Lymphomas are a heterogeneous group of malignancies that arise from malignant transformation of immune cells residing predominantly in lymphoid tissues. Differences in histology have led to the classification of Hodgkin and non-Hodgkin lymphoma (HL and NHL, respectively), which are addressed separately in this chapter.
WHAT ARE THE CAUSES OF LYMPHOMAS?
B-cell transcriptional processes are disrupted during malignant transformation, preventing the expression of B-cell surface markers and production of immunoglobulin messenger RNA. Alterations in the normal apoptotic pathways favour cell survival and proliferation.
Malignant Reed–Sternberg cells overexpress nuclear factor-κ B, which is associated with cell proliferation and antiapoptotic signals. Infections with viral and bacterial pathogens upregulate nuclear factor-κ B. Epstein–Barr virus is found in many, but not all, HL tumours.
WHAT ARE THE SIGNS AND SYMPTOMS OF LYMPHOMAS?
Most patients with HL present with a painless, rubbery, enlarged lymph node in the supradiaphragmatic area and commonly have mediastinal nodal involvement. Asymptomatic adenopathy of the inguinal and axillary regions may also be present.
Constitutional, or “B,” symptoms (e.g., fever, drenching night sweats, and weight loss) are present at diagnosis in approximately 25% of patients with HL.
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