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Linfoma não Hodgkin

Last reviewed: 17 Aug 2025
Last updated: 16 Dec 2024

Summary

Definition

History and exam

Key diagnostic factors

  • Sintomas B (febre, sudorese noturna, perda de peso)
  • fadiga/mal-estar
Full details

Other diagnostic factors

  • linfadenopatia
  • esplenomegalia
  • hepatomegalia
  • dispneia
  • tosse
  • desconforto abdominal
  • cefaleia
  • alteração do estado mental
  • deficits neurológicos focais
  • dor torácica
  • dor óssea, dorsalgia
  • icterícia
  • palidez
  • púrpura
  • lesões cutâneas
  • anormalidades neurológicas no exame
  • mastalgia
  • edema ou massa na mama
Full details

Risk factors

  • idade >50 anos
  • sexo masculino
  • Vírus Epstein-Barr (EBV)
  • vírus linfotrópico de células T humanas tipo 1 (HTLV-1)
  • herpes-vírus humano tipo 8 (herpes-vírus associado ao sarcoma de Kaposi)
  • Helicobacter pylori
  • doença celíaca
  • vírus da imunodeficiência humana (HIV)
  • vírus da hepatite C (HCV)
  • Síndrome de Sjögren
  • Síndrome de Wiskott-Aldrich
  • ataxia-telangiectasia
  • uso de medicamentos imunomoduladores
  • transplante de órgãos
  • Borrelia burgdorferi
  • Coxiella burnetii
  • Chlamydia psittaci
  • Campylobacter jejuni
  • artrite reumatoide
  • lúpus eritematoso sistêmico (LES)
  • imunodeficiência comum variável
  • Síndrome de Chediak-Higashi
  • Síndrome de Klinefelter
  • pesticidas
  • herbicidas à base de fenóxidos
  • implantes mamários
Full details

Diagnostic investigations

1st investigations to order

  • Hemograma completo com diferencial
  • esfregaço de sangue periférico
  • perfil metabólico completo (incluindo testes da função hepática [TFHs])
  • lactato desidrogenase (LDH) sérica
  • ácido úrico
  • biópsia de linfonodos
  • biópsia (sítios extranodais, por exemplo, cérebro, pele)
  • biópsia ou aspirado da medula óssea
  • imuno-histoquímica
  • citometria de fluxo
  • PET com fluordesoxiglucose (FDG)-CT
Full details

Исследования, проведение которых нужно рассмотреть

  • biópsia percutânea com agulha grossa
  • biópsia por aspiração com agulha fina (AAF)
  • teste genético
  • sorologia para hepatite B e C
  • teste de vírus da imunodeficiência humana (HIV)
  • Exame para vírus Epstein-Barr (EBV)
  • teste para vírus linfotrópico de células T humanas (HTLV)
  • RNM (cérebro, coluna)
  • ultrassonografia (mama, axila)
  • punção lombar
  • endoscopia e colonoscopia
  • eletroforese de proteínas séricas com imunofixação
  • imunoglobulinas quantitativas
  • microglobulina beta-2 sérica
  • Teste para Helicobacter pylori
  • angiografia sincronizada multinuclear (MUGA)
  • ecocardiografia
Полная информация

Алгоритм лечения

ПРОДОЛЖЕНИЕ

linfomas agressivos de células B

linfomas de células T agressivos

linfomas de células B indolentes

linfomas de células T indolentes

Составители

Авторы

Julie E. Chang, MD

Associate Professor

Department of Medicine, Section of Hematology & Oncology

University of Wisconsin School of Medicine and Public Health

Madison

WI

Раскрытие информации

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

Выражение благодарностей

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.

Раскрытие информации

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

Рецензенты

Leonidas G. Koniaris, MD

Associate Professor Surgery

Department of Cell Biology and Anatomy

University of Miami School of Medicine

Coral Gables

FL

Раскрытие информации

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

Раскрытие информации

SP declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

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Основные статьи

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

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

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.Полный текст  Аннотация

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.Полный текст  Аннотация

Статьи, указанные как источники

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