Lymphoma

A group of malignancies that develop from lymphocytes
There are over 80 types of lymphoma.
Unlike leukemia lymphoma is a solid tumor
Generally speaking (this is by no means 100% true)
lymphoma develops in the lymphatic system
Think lymph nodes and spleen
Leukemia develops in the bone marrow
The two main classifications of lymphoma are Hodgkin’s lymphoma (10%) of cases and Non-Hodgkin’s lymphoma (90% of cases).
Symptoms of lymphoma include
Enlarged generally painless lymph nodes
Drenching night sweats
Loss of appetite and unexplained weight loss
Pruritus
Exhaustion

Hodgkin Lymphoma

Reed Sternberg cells
These are the malignant B lymphocytes of Hodgkin lymphoma
They have a distinct bilobed nucleus (appear to be multinuclear)
The two nuclei give an “owl eye” appearance.
Risk factors
Infection
About half of cases will also have a history of Epstein barr
TB, HIV
Exposure to radiation or chemotherapy
Certain immunodeficiency disorders or autoimmune diseases carry an increased risk.
Most commonly diagnosed between 15 and 40 years old

A common presentation is with painless lymphadenopathy most frequently the cervical and axillary regions
Enlarged lymph nodes may ache and become painful after drinking alcohol
Drenching night sweats
Loss of appetite and unexplained weight loss
Pruritus
Exhaustion
Splenomegaly
Symptoms secondary to mass effect

Stage one
A single site
Stage two
Two or more lymph nodes on the same side of the diaphragm
Or One extralymphatic site and one lymph node on the same side of the diaphragm
Stage three
Affected lymph nodes on both sides of the diaphragm or involvement with the spleen or another extralymphatic site
Stage four
Diffuse extra lymphatic involvement

A category of blood cancers that includes does includes blood cancers that are not Hodgkin’s lymphoma
Because there are so many subtypes symptoms and course vary
Far more common than Hodgkin’s lymphoma
Most are malignant B cells
Disease is generally widespread at diagnosis
Risk factors
Infection
Epstien Barr, TB, HIV, Hep C
Exposure to radiation or chemotherapy
Certain immunodeficiency disorders or autoimmune diseases carry an increased risk.

Stage one
A single site
Stage two
Two or more lymph nodes on the same side of the diaphragm
Or One extralymphatic site and one lymph node on the same side of the diaphragm
Stage three
Affected lymph nodes on both sides of the diaphragm or involvement with the spleen or another extralymphatic site
Stage four
Diffuse extra lymphatic involvement

Cancer of the antibody creating plasma cell
(Remember Plasma cells are differentiated from B – cells)
There is a build up of plasma cells in the bone marrow interfering with production of normal blood cells.
Risk factors
Obesity
Radiation exposure
Chemical exposure
Infection
Ebsptein-Barr virus
HIV
Most commonly affects people over 40 years old.

Symptoms are secondary to poor cell production in the bone marrow and the overproduction of a nonfunctioning antibody like protein
Bone pain
Symptoms of anemia
Poor immune response and infections
Renal failure
Excessive paraproteins overwhelm the kidney
Hypercalcemia may lead to stones
Weakness
Fatigue
Confusion

Skeletal survey
Malignant plasma cells release hormones that increase osteoclast activity and suppress osteoblast activity
X-ray of the skull showing punched out lesions
Lytic lesions
MRI/CT
Bone marrow biopsy
Measure circulating IgA, IgG, IgM
Urine specimen containing monoclonal protein
Serum specimen containing monoclonal protein
Hypercalcemia due to bone resorption
Normocytic normochromic anemia

Reed Sternberg cells = Hodgkin’s lymphoma
Hodgkin’s lymphoma is more of a continuous development. Non-Hodgkin’s lymphoma is more of a disseminated progression
B symptoms more common in Hodgkin’s lymphoma
Epstein barr is more associated with Hodgkin’s lymphoma. Non-Hodgkin’s lymphoma is more associated with HIV/immunosuppression