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Non-Hodgkin lymphoma

Последний просмотренный: 18 Jun 2025
Last updated: 16 Dec 2024

Резюме

Definição

História e exame físico

Principais fatores diagnósticos

  • B symptoms (fever, night sweats, weight loss)
  • fatigue/malaise
Detalhes completos

Outros fatores diagnósticos

  • lymphadenopathy
  • splenomegaly
  • hepatomegaly
  • shortness of breath
  • cough
  • abdominal discomfort
  • headache
  • change in mental status
  • focal neurologic deficits
  • chest pain
  • bone pain, back pain
  • jaundice
  • pallor
  • purpura
  • skin lesions
  • neurologic abnormalities on exam
  • breast pain
  • swelling or mass in the breast
Detalhes completos

Fatores de risco

  • age >50 years
  • male sex
  • Epstein-Barr virus (EBV)
  • human T-lymphocytotrophic virus-1 (HTLV-1)
  • human herpesvirus-8 (Kaposi sarcoma-associated herpesvirus)
  • Helicobacter pylori
  • celiac disease
  • HIV
  • hepatitis C virus (HCV)
  • Sjogren syndrome
  • Wiskott-Aldrich syndrome
  • ataxia-telangiectasia
  • use of immunomodulatory drugs
  • organ transplant
  • Borrelia burgdorferi
  • Coxiella burnetii
  • Chlamydia psittaci
  • Campylobacter jejuni
  • rheumatoid arthritis
  • systemic lupus erythematosus (SLE)
  • common variable immunodeficiency
  • Chediak-Higashi syndrome
  • Klinefelter syndrome
  • pesticides
  • phenoxyherbicides
  • breast implants
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • CBC with differential
  • peripheral blood smear
  • comprehensive metabolic panel (including liver function tests [LFTs])
  • serum lactate dehydrogenase (LDH)
  • uric acid
  • lymph node biopsy
  • biopsy (extranodal sites e.g., brain, skin)
  • bone marrow biopsy and aspirate
  • immunohistochemistry
  • flow cytometry
  • fluorodeoxyglucose (FDG)-PET/CT scan
Detalhes completos

Investigações a serem consideradas

  • core needle biopsy
  • fine-needle aspiration (FNA) biopsy
  • genetic testing
  • hepatitis B and C serology
  • HIV testing
  • Epstein-Barr virus (EBV) testing
  • human T-cell lymphotropic virus (HTLV) testing
  • MRI (brain, spine)
  • ultrasound (breast, axilla)
  • lumbar puncture
  • endoscopy and colonoscopy
  • serum protein electrophoresis with immunofixation
  • quantitative immunoglobulins
  • serum beta-2 microglobulin
  • Helicobacter pylori testing
  • multigated acquisition (MUGA) scan
  • echocardiography
Detalhes completos

Algoritmo de tratamento

CONTÍNUA

aggressive B-cell lymphomas

aggressive T-cell lymphomas

indolent B-cell lymphomas

indolent T-cell lymphomas

Colaboradores

Autores

Julie E. Chang, MD

Associate Professor

Department of Medicine, Section of Hematology & Oncology

University of Wisconsin School of Medicine and Public Health

Madison

WI

Declarações

JEC has been paid for time served on advisory boards for MorphoSys, BeiGene, and Genentech. JEC has research funding from Genentech and Celgene.

Agradecimentos

Dr Julie Chang would like to gratefully acknowledge Dr Esther Chan, Dr Chin Hin Ng, Dr Melissa Ooi, Dr Michelle Poon, Dr Boris Kobrinsky, and Dr Kenneth B. Hymes, previous contributors to this topic.

Declarações

EC, CHN, MO, BK, and KBH declare that they have no competing interests. MP has received sponsorship from Sanofi and Janssen to attend conferences.

Revisores

Leonidas G. Koniaris, MD

Associate Professor Surgery

Department of Cell Biology and Anatomy

University of Miami School of Medicine

Coral Gables

FL

Declarações

LGK declares that he has no competing interests.

Shankaranarayana Paneesha, MD, MRCP, FRCPath

Consultant Haematologist

Department of Haematology and Stem Cell Transplantation

Heartlands Hospital

Birmingham

UK

Declarações

SP declares that he has no competing interests.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: B-cell lymphomas [internet publication].Texto completo

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: T-cell lymphomas [internet publication].Texto completo

Tilly H, Gomes da Silva M, Vitolo U, et al. Diffuse large B-cell lymphoma (DLBCL): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015 Sep;26(suppl 5):v116-25.Texto completo  Resumo

Vitolo U, Seymour JF, Martelli M, et al. Extranodal diffuse large B-cell lymphoma (DLBCL) and primary mediastinal B-cell lymphoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016 Sep;27(suppl 5):v91-102.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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