(Cancer)

Overview

Lymphoma ⇒ malignant proliferation of lymphocytes (B and T cells) which accumulate in lymph nodes or other organs

• HL vs NHL
• Hodgkin’s Lymphoma → malignant lymphoma of B-cell origin. Uncommon malignancy. Characterised by presence of reed-sternberg cells.
  • Subtypes
• M>F, bimodal age distribution 1st peak 25-30 years and 2nd peak 50-70 years
• Aetiology → strong association with Epstein-Barr Virus, immunodeficiency and autoimmune disease (eg. RA, sarcoidosis)

• Non-Hodgkin’s Lymphoma → every other type of lymphoma that is not HL (ie. no reed-sternberg cells). May affect B or T cells. Much more common than HL.
• Incidence increases with age
• Aetiology → chromosomal translocations, infections (EBV, HIV, h.pylori), autoimmune diseases, immunodeficiency

Making Diagnosis

Clinical Features:

• Hodgkin’s Lymphoma → painless lymphadenopathy most commonly involving the cervical or supraclavicular nodes. Involvement of single group of lymph nodes. Alcohol induced pain. Pruritus. B symptoms.
• Non-Hodgkin’s Lymphoma → rubbery painless lymphadenopathy associated with fatigue. Splenomegaly. Extranodal disease = GI (dyspepsia, dysphagia, abdo pain), bone marrow (bone pain), neurological (headache). Affects multiple nodes.
  • Subtype ⇒ burkitt’s lymphoma (’starry sky’ appearance on microscopy). Common in patients HIV. Chemotherapy tends to produce rapid response which can cause tumour lysis syndrome (hyperkalaemia, hyperphosphataemia, hyperuricaemia, hypocalcaemia).
• B Symptoms → unexplained fevers, night sweats, weight loss. Typically occur earlier in Hodgkin’s and later in Non-Hodgkin’s.
  • Associated with poor prognosis in Hodgkin’s