Non-Hodgkin’s Lymphoma (NHL)
Non-Hodgkin’s Lymphoma (NHL) is a classification of neoplastic diseases that include the fifth and sixth most common malignancies in men and women. NHLs include multiple neoplastic disorders of the lymphoid system with overlapping features and are among the most rapidly increasing malignancies. Clinically, immune suppression and stimulation are important cofactors for the development of NHL as their origins are found in the roots of the immune system, the white blood cells. Their course of presentation varies from indolent to aggressive and from curable to incurable.
The most common forms of NHLs are B-cell lymphomas which begin in the antibody-producing form of white blood cells, the B-lymphocytes. T-cell lymphomas begin in the T-lymphocytes which attack bacteria and viruses. The natural killer or NK lymphocytes attack substances they consider foreign to the body and are the origin of NK-cell lymphomas, the least common forms of NHLs.
Classification of NHLs currently organizes them into groups with shared pathogenesis and clinical behavior to assist in guiding course of treatment. This classification incorporates findings from the Revised European-American Classification of Lymphoid Neoplasms (REAL) and earlier World Health Organization (WHO) classifications and is published as the World Health Organization Classification of Neoplastic Diseases of Hematopoietic and Lymphoid Tissues. The WHO classification is summarized in the following table.
World Health Organization Classification of Lymphomas
Precursor B lymphoblastic leukemia/lymphoma
Chronic lymphocytic leukemia/small lymphocytic lymphoma
Splenic marginal zone lymphoma
Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)
Nodal marginal zone B-cell lymphoma
Mantle cell lymphoma
Diffuse large B-cell lymphoma
Mediastinal (thymic) large B-cell lymphoma
Intravascular large B-cell lymphoma
Primary effusion lymphoma
B-cell proliferations of uncertain malignant potential
Post-transplant lymphoproliferative disorder, polymorphic
T-CELL AND NK-CELL NEOPLASMS
Precursor T lymphoblastic leukemia/lymphoma
Blastic NK cell lymphoma
Mature T-cell and NK-cell
Adult T-cell leukemia/lymphoma
Extranodal NK/T cell lymphoma, nasal type
Enteropathy-type T-cell lymphoma
Hepatosplenic T-cell lymphoma
Subcutaneous panniculitis-like T-cell lymphoma
Primary cutaneous anaplastic large cell lymphoma
Peripheral T-cell lymphoma, unspecified
Angioimmunoblastic T-cell lymphoma
Anaplastic large cell lymphoma
Wilson, W. H., & Armitage, J. O. (2008). Non-Hodgkin’s lymphoma. In M. D. Abeloff, J. O. Armitage, J. E. Niederhuber. M. B. Kastan & W. G. McKenna (Eds.), Abeloff’s clinical oncology (ch.112). Philadelphia: Churchill Livingstone Elsevier.
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