Nodal marginal zone lymphoma: Difference between revisions
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== Diagnosis == | == Diagnosis == | ||
===Staging=== | |||
Staging for nodal marginal zone lymphoma is provided in the following table:<ref>{{Cite journal| doi = 10.1200/JCO.2013.54.8800| issn = 1527-7755| volume = 32| issue = 27| pages = 3059–3068| last1 = Cheson| first1 = Bruce D.| last2 = Fisher| first2 = Richard I.| last3 = Barrington| first3 = Sally F.| last4 = Cavalli| first4 = Franco| last5 = Schwartz| first5 = Lawrence H.| last6 = Zucca| first6 = Emanuele| last7 = Lister| first7 = T. Andrew| last8 = Alliance, Australasian Leukaemia and Lymphoma Group| last9 = Eastern Cooperative Oncology Group| last10 = European Mantle Cell Lymphoma Consortium| last11 = Italian Lymphoma Foundation| last12 = European Organisation for Research| last13 = Treatment of Cancer/Dutch Hemato-Oncology Group| last14 = Grupo Español de Médula Ósea| last15 = German High-Grade Lymphoma Study Group| last16 = German Hodgkin's Study Group| last17 = Japanese Lymphorra Study Group| last18 = Lymphoma Study Association| last19 = NCIC Clinical Trials Group| last20 = Nordic Lymphoma Study Group| last21 = Southwest Oncology Group| last22 = United Kingdom National Cancer Research Institute| title = Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification| journal = Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology| date = 2014-09-20| pmid = 25113753}}</ref> | |||
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center | |||
|+ '''Revised staging system for primary nodal lymphomas (Lugano classification)''' | |||
! style="background: #4479BA; color:#FFF;" | Stage | |||
! style="background: #4479BA; color:#FFF;" | Involvement | |||
! style="background: #4479BA; color:#FFF;" | Extranodal (E) status | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" colspan=3 | '''Limited''' | |||
|- | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Stage I | |||
| style="padding: 5px 5px; background: #F5F5F5;" | One node or a group of adjacent nodes | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Single extranodal lesions without nodal involvement | |||
|- | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Stage II | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Two or more nodal groups on the same side of the diaphragm | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Stage I or II by nodal extent with limited contiguous extranodal involvement | |||
|- | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Stage II bulky | |||
| style="padding: 5px 5px; background: #F5F5F5;" | II as above with "bulky" disease | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Not applicable | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" colspan=3 | '''Advanced''' | |||
|- | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Stage III | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Nodes on both sides of the diaphragm; nodes above the diaphragm with spleen involvement | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Not applicable | |||
|- | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Stage IV | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Additional noncontiguous extralymphatic involvement | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Not applicable | |||
|} | |||
=== Symptoms === | === Symptoms === | ||
Symptoms of the nodal marginal zone lymphoma include: | Symptoms of the nodal marginal zone lymphoma include: | ||
Revision as of 16:57, 4 March 2016
For patient information, click Insert page name here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]
Synonyms and keywords:: NMZL; Nodal marginal zone B cell lymphoma; Monocytoid B-cell lymphoma; Nodal monocytoid B-cell lymphoma
Overview
Pathophysiology
Genetics
Associated Conditions
A very small number of people with nodal marginal zone lymphoma will also have hepatitis C infection (HCV).
Gross Pathology
Microscopic Pathology
Causes
There are no established causes for nodal marginal zone lymphoma.
Differentiating type page name here from other Diseases
Nodal marginal zone lymphoma must be differentiated from other diseases such as:
- Chronic lymphocytic leukemia
- Splenic marginal zone lymphoma
- Mantle cell lymphoma
- Diffuse large B cell lymphoma (DLBCL)
Epidemiology and Demographics
Age
The incidence of nodal marginal zone lymphoma increases with age; the median age at diagnosis is 60 years.
Gender
Females are more commonly affected with nodal marginal zone lymphoma than males.
Risk Factors
There are no established risk factors for nodal marginal zone lymphoma.
Screening
According to the the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine screening for nodal marginal zone lymphoma.
Natural History, Complications and Prognosis
Nodal marginal zone lymphoma is often slow growing (indolent). However, it can change (transform) into a more aggressive large cell lymphoma. Nodal marginal zone lymphomas behave slightly more aggressively than MALT lymphomas.
Diagnosis
Staging
Staging for nodal marginal zone lymphoma is provided in the following table:[1]
| Stage | Involvement | Extranodal (E) status |
|---|---|---|
| Limited | ||
| Stage I | One node or a group of adjacent nodes | Single extranodal lesions without nodal involvement |
| Stage II | Two or more nodal groups on the same side of the diaphragm | Stage I or II by nodal extent with limited contiguous extranodal involvement |
| Stage II bulky | II as above with "bulky" disease | Not applicable |
| Advanced | ||
| Stage III | Nodes on both sides of the diaphragm; nodes above the diaphragm with spleen involvement | Not applicable |
| Stage IV | Additional noncontiguous extralymphatic involvement | Not applicable |
Symptoms
Symptoms of the nodal marginal zone lymphoma include:
- Fever
- Weight loss
- Night sweats
- Painless swelling in the neck, axilla, groin, thorax, and abdomen
Physical Examination
Vitals
- Fever is often present
HEENT
Thorax
- Thoracic masses suggestive of central lymphadenopathy
Abdomen
- Abdominal masses suggestive of central lymphadenopathy
Extremities
Laboratory Findings
Laboratory tests for nodal marginal zone lymphoma include:
- Complete blood count (CBC)
- Blood chemistry studies
- Cytogenetic analysis
- Flow cytometry
- Immunohistochemistry
- Immunophenotyping
Biopsy
Lymph node or bone marrow biopsy is diagnostic of nodal marginal zone lymphoma.
CT
CT scan may be helpful in the diagnosis of nodal marginal zone lymphoma.
MRI
MRI scan may be helpful in the diagnosis of nodal marginal zone lymphoma.
Other Imaging Findings
PET scan may be helpful in the diagnosis of nodal marginal zone lymphoma.
Treatment
Medical Therapy
| Therapy | Description |
|---|---|
| Watchful waiting |
|
| Chemotherapy |
|
| Biological therapy |
|
| Radiation therapy |
|
| Stem cell transplant |
|
References
- ↑ Cheson, Bruce D.; Fisher, Richard I.; Barrington, Sally F.; Cavalli, Franco; Schwartz, Lawrence H.; Zucca, Emanuele; Lister, T. Andrew; Alliance, Australasian Leukaemia and Lymphoma Group; Eastern Cooperative Oncology Group; European Mantle Cell Lymphoma Consortium; Italian Lymphoma Foundation; European Organisation for Research; Treatment of Cancer/Dutch Hemato-Oncology Group; Grupo Español de Médula Ósea; German High-Grade Lymphoma Study Group; German Hodgkin's Study Group; Japanese Lymphorra Study Group; Lymphoma Study Association; NCIC Clinical Trials Group; Nordic Lymphoma Study Group; Southwest Oncology Group; United Kingdom National Cancer Research Institute (2014-09-20). "Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification". Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 32 (27): 3059–3068. doi:10.1200/JCO.2013.54.8800. ISSN 1527-7755. PMID 25113753.