Hodgkin’s

Lymphoma is the malignant proliferation of lymphocytes which accumulate in lymph nodes or other organs. Lymphoma may be classified as either Hodgkin's lymphoma (a specific type of lymphoma characterized by the presence of Reed-Sternberg cells) or non-Hodgkin's lymphoma (every other type of lymphoma that is not Hodgkin's lymphoma). Non-Hodgkin's lymphoma is the 6th most common cause of cancer in the UK. Non-Hodgkin's lymphoma may affect either B or T-cells and can be further classified as high grade or low grade.

Epidemiology

• Non-Hodgkin's lymphoma is much more common than Hodgkin's lymphoma
• While different subtypes can affect different ages, it typically affects the elderly with one-third of cases occurring in those over 75 years of age
• The incidence rate is 28 for men and 20 for females per 100,000 of the population

Risk factors

• Elderly
• Caucasians
• History of viral infection (specifically Epstein-Barr virus)
• Family history
• Certain chemical agents (pesticides, solvents)
• History of chemotherapy or radiotherapy
• Immunodeficiency (transplant, HIV, diabetes mellitus)
• Autoimmune disease (SLE, Sjogren's, coeliac disease)

Clinical presentation

Symptoms

• Painless lymphadenopathy (non-tender, rubbery, asymmetrical)
• Constitutional/B symptoms (fever, weight loss, night sweats, lethargy)
• Extranodal Disease - gastric (dyspepsia, dysphagia, weight loss, abdominal pain), bone marrow (pancytopenia, bone pain), lungs, skin, central nervous system (nerve palsies)