Non-Hodgkin lymphoma classification: Difference between revisions

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==Classification==
==Classification==
===A. Updated WHO classification===
===A. Updated WHO classification===
* Non-Hodgkin lymphoma may be classified according to updated [[WHO]] classification into 2 groups:<ref name=”cancer gov”>National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/publications/pdq</ref>
* Non-Hodgkin lymphoma may be classified according to updated [[WHO]] classification into 2 groups:<ref name="”cancer">National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/publications/pdq</ref>
:* B-cell neoplasms
:* B-cell neoplasms
:* T-cell and putative NK-cell neoplasms
:* T-cell and putative NK-cell neoplasms
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
|+ '''Updated WHO classification of Non-Hodgkin lymphoma'''
|+ '''Updated WHO classification of Non-Hodgkin lymphoma'''
! style="background: #4479BA; color:#FFF; text-align: center; font-weight: bold;" | B-cell neoplasms
! style="background: #4479BA; color:#FFF; text-align: center; font-weight: bold;" | B-cell neoplasms
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===B. Classification based on rate of growth===
===B. Classification based on rate of growth===
* Non-Hodgkin lymphoma may be classified based on rate of growth into 2 groups:<ref name=CCS>{{cite web | title = Canadian Cancer Society Grades of non-Hodgkin lymphoma
* Non-Hodgkin lymphoma may be classified based on rate of growth into 2 groups:<ref name="CCS">{{cite web | title = Canadian Cancer Society Grades of non-Hodgkin lymphoma
| url =http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/grading/?region=ab}}</ref>
| url =http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/grading/?region=ab}}</ref>
:* Low-grade or Indolent lymphoma
:* Low-grade or Indolent lymphoma
:* High-grade or Aggressive lymphoma
:* High-grade or Aggressive lymphoma


{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
|+ '''Non-Hodgkin lymphoma classification'''
|+ '''Non-Hodgkin lymphoma classification'''
! style="background: #4479BA;; color:#FFF;" | Grade
! style="background: #4479BA;; color:#FFF;" | Grade
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* Can frequently be successfully treated with intensive chemotherapy treatment
* Can frequently be successfully treated with intensive chemotherapy treatment
|}
|}
{|
! style="background:#4479BA; color: #FFFFFF;" align="center" + | Severity
! style="background:#4479BA; color: #FFFFFF;" align="center" + | Calcium concentration
! style="background:#4479BA; color: #FFFFFF;" align="center" + | Key Points
|-
| style="background:#DCDCDC;" align="center" + |Mild hypercalcemia
| style="background:#F5F5F5;" align="center" + |<3.0 mmol/L
| style="background:#F5F5F5;" + |
*Often asymptomatic
*No urgent correction needed
|-
| style="background:#DCDCDC;" align="center" + |Moderate hypercalcemia
| style="background:#F5F5F5;" align="center" + |3.0–3.5 mmol/L
| style="background:#F5F5F5;" + |
* Tolerated well if there is a slow rise
* Symptoms may be present
* Treatment indicated in symptomatic cases
|-
| style="background:#DCDCDC;" align="center" + |Severe hypercalcemia
| style="background:#F5F5F5;" align="center" + |>3.5 mmol/L
| style="background:#F5F5F5;" + |
*Urgent correction is recommended
* Risk of dysrhythmia and coma if not corrected
|}


==References==
==References==

Revision as of 16:46, 14 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]

Overview

Non-Hodgkin lymphoma may be classified into subtypes according to updated WHO classification and rate of growth.

Classification

A. Updated WHO classification

  • Non-Hodgkin lymphoma may be classified according to updated WHO classification into 2 groups:[1]
  • B-cell neoplasms
  • T-cell and putative NK-cell neoplasms
Updated WHO classification of Non-Hodgkin lymphoma
B-cell neoplasms T-cell and putative NK-cell neoplasms
Precursor B-cell neoplasm Precursor T-cell neoplasm
Precursor B-acute lymphoblastic leukemia / lymphoblastic lymphoma (LBL) Precursor T-acute lymphoblastic leukemia / lymphoblastic lymphoma (LBL)
Peripheral B-cell neoplasms Peripheral T-cell and NK-cell neoplasms
B-cell CLL / small lymphocytic lymphoma T-cell CLL / prolymphocytic leukemia
B-cell prolymphocytic leukemia T-cell granular lymphocytic leukemia
Lymphoplasmacytic lymphoma / immunocytoma Mycosis fungoides / Sézary syndrome
Mantle cell lymphoma Peripheral T-cell lymphoma, not otherwise characterized
Follicular lymphoma Hepatosplenic gamma / delta T-cell lymphoma
Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphatic tissue (MALT) type Subcutaneous panniculitis-like T-cell lymphoma
Nodal marginal zone B-cell lymphoma (± monocytoid B-cells) Angioimmunoblastic T-cell lymphoma
Splenic marginal zone lymphoma (± villous lymphocytes) Extranodal T-/NK-cell lymphoma, nasal type
Hairy cell leukemia Enteropathy-type intestinal T-cell lymphoma
Plasmacytoma / plasma cell myeloma Adult T-cell lymphoma / leukemia (human T-lymphotrophic virus [HTLV] 1+)
Diffuse large B-cell lymphoma Anaplastic large cell lymphoma, primary systemic type
Burkitt lymphoma Anaplastic large cell lymphoma, primary cutaneous type
Aggressive NK-cell leukemia

B. Classification based on rate of growth

  • Non-Hodgkin lymphoma may be classified based on rate of growth into 2 groups:[2]
  • Low-grade or Indolent lymphoma
  • High-grade or Aggressive lymphoma
Non-Hodgkin lymphoma classification
Grade Description
Low-grade or Indolent lymphoma
  • Tend to grow very slowly
  • Tend to be widespread by the time they are diagnosed
  • Often involving the bone marrow and spleen
  • Often treated only when symptoms appear
  • Can shrink or seem to disappear with treatment, but they tend to come back
  • Can change into more aggressive lymphomas
  • Have a fairly good prognosis
High-grade or Aggressive lymphoma
  • Grow quickly and tend to spread to lymph nodes or other organs throughout the body
  • Cause symptoms and need treatment right away
  • Can frequently be successfully treated with intensive chemotherapy treatment


Severity Calcium concentration Key Points
Mild hypercalcemia <3.0 mmol/L
  • Often asymptomatic
  • No urgent correction needed
Moderate hypercalcemia 3.0–3.5 mmol/L
  • Tolerated well if there is a slow rise
  • Symptoms may be present
  • Treatment indicated in symptomatic cases
Severe hypercalcemia >3.5 mmol/L
  • Urgent correction is recommended
  • Risk of dysrhythmia and coma if not corrected


References

  1. ↑ National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/publications/pdq
  2. ↑ "Canadian Cancer Society Grades of non-Hodgkin lymphoma".

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