Nine in ten lymphomas are non-Hodgkin; Reed–Sternberg marks Hodgkin
Lymphomas are cancers of lymphocytes. Non-Hodgkin lymphomas make up about ninety percent of cases; Hodgkin lymphoma about ten percent, marked by Reed–Sternberg cells. Worldwide in 2012 they arose in 566,000 people and caused 305,000 deaths—roughly three to four percent of cancers, seventh most common, and third in children.
Typical signs include painless enlarged nodes, fever, night sweats, unintended weight loss, itching, and fatigue—the so-called B symptoms of fever, sweats, and weight loss that track more advanced disease. Extranodal spread is common in non-Hodgkin disease (about forty percent of patients); the gut is the top extranodal site (thirty to forty percent of those cases) yet rare in Hodgkin lymphoma (under one percent). Marrow involvement can bring anemia and low platelets, especially in follicular, mantle cell, and small B-cell subtypes (forty to ninety percent depending on type).
Diagnosis rests on lymph-node or extranodal biopsy under the microscope, often backed by blood work, marrow tests, CT for enlargement, and FDG-PET for metabolic activity. Staging uses the Lugano system, a revision of 1971 Ann Arbor stages I–IV; a B/A suffix for B symptoms applies to Hodgkin disease. WHO classifications (2001 onward, updated through 2022) group neoplasms by the lymphocyte population of origin, building on REAL. Risk factors differ: Epstein–Barr virus and family history for Hodgkin; autoimmune disease, HIV/AIDS, HTLV, immunosuppressants, some pesticides, and possibly heavy red meat and smoking for common non-Hodgkin types.
Treatment may combine chemotherapy, radiation, proton therapy, targeted drugs, or surgery; some non-Hodgkin cases need plasmapheresis when excess protein thickens blood, and watchful waiting suits certain indolent forms. U.S. five-year survival is about eighty-nine percent for Hodgkin subtypes and seventy-four percent for non-Hodgkin lymphomas. Aggressive diseases such as Burkitt’s can kill quickly yet often respond; indolent small lymphocytic lymphoma may allow long life even untreated. Correct pathologist classification—usually by a hematopathologist—decides which future a patient faces. Imaging choices follow avidity: FDG-PET/CT stages fluorodeoxyglucose-avid diseases such as Hodgkin lymphoma, while CT suits some non-avid non-Hodgkin subtypes, and PET/CT can replace marrow biopsy in selected cases.
Source: Lymphoma
