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The management of lymphoma has developed into
a specialized area of clinical practice.
It is essential that the oncologist, surgeon,radiologist and pathologist discuss
at all stages in the diagnostic process.
Histological evaluation of biopsy tissue is central to diagnosis and subsequent
It is greatly helped by immunohistochemical detection of markers for B-cells and
In some circumstances, establishing that a lesion is malignant depends
on showing that a cell proliferation is monoclonal by demonstrating clonal
gene re-arrangement (B-lymphocytes) and clonal T-cell receptor gene
Cytogenetic investigation may demonstrate the
of a specific chromosomal marker, e.g. the translocations seen in follicular
lymphomas and Burkitt's lymphomas.
In cases of suspected lymphoma, tissue removed for biopsy is now received fresh
laboratory and carefully divided to allow a detailed morphological and molecular
Staining of lymphomas with markers of T-cells or B-cells is routine practice in
of these tumours. Here, a lymphoma presenting as lumps in the skin shows
a B-cell marker (brown reaction) indicating a B-cell lymphoma.
SURVIVAL AND PROGNOSIS IN LYMPHOMA
Survival for all types of treated non-Hodgkin's lymphoma evens out after
ten years because low-grade disease is hard to cure
The survival for patients with non-Hodgkin's lymphoma varies according to the
disease and its extent. Paradoxically, patients with high-grade disease may be
whereas many patients with low-grade disease suffer late relapses.
high-grade disease are often encountered at an early stage and may be cured by
Patients with low-grade disease often have extensive dissemination
and, although disease may be controlled by therapy, cure is seldom achieved.
Although there is a 70% five-year survival for low-grade non-Hodgkin's lymphoma,
with a 40%
five-year survival for high-grade disease, survival at ten years is still about
both types, reflecting continued deaths in patients with low-grade disease.
Patients who tend to die early with non-Hodgkin's lymphoma include the elderly,
those who have
extensive dissemination with haematological abnormalities, and those with
symptoms or weight loss and fever.
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We give here simplified and accurate information about the disease
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