Lymphoma

Lymphoma Overview

Definition

  • Lymphoma: Neoplastic proliferation of lymphoid cells that forms a mass, can arise in a lymph node or extranodal tissue.

  • Divided into two main categories:

    • Non-Hodgkin Lymphoma (NHL): 60% of cases

    • Hodgkin Lymphoma (HL): 40% of cases

Key Differences between Hodgkin and Non-Hodgkin Lymphoma

  • Hodgkin Lymphoma Characteristics:

    • Typically localized to stage I and II (80%-90% of cases).

    • Centralizes around the cervical area.

    • Presence of Reed-Sternberg cells on pathology.

    • Pathologic classification: Lymphocyte predominant (best prognosis), lymphocyte depleted (worst prognosis).

  • Non-Hodgkin Lymphoma Characteristics:

    • More disseminated; stages III and IV present in 80%-90% of cases.

    • No Reed-Sternberg cells found on pathology.

    • More diverse pathology with various subtypes such as Burkitt and immunoblastic lymphoma.

Hodgkin Lymphoma

Clinical Presentation

  • Symptoms:

    • Enlarged, painless, rubbery lymph nodes, nontender and nonerythematous.

    • "B" symptoms: Drenching night sweats, weight loss >10%, and fevers due to cytokine release from Reed-Sternberg cells.

  • Common Sites of Lymphadenopathy:

    • Cervical, supraclavicular, axillary lymph nodes; can develop anywhere in the body.

    • Extralymphatic sites may include splenic, skin, gastric, lung, CNS.

Staging of Hodgkin Lymphoma

  • Stages:

    • Stage I: 1 lymphatic group or single extranodal site.

    • Stage II: 2 lymphatic groups or extranodal sites on the same side of the diaphragm.

    • Stage III: Involvement of lymphatic groups on both sides of the diaphragm.

    • Stage IV: Widespread disease with diffuse extranodal sites.

  • B symptoms impact prognosis and treatment decisions.

Non-Hodgkin Lymphoma (NHL)

Definition and Presentation

  • NHL: Neoplastic transformation of B and T cell lineages; accumulations occur more diffusely in lymph nodes and extralymphatic organs.

  • Greater likelihood of widespread involvement compared to Hodgkin lymphoma.

Clinical Presentation and Common Symptoms

  • Similar symptoms to HL including enlarged, painless