Sunday, August 12, 2007

Lympoma

Lymphoma is a type of cancer that originates in lymphocytes. There are many types of lymphoma. Lymphomas are part of the broad group of diseases called hematological neoplasms.

In the 19th and 20th centuries the affliction was called Hodgkin's Disease, as it was discovered by Thomas Hodgkin in 1832. Colloquially, lymphoma is broadly categorized as Hodgkin's lymphoma and non-Hodgkin lymphoma (all other types of lymphoma). Scientific classification of the types of lymphoma is more detailed.

Although older classifications referred to histiocytic lymphomas, these are recognized in newer classifications as of B, T or NK cell lineage. Histiocytic malignancies are rare and are classified as sarcomas.

Prevalence
According to the U.S. National Institutes of Health, lymphomas account for about five percent of all cases of cancer in the United States, and Hodgkin's lymphoma in particular accounts for less than one percent of all cases of cancer in the United States.

Because the lymphatic system is part of the body's immune system, patients with weakened immune system, such as from HIV infection or from certain drugs or medication, also have a higher incidence of lymphoma.

Classification

WHO classification
The WHO Classification is the latest classification of lymphoma, published by the World Health Organization in 2001. It was based upon the "Revised European-American Lymphoma classification" (REAL).

This classification attempts to classify lymphomas by cell type, i.e. the normal cell type that most closely resembles the tumor. They are classified in three large groups: the B cell tumors, the T cell and natural killer cell tumors, Hodgkin lymphoma, and other minor groups: (ICD-O codes are provided where available)

Mature B cell neoplasms

DNA-microarray analysis of Burkitt's lymphoma and diffuse large B-cell lymphoma (DLBCL) showing differences in gene expression patterns. Colors indicate levels of expression; green indicates genes that are overexpressed in normal cells compared to lymphoma cells and red indicates genes that are overexpressed in lymphoma cells compared to normal cells.
Chronic lymphocytic leukemia/small lymphocytic lymphoma
B-cell prolymphocytic leukemia
Lymphoplasmacytic lymphoma/Waldenström macroglobulinemia
Splenic marginal zone lymphoma
Plasma cell neoplasms
Plasma cell myeloma
Plasmacytoma
Monoclonal immunoglobulin deposition diseases
Heavy chain diseases
Extranodal marginal zone B cell lymphoma (MALT lymphoma)
Nodal marginal zone B cell lymphoma
Follicular lymphoma
Mantle cell lymphoma
Diffuse large B cell lymphoma
Mediastinal (thymic) large B cell lymphoma
Intravascular large B cell lymphoma
Primary effusion lymphoma
Burkitt lymphoma/leukemia
Lymphomatoid granulomatosis

Mature T cell and natural killer (NK) cell neoplasms

T cell prolymphocytic leukemia
T cell large granular lymphocytic leukemia
Aggressive NK cell leukemia
Adult T cell leukemia/lymphoma
Extranodal NK/T cell lymphoma, nasal type
Enteropathy-type T cell lymphoma
Hepatosplenic T cell lymphoma
Blastic NK cell lymphoma
Mycosis fungoides / Sezary syndrome
Primary cutaneous CD30-positive T cell lymphoproliferative disorders
Primary cutaneous anaplastic large cell lymphoma
Lymphomatoid papulosis
Angioimmunoblastic T cell lymphoma
Peripheral T cell lymphoma, unspecified
Anaplastic large cell lymphoma

Hodgkin Lymphoma

Nodular lymphocyte-predominant Hodgkin lymphoma
Classical Hodgkin lymphoma
Nodular sclerosis
Mixed cellularity
Lymphocyte-rich
Lymphocyte depleted or not depleted

Immunodeficiency-associated lymphoproliferative disorders

Associated with a primary immune disorder
Associated with the Human Immunodeficiency Virus (HIV)
Post-transplant
Associated with Methotrexate therapy

Working formulation
The Working Formulation, published in 1982, is primarily descriptive. It is still occasionally used, but has been superseded by the WHO classification, above.

Low grade
Malignant Lymphoma, small lymphocytic (chronic lymphocytic leukemia)
Malignant Lymphoma, follicular, predominantly small cleaved cell
Malignant Lymphoma, follicular, mixed (small cleaved and large cell)

High grade
Malignant Lymphoma, large cell, immunoblastic
Malignant Lymphoma, lymphoblastic
Malignant Lymphoma, small non-cleaved cells (Burkitt's lymphoma)

Miscellaneous
Composite
Mycosis fungoides
Histiocytic
Extramedullary plasmacytoma
Unclassifiable

Other classification systems
ICD-O (codes 9590-9999, details at) (archive link, was dead)
ICD-10 (codes C81-C96, details at)

For diagnosis, etiology, staging, prognosis, and treatment
Please see separate links to Hodgkin's lymphoma and non-Hodgkin's lymphoma.

Genetics
Enteropathy associated T-cell lymphoma (EATL) is environmentally induced as a result of the consumption of Triticeae glutens. In gluten sensitive individuals with EATL 68% are homozygotes of the DQB1*02 subtype at the HLA-DQB1 locus (serotype DQ2).

Lymphoma

Lympoma

No comments: