LYMPHOMA By: Alexander Pilzer, Blakelee Ross, and Joshua Epley

DISCOVERY Thomas Hodgkin published the first description of

lymphoma, in 1832.

This disease affects the white blood cells and circulates through the spleen, bone marrow, thymus, and lymph nodes.

The lymphoma he discovered was named Hodgkin’s lymphoma after all the work he did on it.

In 1982, the Working formulation became very popular because it introduced “Non-Hodgkin lymphoma” which divided into sixteen diseases.

The latest classification has been made by the World Health Organization (WHO) which listed lymphoma’s seventy forms into four categories.

THE FOUR GROUPS OF LYMPHOMA The groups of Lymphoma are: Diffuse Large B-Cell LymphomaMature T cell and natural killer (NK) cell neoplasms Classical Hodgkin’s LymphomaImmunodeficiency-associated lymph proliferative disorders

The WHO system groups lymphomas based on:

How they look under a microscope. The chromosome features of the lymphoma cells The presence of certain proteins on the surface of the cells. 

DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL)

o This is the most common type of non-Hodgkin lymphoma in the United states, accounting for one out of three cases.

o When seen under a microscope, these cells are fairly large this lymphoma can arise in many different places in the body rather than just the lymph nodes. (skin, breasts, bone, brain, etc.)

o This lymphoma has sub-types that can affect how well the patients will do with standard treatment of the lymphoma.

o For example, a DLBCL that only affects the brain is treated different from a DLBCL that affects areas outside of it.

DLBCL LYMPHOMA

SIGNS OF DLBCL Often the first signs of DLBCL can be rapid, painful

swelling in the neck, armpit, or groin.

This is caused by enlarged lymph nodes. For Some patients they don’t feel the pain and this could be a bad thing when it comes to recognizing it or not.

Other symptoms include night sweats, unexplainable fevers, and drastic weight loss.

Most of the time, this lymphoma is seen in adults but can still be seen in children, just it’s less common.

MATURE T-CELL AND NATURAL KILLER (NK) CELL NEOPLASMS Includes extra nodal NK/T-cell lymphoma and

aggressive NK cell leukemia, are generally rare, more commonly in people of Oriental, Mexican, and South American descent.

These neo-plasms are highly aggressive, and show a strong association with Epstein-Barr virus.

NK/T-cell lymphoma most commonly affects the nasal cavity and other mucosal sites of the upper aero-digestive tract.

There is no found treatment yet. Even the stage it is in doesn’t matter because overall survival is poor.

Mature T-Cell and Natural Killer (NK) Cell Neoplasms

Mature T Cell

Natural Killer

SIGNS OF MATURE T-CELL AND NATURAL KILLER (NK) CELL NEOPLASMS Aggressive NK cell leukemia affects younger patients,

with poor general condition, fever, and disseminated disease.

They often die within a short time from systemic disease or complications such as multi-organ failure.

The peripheral blood and bone marrow show atypical large granular lymphocytes, which exhibit an immunophenotype similar to that of extra nodal NK/T-cell lymphoma.

CLASSICAL HODGKIN’S LYMPHOMA Classical Hodgkin’s Lymphoma (HL) is not as common as

any of the Non-Hodgkin’s lymphomas. This lymphoma is characterized by the presence of very large cells known as Reed-Sternberg (R-S).

This lymphoma also has many sub-types which can be a problem when treating it.

HL usually starts in the lymph nodes and often spreads from one lymph node to another, to another, and to another until it starts to infect your organs.

This lymphoma can be found in adults and children, but is most commonly found in young adults in between the ages of fifteen and thirty five.

Classical Hodgkin’s Lymphoma

SIGNS OF CLASSIC HODGKIN LYMPHOMA A cancer of the immune system that is marked by the

presence of a type of cell called the Reed-Sternberg cell.

Symptoms include the painless enlargement of lymph nodes, spleen, or other immune, tissues, constant fevers, night sweats, unexplained weight loss, and lack of energy.

Classic Hodgkin's lymphoma may be treated with radiation therapy, chemotherapy, or hematopoietic stem cell transplantation.

There are a couple of factors that come in to play when treating HL like age, the kind of HL you have, etc. and the only way to treat it is through chemotherapy and/or radiotherapy.

IMMUNODEFICIENCY-ASSOCIATED LYMPH PROLIFERATIVE DISORDERS Associated with the Human

Immunodeficiency Virus (HIV)

Associated with methotrexate therapy

Associated with a primary immune disorder

Primary central nervous system lymphoma occurs most often in immuno-compromised patients, in particular those with AIDS, but it can occur in the immunocompetent as well.

Immunodeficiency-associated lymphoproliferative disorders

SIGNS OF IMMUNODEFICIENCY-ASSOCIATED LYMPH PROLIFERATIVE DISORDERS

Large tumors growing inside the mouth or on other sensitive areas of the body.

A large drop in White blood cells due to HIV related symptoms.

Smaller tumors growing almost anywhere on the body.

A Picture of a young boy who has a form of Immunodeficiency-associated lymph proliferative disorders

WORKING FORMULATION The 1996 Working Formulation was a

classification of non-Hodgkin lymphoma.

It excluded the Hodgkin lymphomas and divided the remaining lymphomas into four grades (Low, Intermediate, High, and Miscellaneous) related to prognosis, with some further subdivisions based on the size and shape of affected cells.

it was widely accepted at the time of its publication but is now obsolete.

SUBTYPES OF LYMPHOMA Precursor T-cell leukemia/lymphoma Follicular lymphoma Mantle cell lymphoma B-cell chronic lymphocytic

leukemia/lymphoma MALT lymphoma Burkitt's lymphoma Mycosis fungoides Peripheral T-cell lymphoma-Not-Otherwise-

Specified

EPIDEMIOLOGY OF LYMPHOMA Lymphoma is the most common form of

hematological malignancy, or "blood cancer", in the developed world.

lymphomas represent 5.3% of all cancers (excluding simple basal cell and squamous cell skin cancers) in the United States and 55.6% of all blood cancers.

lymphomas account for about five percent of all cases of cancer in the United States.

WORLD WIDE The most amount of deaths a day from lymphoma

occur in central Africa with more than 20 deaths a day.

The places where deaths are limited to less than two deaths a day are, Russia, Asia, Several parts of Europe, and Australia.

World wide in the year of 2012 about 12.8 million people died of one of the four main types of lymphoma, with a couple hundred thousand more being recorded for the sub-types.

WORK CITED http://www.cancerresearchuk.org/cancer-info/

cancerstats/keyfacts/hodgkin-lymphoma/

http://www.cancer.org/cancer/hodgkindisease/overviewguide/hodgkin-disease-overview-key-statistics

http://theoncologist.alphamedpress.org/content/13/5/577.full