Advances in the diagnosis and management of lymphoma

Abstract

The lymphomas are a heterogeneous group of cancers that have played a prominent role in the history of oncology, being among the first cancers to respond to radiotherapy or systemic chemotherapy. Progressive improvement in the understanding of the biology and natural history of these diseases has led to changes in both classification and management. Because of the heterogeneity present among the lymphomas, accurate diagnosis and staging are essential prerequisites to their effective management. Lymphoma stage frequently informs treatment decisions, but in contrast with solid tumor malignancies carries limited prognostic value. This has led to the development of prognostic models in lymphoma, which use patient and disease characteristics to stratify patients by risk. Modern approaches to Hodgkin's lymphoma include chemotherapy only, combined-modality therapy with both chemotherapy and radiotherapy, and risk-adapted approaches that modify treatment based on initial response. Management of non-Hodgkin's lymphoma (NHL) varies widely depending upon histology. Use of rituximab, the anti-CD20 monoclonal antibody, is included in the management of most B cell lymphomas and has improved outcomes in these diseases. The T cell lymphomas are less common and generally less well understood than the B cell diseases, and their management has only recently become disease-specific. Though effective therapy is available for many types of lymphoma, relapse remains common in a number of subtypes, and management of relapsed and refractory disease remain research priorities.

Lymphoma and the Microenvironmental Cross-Talk between Sex Hormone Receptors and Epstein-Barr Virus in Predicting Lymphoma Clinical Status

“…Lymphoma is diagnosed primarily through pathologic examination of an acceptable tissue specimen in the right clinical situation, which may include morphologic, immunophenotypic, and cytogenetic studies as needed. Individual lymphomas are treated differently, necessitating an accurate and specific diagnosis to provide appropriate patient care [27]. The choice of biopsy procedure and place is a common practical challenge in patients suspected of having lymphoma.…”

“…Expert pathology review is recommended and should be regarded standard of care because proper therapy is fundamentally dependent on correct pathologic diagnosis. When the diagnosis of lymphoma is unclear, medical imaging can be helpful in staging, but a definitive diagnosis of lymphoma and determination of the histologic subtype require pathological examination [27]. Though not conclusive, [18F]-fluoro-2deoxyglucose positron emission tomography (FDG-PET) imaging can identify aggressive from indolent lymphomas based on standard uptake value assessment and can help predict indolent lymphoma transformation (usually DLBCL).…”

Immunofluorescent labeling of CD20 tumor marker with quantum dots for rapid and quantitative detection of diffuse large B‐cell non‐Hodgkin's lymphoma

“…More recently developing high‐potential fluorescent nanocrystals is highly interesting in biomedical applications . Pathologic features such as immune‐phenotypic, morphology, and cytogenetic aberrations of appropriate tissue sample are major features used in National Comprehensive Cancer Network guidelines (version 4.2014), for identifying NHL . The immunohistochemistry (IHC) test is performed routinely for cancer diagnosis, but due to the discrepancies in its results reported by different laboratories, providing a precise diagnostic method for NHL is indispensable .…”

“…7 Pathologic features such as immune-phenotypic, morphology, and cytogenetic aberrations of appropriate tissue sample are major features used in National Comprehensive Cancer Network guidelines (version 4.2014), for identifying NHL. [8][9][10] The immunohistochemistry (IHC) test is performed routinely for cancer diagnosis, but due to the discrepancies in its results reported by different laboratories, providing a precise diagnostic method for NHL is indispensable. 11 Quantum dots (QDs) are semiconductor nanoparticles with ranging size of 1 to 20 nm and made mainly from cadmium and selenium.…”