(Non-Hodgkin’s lymphoma)

Non-Hodgkin’s lymphomas (NHL) are comprise a heterogeneous group of diseases, malignant monoclonal proliferation of lymphatic cells in lymphoreticular tissues, including lymph nodes, bone marrow, spleen, liver and gastrointestinal tract. The pioneering symptoms usually include the peripheral lymphadenopathy. However, some patients present without lymphadenopathy, but with abnormal lymphocytes in the circulation. Compared to Hodgkin’s lymphoma there is a higher probability of disseminated disease at diagnosis. The diagnosis is usually made by a lymph node and / or bone marrow biopsy. The treatment includes radiation and / or chemotherapy. The stem cell transplantation is conventionally provided for the salvage treatment after incomplete remission or relapse.

Non-Hodgkin’s lymphomas are more common than Hodgkin’s lymphomas. They are the sixth most common cancer in the United States; about 70,000 new cases are diagnosed in all age groups every year. However, NHL is not a disease, but rather a class lymphocytic malignant tumors. The incidence increases with age (median age 50 years).

Non-Hodgkin’s lymphomas (NHL) are comprise a heterogeneous group of diseases, malignant monoclonal proliferation of lymphatic cells in lymphoreticular tissues, including lymph nodes, bone marrow, spleen, liver and gastrointestinal tract. The pioneering symptoms usually include the peripheral lymphadenopathy. However, some patients present without lymphadenopathy, but with abnormal lymphocytes in the circulation. Compared to Hodgkin’s lymphoma there is a higher probability of disseminated disease at diagnosis. The diagnosis is usually made by a lymph node and / or bone marrow biopsy. The treatment includes radiation and / or chemotherapy. The stem cell transplantation is conventionally provided for the salvage treatment after incomplete remission or relapse. Non-Hodgkin’s lymphomas are more common than Hodgkin’s lymphomas. They are the sixth most common cancer in the United States; about 70,000 new cases are diagnosed in all age groups every year. However, NHL is not a disease, but rather a class lymphocytic malignant tumors. The incidence increases with age (median age 50 years). Etiology The cause of NHL is unknown, although, (z. B. exist as the leukemias, sound evidence of viral cause human T-cell leukemia-lymphoma virus, Epstein-Barr virus, hepatitis C virus, HIV). Risk factors for NHL include immunodeficiency (secondary to Posttransplantationsimmunsuppression, AIDS, primary immune disorder, dry eye syndrome, rheumatoid arthritis), Helicobacter pylori infection, and certain chemical exposures previous treatment for a Hodgkin lymphoma. NHL is the second most common cancer in HIV-infected patients (tumor diseases that are common in HIV-infected patients: non-Hodgkin’s lymphoma), and some AIDS patients present with lymphoma. C-myc gene arrangements are characteristic of some AIDS-associated lymphomas. Pathophysiology Most (80-85%) NHL arise from B cells, while the rest develop from T cells or natural killer cells. In all cases, either precursor or mature cells are involved. There is an overlap between lymphatic leukemia and NHL, as both involve the proliferation of lymphocytes and their precursor cells. A leukemia-like image with peripheral lymphocytosis and bone marrow involvement may be with some forms of NHL in up to 50% of children and 20% of adults. The differentiation can be difficult, but it is usual in patients with more extensive nodal involvement (especially mediastinal), a few circulating abnormal cells and fewer bone marrow blasts (<25%) of lymphoma from. A prominent leukemic running at an aggressive lymphoma apart from the Burkitt (s. Burkitt's lymphoma) and lymphoblastic lymphoma less common. A conditional by progressive reduction in immunoglobulin production occurs hypogammaglobulinemia in 15% of patients, especially those which show similarities to chronic lymphocytic leukemia, and can cause severe bacterial infections. Tips and Risks There is an overlap between non-Hodgkin's lymphoma and leukemia; both can have peripheral lymphocytosis and bone marrow involvement. Classification Pathological classification of NHL continues to evolve, reflecting new insights into the cellular origin and the biological basis of this heterogeneous disease. The WHO classification (s. Subsets of non-Hodgkin's lymphomas (WHO Classification)) is valuable because it includes immunophenotyping, genotype and cytogenetics; There are however still many other classification systems (eg. as the Lyon-classification). Among the most important new lymphomas