NON-HODGKINS LYMPHOMAS

NON-HODGKINS LYMPHOMAS


These are a large group of lymphoid tumors ,most commonly of B-cell origin ,whose clinical presentation and natural history are more variable than in Hodgkins lymphoma.
• They are characterized by an irregular pattern of spread and a significant roportion of patients develops extra nodal disease .
• Classification
• A number of classifications have been used over the years and the more recent one is WHO ( world health organization) classification which includes all lymphoid malignancy as well as lymphomas.
• This classification considers the:
• Morphology.
• Cell of origin (determined in practice by immunophenotype as B,T,NK cells ).
• Clinical features and genotype( karyotype and presence of viral genome).
• WHO classification is divided into:
• 1- B-cell disorders which are comprise 85 % of cases and include( the most common types):
• Precursor B-cell neoplasm: B-cell lymphoblastic leukaemia/lymphoma
• Mature B-cell neoplasm:
B-cell small lymphocytic lymphoma
• B-cell prolymphocytic leukaemia
• Hairy cell leukaemia
• Follicular lymphoma
• Mantle cell lymphoma
• Marginal zone lymphoma
• Burkett s lymphoma
• Diffuse large B-cell lymphoma
• 2- T-cell and NK cells which are comprise 15 % of cases and include( the most common types):
• Precursor T-cell neoplasm: T-cell lymphoblastic leukemia/lymphoma.
• Mature T-cell neoplasm:T-cell prolymphocytic leukaemia
• Aggressive NK-cell leukaemia
• Mycosis fungoides/ sezary syndrome
• Adult T-cell lymphoma/leukaemia
• Low-grade and high grade non-Hodgkins lymphoma:
• The non- Hodgkins lymphoma are diverse group of disease and vary from highly proliferative and rapidly fatal diseases to some of the most indolent and well-tolerated malignancies, so it divided into high grade and low grade disease.
•
• The low grade lymphoma are relatively indolent ,respond well to chemotherapy but are very difficult to cure .
• High-grade lymphoma are aggressive and need urgent treatment but are often curable.