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Lymphoma

David Lee MD, FRCPC

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Overview

Concepts, classification, biology

pidemiology

Clinical presentation

Diagnosis

!taging "hree important types of lymphoma

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Concept#ali$ing lymphoma

neoplasms of lymphoid origin, typically

ca#sing lymphadenopathy

le#%emia vs lymphoma

lymphomas as clonal e&pansions of

cells at certain developmental stages

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'LL'LL MMMMCLLCLL LymphomasLymphomas

(ematopoietic

stem cell)e#trophils

osinophils

*asophils

Monocytes

Platelets

Red cells

Myeloid

progenitor

Myeloproliferative disordersMyeloproliferative disorders'ML'ML

Lymphoid

progenitor "+lymphocytes

Plasma

cells

*+lymphocytes

nanaveve

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*+cell development

stem

cell

lymphoid

progenitor

progenitor+*

pre+*

immat#re

*+cell

memory*+cell

plasma cellplasma cell

DLBCL,FL, HL

ALL

CLL

MM

germinalgerminal

centercenter

*+cell*+cell

mat#re

naive

*+cell

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Clinically useful

classification

Diseases that have distinctclinical feat#resnat#ral historyprognosistreatment

Biologically rational

classification

Diseases that have distinctmorphologyimm#nophenotypegenetic feat#resclinical feat#res

Classification

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Lymphoma classification

-../ 0(O1 *+cell neoplasms

2 prec#rsor

2 mat#re

"+cell 3 )4+cell neoplasms

2 prec#rsor

2 mat#re

(odg%in lymphoma

)on+(odg%in

Lymphomas

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' practical way to thin% of lymphoma

Category Survival of

untreatedpatients

Curability To treat or

not to treat

)on+

(odg%in

lymphoma

5ndolent 6ears 7enerally

not c#rable

Generally

defer Rx if

asymptomatic'ggressive Months C#rable in

some

"reat

8ery

aggressive

0ee%s C#rable in

some

"reat

(odg%in

lymphoma

'll types 8ariable 2

months to

years

C#rable in

most

"reat

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Mechanisms of

lymphomagenesis 7enetic alterations

5nfection

'ntigen stim#lation

5mm#nos#ppression

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5ncidence of lymphomas in comparison

with other cancers in Canada

6ear

/

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'ge distrib#tion of new )(L cases in

Canada

'ge ,years1

.+//+A9+