Lymphoma and Infections

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Questions and Answers

Based on the characteristics of which cell do the subtypes in Hodgkin lymphoma classifications rely?

Reed-Sternberg cell

What percentage of patients with advanced disease present with B symptoms?

Up to 50%

What is the primary cell of origin in lymphomas?

Lymphocyte

What laboratory tests are helpful in treatment planning and prognosis?

Complete blood count, complete metabolic panel, LDH, and ESR Signup and view all the answers

What is a common site of lymph node involvement in patients with Hodgkin lymphoma?

Mediastinal area Signup and view all the answers

What are the common sites of extranodal disease in non-Hodgkin’s lymphoma?

Stomach, skin, oral cavity and pharynx, small intestine, and CNS Signup and view all the answers

What are the two main histological categories of lymphomas?

Hodgkin lymphoma and Non-Hodgkin lymphoma Signup and view all the answers

Who first described Hodgkin lymphoma?

Thomas Hodgkin Signup and view all the answers

What is the characteristic histological feature of Hodgkin lymphoma?

Reed–Sternberg cells Signup and view all the answers

What is the percentage of Non-Hodgkin lymphomas in the United States that are of B-cell origin?

85% to 90% Signup and view all the answers

What is the role of an expert hematopathologist in diagnosing Hodgkin lymphoma?

To review the biopsy and make a diagnosis Signup and view all the answers

What are the immunological filters for interstitial lymphatic fluid from the body’s tissues?

Lymph nodes Signup and view all the answers

What is the significance of persistence of lymphadenopathy for more than 2 months?

It warrants evaluation Signup and view all the answers

Why is it important to assess pregnancy tests and HIV status in patients with Hodgkin lymphoma?

To aid in treatment planning Signup and view all the answers

What is the result of the interaction between debris and APCs in lymph nodes?

Activated immune cells and tumor cells that can cause lymphadenopathy Signup and view all the answers

What is the most common site of malignancy in lymphomas?

Lymph node Signup and view all the answers

What is the preferred type of biopsy for diagnosing Hodgkin lymphoma?

Excisional biopsy Signup and view all the answers

According to the World Health Organization classification, what are the two major categories of lymphoid malignancies?

B-cell lymphomas and T-cell (and natural killer cell) lymphomas Signup and view all the answers

What is the name of the lymphoma associated with gastric infection by Helicobacter pylori?

Gastric MALT lymphomas Signup and view all the answers

What is the name of the lymphoma associated with human T-cell lymphotropic virus type 1 infection?

Adult T-cell leukemia/lymphoma Signup and view all the answers

What is the term for the uniform population of lymphoid cells that replace normal cells and architecture in lymph nodes or bone marrow?

Monoclonal proliferation of malignant B or T lymphocytes Signup and view all the answers

What are the three main features used to classify Non-Hodgkin lymphomas?

Cell of origin, clinical features, and morphologic features Signup and view all the answers

What is the name of the category of lymphoid malignancies that includes precursor B-lymphoblastic leukemia/lymphoma?

Precursor B- and T-Cell Neoplasms Signup and view all the answers

What additional markers are used to further classify Non-Hodgkin lymphomas into subtypes?

Immunohistochemical markers, cytogenetic features, and genotypic characteristics Signup and view all the answers

Study Notes

Infection and Lymphoma

Infection with human T-cell lymphotropic virus type 1 in early childhood is strongly associated with adult T-cell leukemia/lymphoma.
Gastric infection with Helicobacter pylori, a gram-negative bacteria, is associated with gastric MALT lymphomas.
Hepatitis C virus is associated with splenic and nodal marginal zone lymphomas.

Pathology and Classification

Non-Hodgkin lymphomas are neoplasms derived from the monoclonal proliferation of malignant B or T lymphocytes and their precursors.
About 85% to 90% of NHLs in the United States are of B-cell origin.
The classification of NHLs has evolved over the past five decades, with advances in immunology and genetics allowing for recognition of previously unrecognized subtypes.

WHO Classification

WHO classification categorizes lymphoid malignancies into two major categories: B-cell lymphomas and T-cell (and natural killer cell) lymphomas.
Precursor B- and T-Cell Neoplasms are categorized into two subtypes: Precursor B-lymphoblastic leukemia/lymphoma and Precursor T-lymphoblastic leukemia/lymphoma.

Lymph Nodes and Lymphoma

Lymph nodes are small, BB-sized lymphoid organs that filter interstitial lymphatic fluid from the body's tissues.
Lymph nodes provide an environment for the interaction of debris with antigen-presenting cells (APCs) and other immune cells.
Lymphoma is cancer of the lymphatic system, arising from malignant transformation of immune cells.
The primary cancerous cell of origin is the lymphocyte, often resulting in overlap between lymphomas and lymphoid leukemias.

Types of Lymphoma

Hodgkin lymphoma is named after Thomas Hodgkin, who first described it in 1832.
Hodgkin lymphoma is characterized by the presence of Reed-Sternberg cells.
Non-Hodgkin lymphoma (NHL) is characterized by the presence of B- or T-cell lymphocyte markers.

Signs and Symptoms

About 25% of patients present with fever, night sweats, and/or weight loss, known as B symptoms.
Patients may also experience nonspecific symptoms including malaise, pruritus, fatigue, and development of pain after alcohol consumption.
Most patients with Hodgkin lymphoma present with a painless, rubbery, enlarged lymph node in the supradiaphragmatic area.

Diagnosis, Staging, and Prognostic Factors

Diagnostic and staging procedures are based on recommendations made at the Ann Arbor and Cotswolds conferences and new scientific advances.
The diagnosis and pathologic classification of Hodgkin lymphoma can only be made by review of a biopsy by an expert hematopathologist.
Routine laboratory tests, including complete blood count, complete metabolic panel, lactate dehydrogenase (LDH), and erythrocyte sedimentation rate (ESR), will be helpful in treatment planning and aid in prognosis.

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Description

Learn about the associations between infections and different types of lymphomas, including adult T-cell leukemia/lymphoma, gastric MALT lymphomas, and splenic and nodal marginal zone lymphomas. Discover the pathology and classification of non-Hodgkin lymphomas.