Non-Hodgkin lymphoma

Clinical history depends on the type of lymphoma and stage at presentation.

Diagnosis is confirmed by tissue sampling (e.g., lymph node, bone marrow, blood, skin).

Diffuse large B-cell lymphoma is the most common type of lymphoma.

Treatment is based on the histologic subtype and severity of symptoms at presentation.

R-CHOP-21 (rituximab plus cyclophosphamide, doxorubicin, vincristine, prednisone given for 21 days) is the most commonly used chemotherapy regimen.

Non-Hodgkin lymphomas (NHL) are a heterogeneous group of malignancies of the lymphoid system.[1]Armitage JO. Treatment of non-Hodgkin's lymphoma. N Engl J Med. 1993 Apr 8;328(14):1023-30. http://www.ncbi.nlm.nih.gov/pubmed/8450856?tool=bestpractice.com This heterogeneity (>30 entities) stems from the functions of the lymphoid arm of the immune system, which employs various types of lymphocytes to defend against external (infectious) and internal (neoplastic) threats.

Malignant lymphoid cells retain many qualities of their normal counterparts (B cells to produce immunoglobulins, T cells to travel to extranodal sites such as skin and central nervous system). In some instances the boundaries between leukemias and lymphomas become blurred, such as in acute lymphocytic leukemia and acute lymphoblastic lymphoma, and chronic lymphocytic leukemia and small lymphocytic lymphoma, depending on relative presence of a solid phase (lymphoma) versus circulating phase (leukemia).