Non-Hodgkin Lymphoma Quiz

Lymphoma Overview

• Lymphoma is a diverse group of solid tumors originating from lymphoid stem cells.
• Lymphomas can form in lymph tissues and bone marrow, potentially affecting the spleen and liver.
• Lymphomas are categorized as Hodgkin or Non-Hodgkin.

Hodgkin Lymphoma (HL)

• Pathophysiology: Characterized by the presence of Reed-Sternberg cells (binucleated/multinucleated giant cells). The exact origin is debated, but the cell type is recognized as neoplastic . This is accompanied by other inflammatory cells. Understanding the exact pathogenesis is still ongoing.
• Clinical Manifestations: About 80% of patients present with painless, enlarging cervical lymph nodes, which have a firm (rubbery) texture. Other symptoms, like low-grade fever, night sweats, pruritus (itching), weight loss, and fatigue, may also occur. In 20% of cases, a mediastinal mass (greater than 1/3 of the chest diameter) is present, along with possible splenomegaly (enlarged spleen) or hepatomegaly (enlarged liver).
• Staging: Staging ranges from I (single lymph node involvement) to IV (extensive involvement of multiple organs). Stage A generally lacks systemic manifestations. Stage B presents with conditions like unexplained fever, drenching night sweats, and unexplained weight loss.
• Diagnosis: A combination of medical history, physical examination, lab tests, and imaging studies like CT scans to detect tumor size and location are used. The key diagnostic finding is the recognition of Reed-Sternberg cells.
• Treatment: Treatment varies based on the stage of the disease. Early-stage HL (Stage IA or IIA) may respond to chemotherapy alone, while later-stage cases (Stages III and IV) often involve a combination of chemotherapy and radiation therapy. Reduced radiation doses are typically recommended for children. Survival rates vary with stage.

Non-Hodgkin Lymphoma (NHL)

• Pathophysiology: Unlike Hodgkin lymphoma, NHL doesn't involve Reed-Sternberg cells. It arises from B-cells or T-cells and is typically more common than Hodgkin lymphoma. Genetic factors, viral infections, and immunodeficiencies may play a role.
• Clinical Manifestations: Systemic symptoms, weight loss, fever, and night sweats may indicate that the lymphoma has progressed beyond the initial localized nodes. There are varied presenting symptoms, depending on the specific subtype.
• Staging: Similar to Hodgkin's, staging progresses from single-node involvement to widely spread involvement of noncontiguous lymph nodes and organs. Specific markers like BCL-2 gene mutations are associated with a type of follicular lymphoma.
• Diagnosis: Patient history and physical examination are crucial for assessing lymph nodes and possible systemic symptoms. In addition to lymph node biopsy to confirm NHL, histopathological and immunophenotyping analysis will be performed to determine cell lineage. CT/MRI/PET scans help to determine tumor size and location. Spinal fluid may be sampled to rule out metastases.
• Treatment: The treatment protocol is usually based on the type of NHL and the extent of spread. It often involves chemotherapy, sometimes in combination with radiation therapy, tailored to the specific type. Early stage cases may use radiation alone, while later stage cases will require aggressive combinations of chemo and/or radiation therapies.

Test your knowledge on non-Hodgkin lymphoma, its diagnostic methods, clinical manifestations, treatment approaches, and related risk factors. This quiz covers essential concepts crucial for understanding this type of cancer and its comparison with Hodgkin lymphoma.