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Lymphoma: Overview

Lymphomas are a group of malignancies of lymphoid tissue. They are classified as either non–Hodgkin’s or Hodgkin’s lymphoma. While lymphomas generally affect lymph nodes or lymphoid tissue, such as the spleen, they can also affect extranodal tissue, such as the lung, liver, or gastrointestinal tract.

Non–Hodgkin’s lymphomas are the sixth most common cause of cancer–related death in the United States. Since 1950, the age–adjusted death rate has more than doubled. These cancers are characterized as B–cell (90%) or T–cell lymphomas, depending on the lymphoid cell of origin. The classification of non–Hodgkin’s lymphoma has more than 40 separate diagnoses. Untreated, the most aggressive forms have an abysmal prognosis, with survival rates measured in weeks or months. However, with appropriate treatment, many of the aggressive types are curable. On the other hand, the less aggressive types may not need immediate treatment, but they are generally not considered curable.

Hodgkin’s lymphoma is characterized by the histologic presence of the Reed–Sternberg cell. There are 5 types of Hodgkin's lymphoma, differentiated by histologic appearance:

  1. Nodular sclerosing Hodgkin's lymphoma.
  2. Mixed cellularity Hodgkin's lymphoma.
  3. Lymphocyte depletion Hodgkin's lymphoma.
  4. Lymphocyte–rich classical Hodgkin's lymphoma.
  5. Nodular lymphocyte–predominant Hodgkin's lymphoma.

Overall, Hodgkin’s lymphoma currently has a cure rate of more than 85%. The different types are generally treated similarly and have comparable outcomes.

Presenting symptoms of both categories of lymphoma include painless lymphadenopathy; constitutional symptoms (eg, fever, night sweats, weight loss, fatigue); pruritis; and symptoms of localized compression, such as coughing and chest discomfort. However, indolent lymphomas are often asymptomatic at presentation.

 

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Lymphoma: Risk Factors >>