Introduction[edit | edit source] Show
Non-Hodgkin lymphoma (NHL) is a neoplasm of the lymphoid tissues, which originates from B cell precursors, mature B cells, T cell precursors, and mature T cells. Non-Hodgkin lymphoma accounts for about 90% of all lymphomas, and the remaining 10% are referred to as Hodgkin lymphoma.
The 12 minute video below gives a summary of the condition. Etiology[edit | edit source]Non-Hodgkin lymphomas (NHL) may be associated with various factors, including infections, environmental factors, immunodeficiency states, and chronic inflammation.
Epidemiolgy[edit | edit source]
There are geographical variations in the incidence of individual subtypes:
Epstein-Barr
Mantle Cell Lymphoma consists of about 7 percent of adult non-Hodgkin lymphomas in the United States and Europe with an incidence of approximately 4 to 8 cases per million persons per year. Incidence increases with age and appears to be increasing overall in the United States. The median age at diagnosis is 68 years.
Characteristics/Clinical Presentation[edit | edit source]
Patients have different presentations and vary according to the site involved.
Evaluation[edit | edit source]Workup in Non-Hodgkin Lymphoma should include the following:
Medications/Treatment[edit | edit source]Treatment of Non-Hodgkin lymphoma is based on the type, stage, histopathological features, and symptoms.
Radiation therapy uses high energy rays to carefully and safely kill cancer cells while attempting to avoid the destruction of healthy cells. 'Radiation therapy is used to try and cure cancer, control the growth and spread of
cancer and relieve symptoms, such as pain. The most common type is external beam radiation therapy, which is a series of daily outpatient treatments to accurately deliver radiation to the cancer cells. Treatment sessions usually last less than 30 minutes. Total nodal irradiation is radiation delivered to all lymph nodes in the body. Total body irradiation is radiation delivered to the entire body, usually prior to any transplants to kill all remaining cancer
cells.'[8] "Chemotherapy[9] is the use of drugs to kill cancer cells and shrink tumors. Chemotherapy drugs are designed to attack rapidly dividing cells. Therefore, the drugs are not specific to cancer cells and will also be cytotoxic to normal, noncancerous cells. Patient's experience serious side effect, often secondary to the destruction of healthy, normal, noncancerous cells. Common side effects include: nausea, vomiting, diarrhea, hair loss, weight loss, mouth sores, depression and leukopenia. More serious side effects include: neutropenia, anemia, peripheral neuropathy, thrombocytopenia, kidney and liver damage, tumor lysis and/or allergic reactions."[9] Common chemotherapy drugs are developed from two different agents:
There is research being done to develop a vaccination against lymphoma.[10] The vaccine itself is made by extracting cells from lymph nodes and identifying a cancer marker, called an "idiotype," that is unique to each patient. This idiotype is then fused with chemicals designed to stimulate the immune system. This vaccine have shown promising results[11] but are not able to cure anyone who currently has lymphoma or prevent anyone from developing lymphoma. The vaccination is a form of chemotherapy and has shown significant success in lengthening the time period before the cancer returns. Prognosis[edit | edit source]
Physical Therapy Management[edit | edit source]Types of interventions
A Flexibility Program is often implemented to help relieve joint stiffness and pain while helping maintain good range of motion. The benefits of stretching include:
See also Physical Activity in Cancer The following links support the use of aerobic exercise:
Patient Education[edit | edit source]The patient should
Differential Diagnosis[edit | edit source]The differential diagnosis of Non-Hodgkin Lymphoma involves the ruling out of obvious and common conditions as well as other possible malignancies.[15] Medical conditions mimicking symptoms similar to Non-Hodgkin lymphoma are:
References[edit | edit source]
What can I expect with nonSigns and symptoms of non-Hodgkin's lymphoma may include: Swollen lymph nodes in your neck, armpits or groin. Abdominal pain or swelling. Chest pain, coughing or trouble breathing.
What is the standard treatment for nonNon-Hodgkin lymphoma is usually treated with chemotherapy or radiotherapy, although some people may not need treatment straight away. In a few cases, if the initial cancer is very small and can be removed during a biopsy, no further treatment may be needed.
Which finding will the nurse expect in a patient who is hospitalized with stage I Hodgkin's lymphoma?In stage 1, symptoms include a single enlarged lymph node (usually), unexplained fever, night sweats, malaise, and generalized pruritis. Although splenomegaly may be present in some clients, night sweats are generally more prevalent. Pericarditis isn't associated with Hodgkin's disease, nor is hypothermia.
When a patient has been diagnosed with nonMRI. Magnetic resonance imaging (MRI) uses powerful magnetic forces and radio-frequency waves to make cross-sectional images of organs, tissues, bones and blood vessels. A computer turns the images into 3-D pictures. MRI is used to check if NHL has spread to the brain and spinal cord.
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