasmablastic lymphoma and the patients reports. Since I am

conducting a case study about a specific patient I will need all of their medical reports this can

include scans, blood reports, white blood count, history of surgeries, etc. Besides this I will also

need my laptop to access patient reports. Dr.Thomas advised me to bring my laptop from which I

can access the patient reports, research about the type of cancer, and start working on my case

study during my mentor meetings. For the research I will be conducting I will need many

credible source about plasmablastic lymphoma, lymphoma after breast implantation, and the

biology of cancer cells. I will be asking Dr.Thomas if she has any books about these that I could

read about and searching for sources online as well.

Conclusions

Overall writing and publishing this case study will give me a better understanding of

diagnosed lymphomas. I will gain an in depth understanding of the molecular changes that take

place when this disease tries to take control of one’s body. I will also understand and write about

the connection between breast implantations and lymphomas, which has been seen to have a

correlation. Since plasmablastic lymphoma is a rare type of cancer writing a case study with a

patient diagnosed with this will definitely help the medical community understand it to another

level. Hopefully medical facilities will be able to access it if I get it published in a medical

journal, from which they can come up with better treatment options for this devastating disease.
Calendar

Week One (3/12-3/18) Dr.Thomas-- out of town

● Research into Plasmablastic Lymphoma

● Look into Medical Journals that publish Case Studies

Week Two (3/19-3/25)

● Get consent from patient

● Talk to Dr.Thomas about treatment plan that is being given to the patient
● If consent is given, collect all necessary medical reports needed of the patient

Week Three (3/26-4/1)

● Go through all the patient history with Dr.Thomas

● Go through medical reports with Dr.Thomas

● Research about the lymphomas diagnosed after breast implantations

● Construct Case Study template

Week Four (4/2-4/8)

● Begin writing case study

● Research Plasmablastic Lymphoma at the molecular level

● Look into Medical Journals wanting to publish case studies

Week Five (4/9-4/15)

● Work on writing case study

● Talk to Dr.Thomas about what I have learned about the molecular biology of cancer cells

Week Six (4/16-4/22)

● Finish writing Case Study

● Approach Journals to publish Case Study

Week Seven (4/23-4/29)

● Make last minute edits in Case Study if needed

● Practice for final presentation night

● Submit Case Study to a Journal

Week Eight (4/30-5/6)


● Complete any remaining finish work

● Practice for final presentation night

Week Nine (5/7-5/13)

● Practice for final presentation night

Week Ten (5/14-5/18)

● Practice for final presentation night