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Unformatted text preview: Non Hodgkin's lymphoma
MD, Professor, Department of Medicine, People's College of Medical Sciences, Bhanpur, Bhopal, India Staging Stage I : Involvement of single LN region (I) or extra lymphatic site (IAE ) Stage II : Two or more LN regions involved (II) or an extra lymphatic site and lymph node regions on the same side of diaphragm Stage III : Involvement of lymph node regions on both sides of diaphragm, with (IIIE) or without (III) localized extra lymphatic involvement or involvement of the spleen (IIS) or both (IISE) Stage IV : Involvement outside LN areas (Liver, bone marrow) A : Absence of `B' symptoms B : B symptoms present Non Hodgkin's lymphoma Incidence NHL>HD Median M>F More is increasing age of presentation is 65-70 yrs often clinically disseminated at diagnosis B-cell-70% ; T-cell-30% Clinical features Widely disseminated at presentation Nodal involvement: Painless lymphadenopathy, often cervical region is the most common presentation Hepatospleenomegaly Extranodal : Intestinal lymphoma ( abdominal pain, anemia, dysphagia); CNS ( headache, cranial nerve palsies, spinal cord compression) ; Skin, Testis; Thyroid; Lung Bone marrow (low grade): Pancytopenia Clinical features contd Systemic symptoms Sweating, weight loss, itching Metabolic complications: hyperuricemia, hypercalcemia, renal failure Compression syndrome: Gut obstruction Ascites SVC obstruction S/C Compression Classification REAL Clinical Low / Working Formulation grade Interme...
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