Non-Hodgkin lymphomas (NHLs) are a group of cancers that originate in the lymphatic system. They are characterized by the uncontrolled growth and multiplication of abnormal lymphocytes, which are a type of white blood cell.
Unlike Hodgkin lymphoma, NHLs do not contain the Reed-Sternberg cells. NHLs are further classified into different subtypes, each with its unique characteristics and treatment options.
Diagnosis of Non-Hodgkin Lymphomas
Diagnosing NHLs involves a series of tests and procedures to determine the subtype, extent, and stage of the cancer. The diagnostic process typically begins with a comprehensive medical history and physical examination.
The doctor may inquire about symptoms, risk factors, and perform a thorough examination of the lymph nodes, spleen, liver, and other organs.
If lymphoma is suspected, the following diagnostic tests may be conducted:.
1. Biopsy
A biopsy is a procedure in which a small sample of tissue is removed and examined under a microscope. It is the gold standard for lymphoma diagnosis.
The most common type of biopsy performed for NHLs is an excisional or incisional biopsy, where either a whole lymph node or a portion of it is taken.
2. Imaging tests
Imaging tests such as X-rays, CT scans, PET scans, and MRI scans may be used to visualize the lymph nodes, organs, and tissues in the body. These tests help determine the extent of the disease and identify any areas of tumor involvement.
3. Blood tests
Various blood tests are conducted to evaluate the overall health of the patient and to identify specific markers that may indicate the presence of lymphoma.
These tests include a complete blood count (CBC), blood chemistry tests, and tests for specific lymphoma-associated markers or genetic abnormalities.
4. Bone marrow biopsy
A bone marrow biopsy is performed to assess the involvement of lymphoma in the bone marrow. A small sample of bone marrow is extracted from the hipbone or sternum and evaluated under a microscope.
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5. Lumbar puncture
In some cases, a lumbar puncture, also known as a spinal tap, may be performed to examine the cerebrospinal fluid for the presence of lymphoma cells.
This test is primarily done if there is suspicion of lymphoma involvement in the central nervous system.
Treatment of Non-Hodgkin Lymphomas
The treatment for NHLs depends on the subtype, stage of the disease, and the patient’s overall health. The main treatment modalities for NHLs include:.
1. Chemotherapy
Chemotherapy involves the use of drugs to kill cancer cells. It is the most common treatment for NHLs and may be administered orally, intravenously, or directly into a specific site in the body.
The choice of chemotherapy drugs and the duration of treatment depend on the subtype and stage of the lymphoma.
2. Radiation therapy
Radiation therapy uses high-energy X-rays or other forms of radiation to destroy cancer cells. It is often used in combination with chemotherapy or as a standalone treatment for localized NHLs.
3. Immunotherapy
Immunotherapy stimulates the immune system to recognize and attack cancer cells. Monoclonal antibodies, checkpoint inhibitors, and CAR-T cell therapy are some of the immunotherapy approaches used in the treatment of NHLs.
4. Targeted therapy
Targeted therapy drugs specifically target cancer cells, blocking their growth and spread. They are designed to interfere with the biological processes that are essential for cancer cell survival.
5. Stem cell transplantation
In certain cases, stem cell transplantation may be recommended for NHLs. It involves replacing diseased bone marrow with healthy stem cells, either from the patient themselves (autologous transplant) or from a donor (allogeneic transplant).
The choice of treatment depends on several factors, including the type and stage of lymphoma, the patient’s age, overall health, and personal preferences.
The treatment plan is often developed and customized by a multidisciplinary team of medical professionals, including hematologists, oncologists, radiation oncologists, and pathologists.
