non-Hodgkins' lymphoma


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non-Hodgkins' lymphoma

A lymphoid cancer that is not Hodgkins disease: NHL ALL, B cell lymphoma, Burkitt's lymphoma, diffuse cell lymphoma, follicular lymphoma, immunoblastic large cell lymphoma, lymphoblastic lymphoma, mantle cell lymphoma, mycosis fungoides, post-transplantation lymphoproliferative disorder, small non-cleaved cell lymphoma, T-cell lymphoma Epidemiology Incidence ↑ 8.5/105 in 1973→15/105 in 1990 (21/105, in 2000, Canada ♂), ±53,900 new cases/yr, US in 2002; 60% of all lymphomas are NHLs, of which 55% are diffuse, 45% are nodular Risk factors AIDS, primary immunodeficiency, immunosuppression, transplants, exposure to pesticides, hair dyes, smoking, alcohol, in older ♀–linked to ↑ consumption of meat/animal fats– Management Chemotherapy, especially CHOP Complications Spinal cord compression occurs in up to 10%, which is often aggressive, and may respond to high-dose RT. See Lymphoma, REAL classification, Working Formulation.
Non-Hodgkin's lymphoma
Stage I CA present in only one lymph node area or in only one extranodal regional/organ
Stage II CA present in ≥ 2 lymph node areas on same side of diaphragm; CA present in only one extranodal area or organ outside the lymph nodes and in the lymph nodes around it. Other lymph node areas on the same side of the diaphragm may also have cancer
Stage III CA present in lymphoid tissue on both sides of the diaphragm; tumor may also have spread to an area or organ near the lymph node areas and/or to the spleen
Stage IV CA has spread to > one organ or organs outside lymphoid tissue; CA has spread to only one organ outside the lymph system, but lymph nodes distant from that organ are involved