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==Overview==
==Overview==
'''Non-Hodgkin lymphoma''' (NHL) describes a group of [[cancer]]s arising from [[lymphocyte]]s, a type of [[white blood cell]]. It is distinct from [[Hodgkin lymphoma]] in its [[pathology|pathologic features]], [[epidemiology]], common sites of involvement, clinical behavior, and treatment. The non-Hodgkin lymphomas are a diverse group of diseases with varying courses, treatments, and [[prognosis|prognosis]].


Non-Hodgkin lymphoma may develop in any organ associated with the lymphatic system (e.g. [[spleen]], [[lymph node]]s, or [[tonsils]]). Most cases start with infiltration of lymph nodes, but some subtypes may be restricted to other lymphatic organs.
The diagnosis of non-Hodgkin lymphoma requires a [[biopsy]] of involved tissue. The numerous subtypes of non-Hodgkin lymphoma are typically grouped into three distinct categories based on their aggressiveness, or histologic grade. These categories are ''indolent''(or low-grade), ''aggressive'' (or intermediate-grade), and ''highly aggressive'' (or high-grade). The treatment of indolent or low-grade lymphoma may initially involve a period of observation, while aggressive or highly aggressive non-Hodgkin lymphoma is typically treated with [[chemotherapy]] and/or [[radiation therapy]].
==Classification==
==Classification==
Non-Hodgkin lymphoma may be classified according to updated REAL / WHO classification into 2 groups: B-cell neoplasms and T-cell and putative NK-cell neoplasms. Non-Hodgkin lymphoma may be classified based on rate of growth into 2 Groups: low-grade or indolent lymphoma and high-grade or aggressive lymphoma.
Non-Hodgkin lymphoma may be classified according to updated REAL / WHO classification into 2 groups: B-cell neoplasms and T-cell and putative NK-cell neoplasms. Non-Hodgkin lymphoma may be classified based on rate of growth into 2 Groups: low-grade or indolent lymphoma and high-grade or aggressive lymphoma.
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==Risk Factors==
==Risk Factors==
The known risk factors in the development of Non-Hodgkin lymphoma are weakened immune system, [[autoimmune disorders]], certain infections and previous cancer treatment. Other possible risk factors include family history of Non-Hodgkin lymphoma, exposure to [[pesticides]], exposure to [[trichloroethylene]], [[diet]], [[obesity]], hair dyes, and occupational exposures.
The known risk factors in the development of Non-Hodgkin lymphoma are weakened immune system, [[autoimmune disorders]], certain infections and previous cancer treatment. Other possible risk factors include family history of Non-Hodgkin lymphoma, exposure to [[pesticides]], exposure to [[trichloroethylene]], [[diet]], [[obesity]], hair dyes, and occupational exposures.
==Diagnosis==
===Staging===
According to the Ann arbor staging system, there are four stages of Non-Hodgkin lymphoma based on the number of nodes and extra nodal involvement.
===Symptoms===
The most common symptom of Non-Hodgkin lymphoma is a painless swelling of the lymph nodes in the neck, underarm (axilla), or groin. Other symptoms of Non-Hodgkin lymphoma may include [[fever]], [[weight loss]], poor appetite, [[night sweats]], constant [[fatigue (physical)|fatigue]], [[pruritis|itchy skin]], reddened patches on the skin, [[cough]], [[shortness of breath]], [[abdominal pain]] or swelling, [[constipation]], [[nausea]], [[vomiting]], [[headache]], concentration problems, personality changes, and [[seizures]].
===Physical Examination===
Common physical examination findings of Non-Hodgkin lymphoma include [[fever]], [[pruritus]], [[petechiae]], chest tenderness, [[abdominal tenderness]], [[hepatomegaly]], [[splenomegaly]], [[Lymphadenopathy|peripheral lymphadenopathy]], [[seizures]], and [[Lymphadenopathy|central lymphadenopathy]].
===Laboratory Tests===
Laboratory tests for Non-hodgkin lymphoma include [[complete blood count]] (CBC), blood chemistry studies, HIV blood test, and Hepatitis B blood test.
===Chest X Ray===
Presence of [[Pulmonary nodule|nodules]] and [[pleural effusion]] on chest x ray may be suggestive of Non-Hodgkin lymphoma.
===CT===
Chest, abdomen, and pelvis [[CT]] scan may be helpful in the diagnosis of Non-Hodgkin lymphoma.
===MRI===
[[MRI]] scan may be helpful in the diagnosis of Non-Hodgkin lymphoma.
===Ultrasound===
On ultrasound, Non-Hodgkin lymphoma is characterized by [[hepatomegaly]] and  [[splenomegaly]].
===Other Imaging Findings===
[[PET]] and [[Bone scan]] may be helpful in the diagnosis of Non-Hodgkin lymphoma.
===Other Diagnostic Studies===
Other diagnostic studies for the diagnosis of Non-Hodgkin lymphoma include [[bone marrow aspiration]] and [[biopsy]] and [[lumbar puncture]].
==Treatment==
===Medical Therapy===
The predominant therapy for Non-Hodgkin lymphoma is chemotherapy. Adjunctive [[radiation]], [[immunotherapy]], and [[stem cell transplantation]] may be required.
===Surgery===
Surgical intervention is not recommended for the management of Non-Hodgkin lymphoma.


==References==
==References==

Revision as of 14:18, 28 September 2015

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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

Classification

Non-Hodgkin lymphoma may be classified according to updated REAL / WHO classification into 2 groups: B-cell neoplasms and T-cell and putative NK-cell neoplasms. Non-Hodgkin lymphoma may be classified based on rate of growth into 2 Groups: low-grade or indolent lymphoma and high-grade or aggressive lymphoma.

Causes

There are no established causes for Non-Hodgkin lymphoma.

Risk Factors

The known risk factors in the development of Non-Hodgkin lymphoma are weakened immune system, autoimmune disorders, certain infections and previous cancer treatment. Other possible risk factors include family history of Non-Hodgkin lymphoma, exposure to pesticides, exposure to trichloroethylene, diet, obesity, hair dyes, and occupational exposures.

Diagnosis

Staging

According to the Ann arbor staging system, there are four stages of Non-Hodgkin lymphoma based on the number of nodes and extra nodal involvement.

Symptoms

The most common symptom of Non-Hodgkin lymphoma is a painless swelling of the lymph nodes in the neck, underarm (axilla), or groin. Other symptoms of Non-Hodgkin lymphoma may include fever, weight loss, poor appetite, night sweats, constant fatigue, itchy skin, reddened patches on the skin, cough, shortness of breath, abdominal pain or swelling, constipation, nausea, vomiting, headache, concentration problems, personality changes, and seizures.

Physical Examination

Common physical examination findings of Non-Hodgkin lymphoma include fever, pruritus, petechiae, chest tenderness, abdominal tenderness, hepatomegaly, splenomegaly, peripheral lymphadenopathy, seizures, and central lymphadenopathy.

Laboratory Tests

Laboratory tests for Non-hodgkin lymphoma include complete blood count (CBC), blood chemistry studies, HIV blood test, and Hepatitis B blood test.

Chest X Ray

Presence of nodules and pleural effusion on chest x ray may be suggestive of Non-Hodgkin lymphoma.

CT

Chest, abdomen, and pelvis CT scan may be helpful in the diagnosis of Non-Hodgkin lymphoma.

MRI

MRI scan may be helpful in the diagnosis of Non-Hodgkin lymphoma.

Ultrasound

On ultrasound, Non-Hodgkin lymphoma is characterized by hepatomegaly and splenomegaly.

Other Imaging Findings

PET and Bone scan may be helpful in the diagnosis of Non-Hodgkin lymphoma.

Other Diagnostic Studies

Other diagnostic studies for the diagnosis of Non-Hodgkin lymphoma include bone marrow aspiration and biopsy and lumbar puncture.

Treatment

Medical Therapy

The predominant therapy for Non-Hodgkin lymphoma is chemotherapy. Adjunctive radiation, immunotherapy, and stem cell transplantation may be required.

Surgery

Surgical intervention is not recommended for the management of Non-Hodgkin lymphoma.

References

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