Symptoms and signs
Non-Hodgkin's Lymphoma News
1. Indolent lymphomas
As a group, low-grade lymphomas are characterized by indolent clinical behavior and comparatively prolonged survival (median survival, 6-10 years). Most patients have advanced- stage disease at diagnosis, and only about 10%-20% have stage I or II disease.
- They usually appear above the age of 50 and present with generalized lymphadenopathy.
- They commonly involve the bone marrow and spleen.
- Despite the relative incurability of the disease in its advanced stages, follicular lymphoma patients tend to experience a long overall survival (8-12 years).
- Lymphoplasmacytic Lymphoma is an indolent lymphoma associated with a monoclonal paraprotein of immunoglobulin M type.
- They usually present with generalized lymph node, splenic and bone marrow involvement.
- Some patients may develop hyperviscosity syndrome (which may lead to retinopathy, congestive heart failure and CNS dysfunction) due to excessive paraprotein secretion.
- Patients may also experience chronic cold agglutinin disease.
Marginal zone lymphomas
- Nodal marginal zone lymphomas involve the nodes and are called monocytoid B-cell lymphomas
- Extranodal marginal zone lymphoma involves the extranodal sites (gastrointestinal tract, thyroid, lung, breast, skin), they are called mucosa-associated lymphatic tissue (MALT) lymphomas.
Splenic marginal zone lymphoma
- Splenic marginal zone lymphoma is an indolent lymphoma that is marked by massive splenomegaly and peripheral blood and bone marrow involvement, usually without adenopathy.
- Splenectomy may result in prolonged remission, otherwise it is treated as low grade lymphoma.
2. Intermediate to high grade lymphoma
The clinical manifestations of intermediate- and high-grade NHLs are diverse and depend on the site of disease involvement. These tumors have a rapid growth rate and present as painless masses that cause symptoms when they infiltrate tissues or obstruct organs.
Lymphomas more frequently affects the lymph nodes, spleen, liver, and bone marrow, but any extranodal site may also be primarily involved.
- As with Hodgkin's disease, NHL also presents with systemic B symptoms, including fever, which may or may not have the Pel-Ebstein relapsing pattern; drenching night sweats; and more than 10% weight loss. Generalized pruritus may also be present.
- Nonparathyroid hormone induced hypercalcemia occurs in approximately 10% of patients.
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