Lymphoma
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Lymphoma | |
Lymph node: Malignant Lymphoma Large Cell Type: Gross natural color excellent view of cut mesentery showing massively enlarged mesenteric nodes with focal hemorrhages case diagnosed several years ago as reticulum cell sarcoma excellent demonstration of nodes with lymphoma. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology |
Lymphoma Main Page |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ross Bonander, Aditya Ganti M.B.B.S. [2]
Overview
Lymphoma is a type of cancer that originates in lymphocytes (a type of white blood cell in the vertebrate immune system). There are many types of lymphoma. Lymphomas are part of the broad group of diseases called hematological neoplasms. It was discovered by Thomas Hodgkin in 1832 and was called Hodgkin's Disease throughout the 19th and 20th centuries. Colloquially, lymphoma is broadly categorized as Hodgkin's lymphoma or non-Hodgkin lymphoma (all other types of lymphoma). Scientific classification of the types of lymphoma is more detailed. Although older classifications referred to histiocytic lymphomas, these are recognized in newer classifications as of B, T or NK cell lineage. Histiocytic malignancies are rare and are classified as sarcomas.[1]
Classification
Lymphoma | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Non-Hodgkin lymphoma | Hodgkin's Lymphoma | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Classical | Nodular sclerosis | Lymphocyte rich | Mixed cellularity | Lymphocyte depleted | Nodular lymphocyte | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
B-cell Lymphoma | T cell Lymphoma | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Precursor B cell | Peripheral B cell | Precursor B cell | Peripheral B cell | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Acute Lymphobalstic lymphoma | Small Lymphocytic lymphoma (SLL) Chronic lymphocytic leukemia Mantle cell lymphoma Follicular Lymphoma Marginal zone lymphoma Diffuse large B cell lymphoma Burkitt lymphoma | Acute Lymphobalstic lymphoma | Anaplastic large cell T lymphoma Peripheral T cell lymphoma Mycosis fungoidies | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Differentiating Lymphoma From Other Diseases
Differentiating diagnosis of Lymphoma | Symptoms | Signs | Diagnosis | Additional Findings | ||||||
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Fever | Rash | Diarrhea | Abdominal pain | Weight loss | Painful lymphadenopathy | Hepatosplenomegaly | Arthritis | Lab Findings | ||
Lymphoma | + | – | – | + | + | – | + | – | Increase ESR, increased LDH | Night sweats, constant fatigue |
Brucellosis | + | + | – | + | + | + | + | + | Relative lymphocytosis | Night sweats, often with characteristic smell, likened to wet hay |
Typhoid fever | + | + | – | + | – | – | + | + | Decreased hemoglobin | Incremental increase in temperature initially and than sustained fever as high as 40°C (104°F) |
Malaria | + | – | + | + | – | – | + | + | Microcytosis,
elevated LDH |
"Tertian" fever: paroxysms occur every second day |
Tuberculosis | + | + | – | + | + | + | – | + | Mild normocytic anemia, hyponatremia, and | Night sweats, constant fatigue |
Mumps | + | – | – | – | – | + | – | – | Relative lymphocytosis, serum amylaseelevated | Parotidswelling/tenderness |
Rheumatoid arthritis | – | + | – | – | – | – | – | + | ESR and CRP elevated, positive rheumatoid factor | Morning stiffness |
SLE | – | + | – | + | + | – | – | + | ESR and CRP elevated, positive ANA | Fatigue |
HIV | – | – | – | + | + | + | – | + | Leukopenia | Constant fatigue |
CNS lymphoma must be differentiated from other causes of seizures, headache, and fever in immunocompromised patients such as disseminated tuberculosis and disseminated aspergillosis.
Disease | Differentiating signs and symptoms | Differentiating tests |
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CNS lymphoma[2] |
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Disseminated tuberculosis[3] |
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Aspergillosis[4] |
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Cryptococcosis |
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Chagas disease[5] |
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CMV infection[6] |
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HSV infection[7] |
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Varicella Zoster infection[8] |
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Brain abscess[9][10] |
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Progressive multifocal leukoencephalopathy[11] |
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Epidemiology and Demographics
- According to the U.S. National Institutes of Health, lymphomas account for about five percent of all cases of cancer in the United States.
- Hodgkin's lymphoma in particular accounts for less than one percent of all cases of cancer in the United States
References
- ↑ Pathology and Genetics of Haemo (World Health Organization Classification of Tumours S.). Oxford Univ Pr. ISBN 92-832-2411-6.
- ↑ Gerstner ER, Batchelor TT (2010). "Primary central nervous system lymphoma". Arch. Neurol. 67 (3): 291–7. doi:10.1001/archneurol.2010.3. PMID 20212226.
- ↑ von Reyn CF, Kimambo S, Mtei L, Arbeit RD, Maro I, Bakari M, Matee M, Lahey T, Adams LV, Black W, Mackenzie T, Lyimo J, Tvaroha S, Waddell R, Kreiswirth B, Horsburgh CR, Pallangyo K (2011). "Disseminated tuberculosis in human immunodeficiency virus infection: ineffective immunity, polyclonal disease and high mortality". Int. J. Tuberc. Lung Dis. 15 (8): 1087–92. doi:10.5588/ijtld.10.0517. PMID 21740673.
- ↑ Latgé JP (1999). "Aspergillus fumigatus and aspergillosis". Clin. Microbiol. Rev. 12 (2): 310–50. PMC 88920. PMID 10194462.
- ↑ Rassi A, Rassi A, Marin-Neto JA (2010). "Chagas disease". Lancet. 375 (9723): 1388–402. doi:10.1016/S0140-6736(10)60061-X. PMID 20399979.
- ↑ Emery VC (2001). "Investigation of CMV disease in immunocompromised patients". J. Clin. Pathol. 54 (2): 84–8. PMC 1731357. PMID 11215290.
- ↑ Bustamante CI, Wade JC (1991). "Herpes simplex virus infection in the immunocompromised cancer patient". J. Clin. Oncol. 9 (10): 1903–15. doi:10.1200/JCO.1991.9.10.1903. PMID 1919640.
- ↑ Hambleton S (2005). "Chickenpox". Curr. Opin. Infect. Dis. 18 (3): 235–40. PMID 15864101.
- ↑ Alvis Miranda H, Castellar-Leones SM, Elzain MA, Moscote-Salazar LR (2013). "Brain abscess: Current management". J Neurosci Rural Pract. 4 (Suppl 1): S67–81. doi:10.4103/0976-3147.116472. PMC 3808066. PMID 24174804.
- ↑ Patel K, Clifford DB (2014). "Bacterial brain abscess". Neurohospitalist. 4 (4): 196–204. doi:10.1177/1941874414540684. PMC 4212419. PMID 25360205.
- ↑ Tan CS, Koralnik IJ (2010). "Progressive multifocal leukoencephalopathy and other disorders caused by JC virus: clinical features and pathogenesis". Lancet Neurol. 9 (4): 425–37. doi:10.1016/S1474-4422(10)70040-5. PMC 2880524. PMID 20298966.