that are recognized by the WHO system, mucosa-associated lymphoid tumors found (MALT, Rare gastritis syndrome: mucosal-associated lymphoid lymphoma (MALT)), mantle cell lymphoma (formerly diffused zentrozytisches lymphoma]) and anaplastic large lymphomas. The anaplastic large Lymphoma is a heterogenous disease in 75% of cases a T-cell origin, 15% have a B-cell origin and 10% are unclassified. The treatment is done in spite of the variety of entities but similar; exception of only certain T-cell lymphomas. Subsets of non-Hodgkin's lymphoma (WHO classification) cell origin tumor precursor B-cell tumor precursor B-lymphoblastic leukemia / lymphoma * Mature B-cell tumors Chronic lymphocytic B-cell leukemia / small-cell lymphocytic Lymphomr † B- prolymphocytic † lymphoplasmacytic lymphoma † splenic marginal zone lymphoma (± villous lymphocytes) † hairy cell leukemia † plasma cell myeloma / plasmacytoma † extranodal marginal zone lymphoma Nodal of MALT-type † marginal zone lymphoma (± monocytoid B cells) † Follicular lymphoma Mantle cell lymphoma ‡ Diffuse large B-cell lymphomas * (including mediastinal large B-cell lymphoma and primary Ergusslymphom) Burkitt's lymphoma precursor T-cell tumor precursor T-lymphoblastic lymphoma / leukemia * Mature T-cell tumors T- prolymphocytic † granular lymphocytic T-cell leukemia * Aggressive NK-cell leukemia * Adultes T-cell lymphoma / leukemia * (HTLV-1 positive) Extranodal NK / T-cell lymphoma, nasal type * T-cell lymphoma by enteropathy type * Hepatosplenisches ?-? T-cell lymphoma Subcutaneous panniculitis-like T *-cell lymphoma * mycosis fungoides / Sezary syndrome † anaplastic large lymphoma, T / null cell, primary cutaneous type * Anaplas large cell lymphomas diagram, T / null cell, primary systemic type * Peripheral T-cell lymphoma, not continuously classified * angioimmunoblastic T-cell lymphoma * * Aggressive. †Indolent. ‡ Indolent, but rapidly progressive. HTLV = human T cell leukemia virus, MALT = mukosaassoziiertes lymphatic tissue; NK = natural killer cells; ± = with or without. Usually, a distinction is also indolent and aggressive lymphomas. Indolent lymphomas are slowly progressive and respond to the therapy, but not curable with standard treatment. Aggressive lymphomas are rapidly progressive, but talk to therapy and are often curable. NHL in children are almost always aggressive. Follicular and other indolent lymphomas are very rare. The treatment of this aggressive lymphomas (Burkitt's, diffuse large B-cell and lymphoblastic lymphoma) poses special problems, including the involvement of the gastrointestinal tract (especially in the terminal ileum), meningeal seeding (with the need for Liquorprophylaxe or treatment) and participation other sanctuaries (z. B. testis, brain). In addition, adverse effects including risks such as late secondary malignant tumors, cardio-respiratory sequelae, preservation of fertility and developmental disabilities must be considered as well as the result of the therapy in these potentially curable lymphoma. The focus of current research is on both these areas as well as on the molecular characteristics and predictors of lymphoma in children. Symptoms and complaints, many patients present with an asymptomatic peripheral lymphadenopathy. Enlarged lymph nodes are rubbery and individually inserted and may coalesce in the course. The disease is localized in some patients, but most patients have a participation of several areas on. Mediastinal and retroperitoneal lymphadenopathy can cause to various organs compression symptoms. Extranodal manifestations may clinically dominate (eg can simulate a stomach participation gastrointestinal cancers;. Intestinal lymphoma can cause a malabsorption syndrome, HIV patients can develop NHL who make often noticeable with CNS involvement). Non-Hodgkin lymphoma (cervical lymphadenopathy) DR P. MARAZZI / SCIENCE PHOTO LIBRARY var model = {thumbnailUrl: '/ - / media / manual / professional / images / m1310141-non-hodgkin-lymphoma-science-photo-library-high_de ? lang = en & .jpg thn = 0 & mw = 350 ', imageUrl:' /-/media/manual/professional/images/m1310141-non-hodgkin-lymphoma-science-photo-library-high_de.jpg?la=de&thn=0 ' , title: 'non-Hodgkin lymphoma (cervical lymphadenopathy)' description: ' u003Ca id = "v38396020 " class = ""anchor "" u003e u003c / a u003e u003cdiv class = ""para "" u003e u003cp u003eDiese figure shows enlarged lymph nodes in the neck of a patient with non-Hodgkin's lymphoma u003c / p u003e u003c / div u003e 'credits'. DR P. MARAZZI / SCIENCE PHOTO LIBRARY'

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