{"id":2716,"date":"2010-02-13T15:38:04","date_gmt":"2010-02-13T20:38:04","guid":{"rendered":"http:\/\/insidesurgery.com\/?p=2716"},"modified":"2010-02-18T20:02:39","modified_gmt":"2010-02-19T01:02:39","slug":"nonhodgkins-lymphoma","status":"publish","type":"post","link":"https:\/\/insidesurgery.com\/2010\/02\/nonhodgkins-lymphoma\/","title":{"rendered":"Non-Hodgkin’s Lymphoma"},"content":{"rendered":"


\nPathophysiology<\/strong><\/p>\n

1)<\/strong> a group of 20 conditions all marked by clonal neoplastic transformation of lymphoid cells 2)<\/strong> initial phase involves infiltration of lymph nodes with a variable secondary leukemic phase in which malignant cells circulate in the bloodstream 3)<\/strong> can be either of B cell (90% of patients) or T cell origin 4)<\/strong> classified as low-grade or indolent (small cell or mixed cell), intermediate grade, or high grade (large cell or lymphoblastic)<\/p>\n

Signs and Symptoms<\/strong><\/p>\n

1)<\/strong> fever and night sweats 2)<\/strong> painless adenopathy 3)<\/strong> enlarged spleen 4)<\/strong> enlarged liver<\/p>\n

Histology\/Gross Pathology<\/strong><\/p>\n

1)<\/strong> lymph nodes have a pale color on cut surface 2)<\/strong> obliteration of normal lymph node architecture with white pulp enlargement 3)<\/strong> adults – 40% of patients have a follicular\/nodular pattern of lymph node involvement (better prognosis) and 60% have a diffuse pattern 4)<\/strong> children – virtually all patients have the diffuse pattern 5)<\/strong> infiltration of spleen, liver (discrete nodules occur in intermediate and high-grade neoplasms), and bone marrow occurs 6)<\/strong> some children have a “starry sky pattern” of lymph node infiltrate.<\/p>\n

Associated Conditions<\/strong><\/p>\n

increased incidence with<\/em> – 1)<\/strong> organ transplantation 2)<\/strong> HIV\/AIDS 3)<\/strong> rheumatoid arthritis 4)<\/strong> sicca syndrome 5)<\/strong> Sjogren’s syndrome 6)<\/strong> Chediak-Higashi disease 7)<\/strong> Wiskott-Aldrich disease 8)<\/strong> ataxia telangiectasia 9)<\/strong> IgA deficiency 10)<\/strong> celiac disease 11)<\/strong> post-treatment for Hodgkin’s disease 12)<\/strong> lupus 13)<\/strong> Klinefelter’s syndrome 14)<\/strong> dioxin exposure 15)<\/strong> treatment with alkylating agents 16)<\/strong> herbicides 17)<\/strong> benzene<\/p>\n

Biochemistry<\/strong><\/p>\n

1)<\/strong> Burkitt’s lymphoma – associated with Ebstein-Barr virus 2)<\/strong> follicular small cell cleaved variant – associated wtih bcl-2<\/em> gene and translocation of chromosomes 14 and 18 3)<\/strong> mature T cell lymphoma – associated with hypergammaglobulinemia 4)<\/strong> low-grade B cell variant – associated with monoclonal immunoglobulin<\/p>\n

Inheritance\/Epidemiology<\/strong><\/p>\n

1)<\/strong> increased in frequency in USA in past 50 years 2)<\/strong> slightly more common in men 3)<\/strong> median age of onset is 50 years<\/p>\n

Treatment<\/strong><\/p>\n

1)<\/strong> chemotherapy 2)<\/strong> radiation<\/p>\n

Tips for USMLE<\/strong><\/p>\n

if question mentions a 68 year-old man with a 2 month history of night sweats, fever, and painless adenopathy in the left axilla, think of a non-Hodgkin’s lymphoma
\n
\n
\nRelated Posts<\/strong><\/p>\n

Non-Hodgkin’s Lymphoma<\/a>
\nBurkitt’s Lymphoma<\/a>
\nAtaxia-telangiectasia<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Pathophysiology 1) a group of 20 conditions all marked by clonal neoplastic transformation of lymphoid cells 2) initial phase involves infiltration of lymph nodes with a variable secondary leukemic phase in which malignant cells circulate in the bloodstream 3) can be either of B cell (90% of patients) or T cell origin 4) classified as […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[63],"tags":[1255,1256,1251,1250,1252,1254,1253],"yoast_head":"\nNon-Hodgkin's Lymphoma - InsideSurgery Medical Information Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/insidesurgery.com\/2010\/02\/nonhodgkins-lymphoma\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Non-Hodgkin's Lymphoma - 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