Lymphomas and Lymphoproliferative Disorders - Differential Diagnosis Algorithm

Hodgkin Lymphoma ~40% - Characteristic For Reed-Sternberg (RS) Cells 

 - usually at a single site in lymphatic system (node) with progression contiguously with lymphatic system.  

 - Bimodal Age Distribution 

 - better prognosis

 • Nodular Lymphocyte - 5% RS cells absent, lymphocyte predominant (LP) tumour B cells are present

 • Classic - Nodular Sclerosis, Mixed Cellularity, Lymphocyte Rich, Lymphocyte Depletion

Non-Hodgkin lymphomas (NHL) ~60%

 - lymphadenopathy more diffuse, can have extra nodal involvement, irregular pattern of spread, B symptoms not as common 

 - T Cell ~10%

 - B-Cell ~90%

 • Low Grade - Slow growing, Poorly Responsive to Treatment

 • Aggressive/ Intermediate - Faster growing Potential For Cure, Most common, Wide age range

 • High Grade - Very Lethal if untreated, Behave and Treated Like  Acute Leukemias, very high mitotic rate correlated with rapid growth, response to treatment and relapse	



- Amy Chung, MD, MSc @AmyChung 



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