Small cell lymphoma
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Synonyms and keywords: SLL
Overview
Small cell lymphoma (also known as SLL) is a type of mature B-cell chronic lymphocytic leukemia that presents primarily in the lymph nodes.
Historical Perspective
- Small cell lymphoma was first discovered by Dr. George Minot, an American physician, in 1924.[1]
Classification
- Small cell lymphoma may be classified according to [classification method] into [number] subtypes/groups:
- [group1]
- [group2]
- [group3]
- Other variants of small cell lymphoma include [disease subtype 1], [disease subtype 2], and [disease subtype 3].
Pathophysiology
- The pathogenesis of small cell lymphoma is characterized by the malignant infiltration of lymphocytic cells into the bone marrow, where they interfere with the production of red blood cells and platelets.
- Small cell lymphoma arises from pre-follicular center B cells that are normally involved in the process of human immunoglobulins production.
- Genes involved in the development of small cell lymphoma, include:
- Chromosome 11 long arm deletion
- Chromosome 13 long arm deletion (most common genetic mutation)
- Chromosome 17 short arm deletion
- Trisomy 12
- On gross pathology, characteristic findings of small cell lymphoma, include:
- No remarkable findings
- On microscopic histopathological analysis, characteristic findings of small cell lymphoma, include:
Causes
- There are no established causes for small cell lymphoma.
Differentiating Small Cell Lymphoma from Other Diseases
- Small cell lymphoma must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
- [Differential dx1
- [Differential dx2]
- [Differential dx3]
Epidemiology and Demographics
- The prevalence of small cell lymphoma is low.
- Small cell lymphoma represents 90 % of all B-cell chronic lymphocytic leukemias in the United States.
Age
- Patients of all age groups may develop small cell lymphoma.
- Small cell lymphoma is more commonly observed among patients aged [age range] years old.
- Small cell lymphoma is more commonly observed among [elderly patients/young patients/children].
Gender
- Males are more commonly affected with small cell lymphoma than females.
Race
- There is no racial predilection for small cell lymphoma.
Risk Factors
- Common risk factors in the development of small cell lymphoma are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
Natural History, Complications and Prognosis
- The majority of patients with small cell lymphoma are symptomatic at the time of diagnosis.
- Early clinical features include
- If left untreated, patients with small cell lymphoma may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
- Common complications of small cell lymphoma, include:
- Prognosis is generally poor, and the 5-year survival rate of patients with small cell lymphoma is approximately
Diagnosis
Symptoms
- Symptoms of small cell lymphoma may include the following:
- Fever
- Recurrent bleeding
- Weight loss
- Muscle wasting
- Generalized weakness
- Anorexia
- Night sweats
Physical Examination
- Patients with small cell lymphoma often appear pale and malnourished.
- Physical examination may be remarkable for:
- Pallor
- Petechiae
- Leukemia cutis (infiltration of neoplastic leukocytes or their precursors into the skin resulting in clinically identifiable cutaneous lesions)
- Enlarged and palpable cervical lymph nodes
- Dacryoadenitis
Laboratory Findings
- Laboratory findings consistent with the diagnosis of small cell lymphoma, include:
- Absolute lymphocytosis (>5000 cells/μl)[2][3]
- Decreased hemoglobin concentration
- Decreased platelets count
- Express CD19, CD20, CD23, and CD5 on the cell surface
Imaging Findings
- CT scan may be helpful in the diagnosis small cell lymphoma.
- [Imaging study 1] is the imaging modality of choice for small cell lymphoma.
- On [imaging study 1], small cell lymphoma is characterized by [finding 1], [finding 2], and [finding 3].
- [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
- The mainstay of therapy for small cell lymphoma is chemotherapy and radiotherapy.
Surgery
- Surgery is the mainstay of therapy for small cell lymphoma.
- [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of small cell lymphoma.
- [Surgical procedure] can only be performed for patients with [disease stage] small cell lymphoma.
Prevention
- There are no primary preventive measures available for small cell lymphoma.
- Effective measures for the primary prevention of small cell lymphoma include [measure1], [measure2], and [measure3].
- Once diagnosed and successfully treated, patients with small cell lymphoma are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
References
- ↑ Rai KR (1993). "Progress in chronic lymphocytic leukaemia: a historical perspective". Baillieres Clin Haematol. 6 (4): 757–65. PMID 8038488.
- ↑ Nabhan C, Rosen ST (2014). "Chronic lymphocytic leukemia: a clinical review". JAMA. 312 (21): 2265–76. doi:10.1001/jama.2014.14553. PMID 25461996.
- ↑ Chronic Lymphocytic Leukimea. Wikipedia (2015) https://en.wikipedia.org/wiki/B-cell_chronic_lymphocytic_leukemia Accessed on October ,12 2015