Summary
Definition
History and exam
Other diagnostic factors
- lymphadenopathy
- massive splenomegaly in marginal zone lymphoma
- hepatomegaly
- shortness of breath
- cough
- abdominal discomfort
- headache
- change in mental status
- dizziness, ataxia
- chest pain
- bone pain, back pain (bone involvement)
- jaundice
- pallor
- purpura
- skin lesions
- neurologic abnormalities on exam
Risk factors
- age >50 years
- male sex
- immunocompromised host
- Epstein-Barr virus (EBV)
- human T-lymphocytotrophic virus-1 (HTLV-1)
- human herpesvirus-8
- Helicobacter pylori
- celiac disease
- HIV
- organ transplant
- hepatitis C virus (HCV)
- Borrelia burgdorferi
- Sjogren syndrome
- rheumatoid arthritis
- systemic lupus erythematosus (SLE)
- common variable immunodeficiency
- Wiskott-Aldrich syndrome
- ataxia-telangiectasia
- Chediak-Higashi syndrome
- Klinefelter syndrome
- pesticides
- phenoxyherbicides
- breast implants
Diagnostic investigations
1st investigations to order
- CBC with differential
- blood smear
- lymph node biopsy
- skin biopsy
- bone marrow biopsy
- basic metabolic panel
- liver function tests
- LDH
Investigations to consider
- flow cytometry
- immunohistochemistry
- polymerase chain reaction for tumor markers
- immunoglobulin gene rearrangement studies
- cytogenetics studies with or without fluorescence in situ hybridization (FISH)
- hepatitis B and C serology
- HIV antibody
- lumbar puncture
- colonoscopy
- CT scan
- multiple-gated acquisition scan
- echocardiography
- PET scan
Treatment algorithm
Contributors
Authors
Consultant
Department of Haematology-Oncology
National University Cancer Institute
Singapore
Disclosures
EC declares that she has no competing interests.
Consultant
Department of Haematology-Oncology
National University Cancer Institute
Singapore
Disclosures
CHN declares that he has no competing interests.
Consultant
Department of Haematology-Oncology
National University Cancer Institute
Singapore
Disclosures
MO declares that she has no competing interests.
Senior Consultant
Department of Haematology-Oncology
National University Cancer Institute
Singapore
Disclosures
MP has received sponsorship from Sanofi and Janssen to attend conferences.
Dr Esther Chan, Dr Chin Hin Ng, Dr Melissa Ooi, and Dr Michelle Poon would like to gratefully acknowledge Dr Boris Kobrinsky and Dr Kenneth B. Hymes, previous contributors to this topic.
Disclosures
BK and KBH declare that they have no competing interests.
Peer reviewers
Associate Professor Surgery
Department of Cell Biology and Anatomy
University of Miami School of Medicine
Coral Gables
FL
Disclosures
LGK declares that he has no competing interests.
Consultant Haematologist
Department of Haematology and Stem Cell Transplantation
Heartlands Hospital
Birmingham
UK
Disclosures
SP declares that he has no competing interests.
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