II. Epidemiology

  1. Most common of solid hematologic malignancies
  2. Incidence: 40,000 new cases/year in United States (19.7 per 100,000 persons)
  3. Prevalence: 509,065 in United States (2013)

III. Symptoms and Signs (differentiate from Hodgkin's)

  1. Presence of Lymphadenopathy draining Waldeyer's ring
    1. Hodgkin's Lymphoma involves Supraclavicular nodes
  2. Epitrochlear lymph nodes
  3. Mediastinal, abdominal and extranodal involvement
    1. Common at presentation
  4. Chest Pain (suggests lung involvement)
  5. Systemic symptoms more common in Hodgkin's

IV. Pathology (Lymph node histology)

  1. Diffuse small cleaved cell
  2. Poorly differentiated Lymphocytes

V. Staging

  1. Similar, but not identical to Hodgkin's Lymphoma

VI. Management

  1. Combination Chemotherapy and Radiation Therapy
  2. Monoclonal Antibody in certain cases
    1. Rituxan binds antigen on mature B Cells

VII. Complications

  1. See Cancer Survivor Care
  2. Other cancers (related to primary cancer or its treatment)
    1. Myelodysplasia
    2. Acute Leukemia
    3. Thyroid Cancer
    4. Head and neck cancer
    5. Breast Cancer
    6. Bladder Cancer
    7. Lung Cancer
    8. Skin cancer
  3. Treatment related adverse effects
    1. Cardiomyopathy
    2. Thyroid disorders
    3. Sexual Dysfunction

VIII. Prognosis

  1. Varies by staging
  2. Overall five year survival: 69%

IX. References

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