Non Hodgkin's lymphomas - non hodgkins lymphomas information

The term 'non-Hodgkin's lymphoma' encompasses many different histological subtypes. Subdivision of the lymphomas into ' low grade ' and ' high grade ' reflects the rate at which the cells are dividing and thus the clinical progression of the disease. Paradoxically, high-grade lymphomas (those in which the cells are dividing quickly) are potentially curable, whereas low-grade lymphomas are generally considered to be incurable with conventional therapy, although patients may live for a number of years and respond to treatment several times. A further subdivision is made on the basis of B or T cell origin. Most NHLs are of B cell phenotype, although T cell tumours are increasingly being recognized.

Several different histological classifications of the non-Hodgkin's lymphomas have been suggested. The most widely used until recently was the Kiel classification, which was then superseded by the REAL (Revised European American Lymphoma Classification) and, latterly, by the proposed WHO classification following additional cytogenetic and immunochemical information.

Clinical Features of Non-Hodgkin's diseases

Most patients present with peripheral lymph node enlargement, with or without systemic symptoms. NHL may also involve mediastinal, intra-abdominal and pelvic lymph nodes with resulting symptoms. They may involve only an extranodal site, such as part of the gastrointestinal tract, lung, brain or testis. Extranodal presentation is more common in NHL than in Hodgkin's disease.

Treatment of Non-Hodgkin's diseases

As in Hodgkin's disease, treatment will depend on the extent and distribution of disease as well as on the histological subtype. Patients with localized indolent lymphoma may enter very long-term remissions with radiotherapy alone. It is not clear whether this is synonymous with cure. Those with more extensive disease require systemic therapy.

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