LYMPHOMA

Muhammad Riza

Departement Of Child Health, Faculty Of Medicine,

University Of Sebelas Maret, Moewardi Hospital
Surakarta
Lymphoma  cancer that develops in the lymph system

part of the body's immune system

•Lymph
•Lymph vessels
•Lymph nodes
•Spleen
•Thymus
•Tonsils
•Bone marrow
Divided into two general types:
Lymphoma divided into two main sub-types:
•Hodgkin Lymphoma
•Non-Hodgkin Lymphoma (NHL)
Epidemiology

• Hodgkin Lymphoma:
Peaks in young adults aged 15 to 34 years, and
older adults over 55 years of age.
• Although NHL  usually diseases of middle-aged
and older people  children and young adults may
develop lymphomas
• Lymphomas that develop in children and young
adults are commonly aggressive subtypes.
 Symptoms and Signs

Hodgkin lymphoma Non-Hodgkin lymphoma

B symptoms (night sweats, fever > 38°C, B symptoms (night sweats, fever > 38°C,
10% weight loss over six months) + 10% weight loss over six months)
pruritus

Contiguous lymph node involvement Non contiguous and may involve nodal
and extranodal sites

Regional adenopathy Systemic adenopathy (painless),

hepatosplenomegaly

Symptom specific for HL is pain at nodal

disease sites after consuming alcohol
(10%)
Diagnosis and Histology

Hodgkin lymphoma Non-Hodgkin lymphoma

CT Scan, Chest X rays CT Scan, Chest X rays

Consider: bone marrow Consider: bone marrow biopsy,
Diagnosis biopsy, LP LP
Diagnosis  Biopsy Diagnosis  Biopsy

Histology Reed-Sternberg Cell Various, but NOT Reed-Sternberg

 Ann Arbor Staging System

stages I-IV can be appended by A or B designations.

A: do not have systemic symptoms
B: symptoms  unexplained loss of more than 10% of body weight in the
preceding 6 months before diagnosis, unexplained fever with temperature above
L, lung;
38°C, H, sweats
night liver; P, pleura; O, bone; M, bone marrow; D, skin; E, extranodal
lymphoid
Types

5%

Adolescents and young

adults 60%- 80%
Most often in patients with human
immunodeficiency virus (HIV)
infection
5% of cases  diagnosed
in advanced

•less than 1%
•Often expresses Epstein-Barr virus
Types

Characterized:
•Painless
•Slowly progressive
•Peripheral lymphadenopaty
•May regress spontaneously.
Advanced disease:
•Malignant transformation
• Occur to intermediate- or
high-grade lymphoma.
• Most common type of
lymphoma
• Increased incidence in HIV
positive patients
• Higher risk of CNS involvement.
 Immunocytochemistry of Small Blue-Cell Tumors
• Because of its appearance as a “small, round, blue-cell tumor,”  it may be
confused with other cancers
• Such as rhabdomyosarcoma, Ewing sarcoma, peripheral neuroepithelioma, germ
cell tumors with neural differentiation.
Treatment
Depending on tumor stage, histology (ie, whether low-,
intermediate-, or high-grade), symptoms, performance status,
patient's age, and comorbidities

Hodgkin lymphoma Non-Hodgkin lymphoma

• Radiaton for localized disease • Radiation
• Chemotherapy for advanced/ • Chemotherapy  Cyclophosphamide,
widespread  Doxorubicin, Doxorubicin, Vincristin, Prednison
Bleomycin, Vinblastin, Dacarbazine (CHOP)
(ABVD) • Rituximab
• Rituximab