Definition: primary malignancy of lymphoid tissue.
Hodgkin's and non-Hodgkin's.
|Commonly localised||Commonly generalised|
|Spread contiguous||Spread haematological|
|Waldeyer's ring rarely involved||Waldeyer's ring commonly involved|
|Extranodal involvement uncommon||Extranodal involvement common|
Definition: Malignant proliferation of Reed-Sternberg cells.
Age: peak in 3rd decade, old age.
Sex: M:F 2:1
Lymphadenopathy: usually cervical, axillary.
Mass effect: SVC obstruction, intestinal obstruction.
Systemic: fever, drenching night sweats, weight loss (B symptoms).
Also, pruritis, EtOH induced pain, Pel-Ebstein fever (fever at 15–28/7 intervals).
|Nodular sclerosing||20–50%||Good||Nodular appearance: bands of collagen.|
|Mixed cellularity||20–40%||Good||Infiltrate prominent granulocytes, plentiful Reed-Sternberg cells.|
|Lymphocyte predominant||10–15%||Good||Infiltrate mostly small lymphocytes.|
|Lymphocyte depleted||1–2%||Poor||Large numbers of atypical mononuclear cells.|
Ann Arbor staging
By CT or MRI.
|Stage I||Single lymph node region|
|Stage II||Two or more lymph node regions on same side of diaphragm|
|Stage III||Lymph nodes on both sides of diaphragm|
A or B. B=fever, weight loss, night sweats.
|Stage IV||Extranodal involvement|
IA, IIA—radiotherapy. Chaemotherapy for everyone else. Cure is
a realistic goal.
70–80% 5 y survival.
B-cell lymphomas are more common than T-cell lymphomas.
Peak 7th decade.
Definition: At least one of CD19, 20, 22.
All show immunoglobulin gene re-arrangement.
Divided into low grade (e.g., follicular lymphoma) and
high grade (e.g., large cell, Burkitt's lymphoma).
Common among children in equatorial belt of Africa.
Characteristic jaw tumour. EBV and malaria?
Cohesive medium-sized blasts, 'starry sky' appearance.
Definition: at least one of CD2, 3, 4, 7, 8.
All show T-cell receptor rearrangement.
Divided in low grade (e.g., mycosis fungoides) and high grade.
Cutaneous T-cell lymphoma
Helper T-cell phenotype. Lutzner 'cerebriform' cells.
Mycosis fungoides when confined to the skin.
Sézary syndrome when systemic.