Lymphoma

Malignancy of lymphoid tissues, causing solid tumours in lymphoid organs. Lymphomas are:

• Divided into:
  • Hodgkin Lymphoma
    • Classically present with:
      • Cervical lymphadenopathy
      • Pruritis
      • B symptoms
    • Predominantly curable with chemotherapy
  • Non-Hodgkin Lymphoma
    Heterogenous group with many subtypes, broadly divided into:
    • High-grade lymphomas
      Aggressive but chemotherapy sensitive. Include:
      • Diffuse large B cell lymphoma
        ~30% of all NHL.
    • Low-grade lymphoma
      Indolent, slow growing, and generally incurable. Include:
      • Follicular lymphoma
      • Mantle cell lymphoma
      • Marginal zone lymphomas
      • Waldenstrom macroglobulinaemia
• Staged by the Ann Arbor system
  Includes both principle stages and modifiers.
  • Principle stages
    • I: Single region
      Usually asymptomatic.
    • II: Two separate regions on one side of the diaphragm
    • III: Regions on both sides of diaphragm
    • IV: Disseminated with involvement of ⩾1 extra-lymphatic organ
  • Modifiers
    • A: Absence of B symptoms
    • B: Presence of B symptoms
    • E: Extranodal spread
    • S: Splenic spread
    • X: One deposit >10cm

B symptoms are a poor prognostic sign and consist of:

• Weight loss
  >10% unintentional ↓ in weight over the preceding 6 months.
• Fever >38°C
• Night sweats

Epidemiology and Risk Factors

Pathophysiology

Aetiology

Clinical Features

Assessment

History:

Exam:

Investigations

Bedside:

Laboratory:

Imaging:

Other:

Diagnostic Approach and DDx

Management

Goals of management

Resuscitation:

Specific therapy:

• Pharmacological
• Procedural
• Physical

Supportive care:

Disposition:

Preventative:

Marginal and Ineffective Therapies

Anaesthetic Considerations

Complications

Prognosis

Key Studies

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References

1. Bersten, A. D., & Handy, J. M. (2018). Oh’s Intensive Care Manual. Elsevier Gezondheidszorg.