Резюме
Definição
História e exame físico
Principais fatores diagnósticos
- B symptoms (fever, night sweats, weight loss)
- fatigue/malaise
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
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
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
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
Algoritmo de tratamento
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
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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