Introduction A neoplasia of lymphoid cells Subtypes of NHL include (from large to small cell) diffuse B-cell lymphoma Burkitt lymphoma follicular lymphoma marginal zone lymphoma mantle cell lymphoma Prognosis small cell NHLs typically have a better prognosis than large cell because a cell becomes small with differentiation Diffuse Large B-cell Lymphoma Introduction large-size B cell proliferation CD20 + may be mature T cell in origin most common subtype of NHL arises de novo or progression from a small B cell NHL subtype generally seen in the adult population, but can be seen in children Presentation rapidly enlarging lymph node Prognosis, Prevention, and Complications very aggressive with poor prognosis Burkitt Lymphoma Introduction intermediate-size B cell proliferation CD20 + caused by 8;14 translocation approximates the Ig heavy chain locus (14) with c-myc (8) increased levels of c-myc drives cell growth associated conditions EBV infection generally seen in pediatric/adolescent population Presentation extranodal mass jaw (African-type) abdomen (sporadic-type) Evaluation biopsy "starry-sky" appearance Follicular Lymphoma Introduction small-size B cell proliferation in the follicles CD20 + caused by 14;18 translocation approximates the Ig heavy chain locus (14) with BCL2 (18) increased levels of Bcl2 inhibits apoptosis generally seen in the adult population Presentation painless lymphadenopathy Evaluation Treatment rituximab (anti-CD 20) only used for symptomatic patients Prognosis, Prevention, and Complications can progress to large B cell lympthoma presents with a rapidly enlarging lymph node Marginal Zone Lymphoma Introduction small B cell proliferation in margin CD20 + associated conditions chronic inflammatory states (Sjogren syndrome, Hashimoto's thyroiditis) H. pylori infections note that gastric MALTomas are a type of marginal zone lymphoma Mantle Cell Lymphoma Introduction small B cell proliferation of the area surrounding the follicular zone (the mantle) CD20+, CD5 + caused by 11;14 translocation approximates the Ig heavy chain locus (14) with Cyclin D (11) increased levels of Cyclin D drives cell into S phase generally seen in older adult population Presentation painless lymphadenopathy