blood disorders
Non Hodgkin Lymphomas
Diagnosis and Classification
Lymph node biopsy Doctors suspect non-Hodgkin lymphoma when a person with no apparent infection develops persistent and painless enlargement of lymph nodes that lasts for several weeks. Sometimes enlarged lymph nodes deep within the chest or abdomen are found unexpectedly when a chest x-ray or computed tomography (CT) is done for another reason. Doctors do a biopsy of an enlarged lymph node to diagnose non-Hodgkin lymphomas and to distinguish them from Hodgkin lymphoma and other disorders that cause enlarged lymph nodes. The type of biopsy depends on which node is enlarged and how much tissue is needed. Doctors must remove enough tissue to be able to distinguish non-Hodgkin lymphoma from other disorders that can cause lymph node enlargement, including Hodgkin lymphomas, infections, inflammation, or other cancers. The best way to obtain enough tissue is with an excisional biopsy (a small incision made to remove a piece of the lymph node). Occasionally, when an enlarged lymph node is close to the body's surface, a sufficient amount of tissue can be obtained by inserting a hollow needle (usually under ultrasound or CT guidance) through the skin and into the lymph node (core needle biopsy). When an enlarged lymph node is deep inside the abdomen or chest, surgery may be needed to obtain a piece of tissue. Although more than 50 different disorders can be called non-Hodgkin lymphomas, doctors sometimes group them into two broad categories. Indolent lymphomasare characterized by A long survival period (many years) Rapid response to many treatments Variable periods of remission but lack of cure with current standard therapies Aggressive lymphomasare characterized by Rapid progression without therapy High rates of cure with standard chemotherapy but short survival when cure is not achieved Although non-Hodgkin lymphomas are usually diseases of middle-aged and older people, children and young adults may develop lymphomas. Lymphomas that develop in children and young adults are commonly aggressive subtypes. 