-IBIS-1.5.0-
tx
immune system
lymphoma: non-Hodgkin's
diagnoses
definition and etiology
definition: A heterogeneous group of diseases causing malignancy of lymphoid cells with early metastasis throughout the body. There are more cases of non-Hodgkin's disease than Hodgkin's disease each year. The onset is typically later than that of Hodgkin's, with cases beginning to occur around 50-59 years old, reaching maximum risk at 60-69. Like Hodgkin's, a viral etiology is suspected but has yet to be proven.
Some, like Burkitt's lymphoma and T-cell lymphoma are associated with viruses, in these cases EBV and HTLV.
signs and symptoms
Typically the patient presents with:
Asymptomatic cervical and/or inguinal (especially in children) adenopathy.
May have fever, weight loss, malaise, etc. at this time.
Early involvement of oropharyngeal lymphoid tissue: tonsils, skin, gastrointestinal tract, and bone.
Increased susceptibility to viral, fungal, and bacterial infections.
Anemia.
lab findings:
Lymph node biopsy (-) for Reed-Sternberg cells.
X-rays.
CT scan.
Lymphangiography.
Laparotomy.
Ultrasound.
CBC: variable WBC, eosinophilia in 20%, lymphopenia.
decreased albumin
increased ESR and CRP in acute stages
course and prognosis
When first diagnosed the disease has spread throughout the body in 70-90% of patients. Prognosis depends upon the amount of dissemination, the staging of the disease and the type of lymphoma. The prognosis is generally improving, with the introduction of new treatment methods. Although most patients develop progressive disease over 2-6 years, survival rate is 75% over five years.
differential diagnosis
Hodgkin's disease.
Acute or chronic leukemia.
Infectious mononucleosis.
TB.
footnotes