Non-Hodgkin's Lymphoma
Definition
Lymphoma: Malignant proliferation of lymphocytes
NHL: Any lymphoma that has absence of Reed-Sternberg cells
Aetiology
Clinical Features
Nodal: (75%)
Extra nodal (25%)
Constitutional sx
Bone marrow (anaemia, WCC, platelets)
Investigations
Bloods: FBC, blood film, LDH (inc = cell turnover = poor prognosis), UEC, LFT
Others: Marrow/ node biopsy, LP if CNS signs
Management
Low grade = incurable (MALT, follicular, CLL)
High grade = curable (eg DLBCL, Burkitt's lymphoma, ALL)
Source
OHCM 9th Ed 2014
Lymphoma: Malignant proliferation of lymphocytes
NHL: Any lymphoma that has absence of Reed-Sternberg cells
- Most arise from B cell lines
Aetiology
- Congenital
- Immunodeficiency
- H. pylori
- HIV
Clinical Features
Nodal: (75%)
Extra nodal (25%)
- Skin: T cell lymphoma --> Sezary Syndrome
- Oropharynx: Waldeyer' sring lymphoma (sore throat, dyspnoea)
- Gastric MALT: Caused by H. pylori
- Non MALT gut lymphoma: diffuse large cell lymphoma
- Small bowel lymphoma: immunoproliferation small intestine disease (IPSID) --> poor prognosis
- Bone, CNS , lunginvolvement
Constitutional sx
Bone marrow (anaemia, WCC, platelets)
Investigations
Bloods: FBC, blood film, LDH (inc = cell turnover = poor prognosis), UEC, LFT
Others: Marrow/ node biopsy, LP if CNS signs
Management
Low grade = incurable (MALT, follicular, CLL)
- No sx: supportive
- Radiotherapy if localised
- Chemo if diffuse
High grade = curable (eg DLBCL, Burkitt's lymphoma, ALL)
- R-CHOP’ regimen: Rituximab Cyclophosphamide, Hydroxydaunorubicin, vincristine (Oncovin®) and Prednisolone
Source
OHCM 9th Ed 2014