Lymphomas
Definition: Malignant neoplasms of lymphoid cells that arise from lymph nodes, extranodal lymphoid tissue, or bone marrow.
Classification:
- Hodgkin lymphoma (HL)
- Characterized by the presence of Reed-Sternberg cells
- Non-Hodgkin lymphoma (NHL)
- Over 60 different subtypes, classified by cell type, stage, and genetic markers
Etiology and Risk Factors:
- Exact cause unknown
- Associated with genetic mutations, viral infections (Epstein-Barr virus, human T-cell leukemia virus), autoimmune disorders, and immunosuppression
Clinical Presentation:
- HL:
- Painless enlargement of lymph nodes, often in the neck or mediastinum
- Other symptoms: fever, night sweats, weight loss
- NHL:
- Variable presentation depending on subtype
- Enlarged lymph nodes, gastrointestinal symptoms, skin lesions, bone pain
Diagnosis:
- Physical examination and history
- Lymph node biopsy
- Blood tests, imaging studies (CT scan, PET scan, MRI)
- Genetic testing
Staging:
- Based on the extent of disease involvement
- Ann Arbor staging system classifies disease into 4 stages (I-IV)
Treatment:
- HL:
- Chemotherapy, radiation therapy, stem cell transplant
- NHL:
- Treatment tailored to the subtype
- Chemotherapy, immunotherapy, targeted therapies, radiation therapy
- Stem cell transplant may be considered for aggressive subtypes
Prognosis:
- Varies depending on the subtype and stage of lymphoma
- Hodgkin lymphoma has a higher survival rate than non-Hodgkin lymphoma
- Long-term remission is possible with early diagnosis and treatment
Other Important Notes:
- Lymphomas can occur at any age, but are most common in adults
- The median age of diagnosis for HL is 40 years
- The median age of diagnosis for NHL is 65 years
- Lymphomas are among the most common cancers worldwide