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Lymphoma

Lymphoma

  • Malignant tumour of lymphoid tissue

Presentation

  1. Primary Tumour
    • Painless progressive lymph node enlargement
    • SVC obstruction
  2. Systemic effects
    • Malaise
    • Weight loss
    • Splenomegaly / Hepatomegaly
  3. Metastatic features
    • Bone pain
  4. Paraneoplastic syndromes

Classification

  Hodgkin's Lymphoma
 Non-Hodgkin's Lymphoma
Cellular
  • Dorothy Reed-Sternberg cells
  • Polymorphic
  • B-cell tumour
  • Monomorphic
Clinical features
  • Bimodal age distribution
  • Step-by-step spread
  • 80% curable
  • Peak 50 years (older)
  • Random spread
  • Poor prognosis
Classification (grading)

Rye Classification

  1. Lymphocyte predominant
  2. Nodular sclerosing
  3. Mixed cellularity
  4. Lymphocyte deplete 
  
Staging

 

Ann Arbor System

  • A - Absence of systemic symptoms (wt loss, fever)
  • B - Presence

 

  • Stage I: one node
  • Stage II: many nodes (same side)
  • Stage III: Both sides of diaphragm
  • Stage IV: Metastatic spread 
Diagnosis
  1. History
  2. Examination
  3. Imaging
    • CXR
    • IVU - retroperitoneal nodes compress renal calyces
    • CT scan
  4. Tissue diagnosis
Treatment Radiotherapy + Chemotherapy 
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