mantle cell lymphoma | 1. NON-Hodgkin indolent lymphomas (Low malignancy)

1. NON-Hodgkin indolent lymphomas (Low malignancy)




1. Follicular lymphoma
Follicular lymphomas are relatively common: they account for 20% to 30% of non-Hodgkin lymphomas. Follicular lymphomas are formed from B lymphocytes and are therefore called B-cell lymphomas. They usually affect middle-aged or older adults. Because of their frequency, follicular lymphomas are often used as models for the treatment of other indolent lymphomas. Follicular lymphomas can evolve into lymphoma with high malignancy. Indolent forms that become aggressive are often more difficult to treat than those that are aggressive at the time of diagnosis. Patients with follicular NHL rarely have localized lymphomas; They are rather located in several parts of the body, including bone marrow. Follicular lymphomas are divided into three grades (I, II, or III) depending on the number of small and large cells found. Grades I and II show a similar evolution, while grade III follicular lymphomas are considered to be aggressive.

2. Lymphocytic lymphoma (LL), chronic lymphoid leukemia (LLC)
Lymphocytic lymphoma is located in the lymph nodes and eventually in the bone marrow. It represents 4% of non-Hodgkin lymphomas and is susceptible to initial treatment. However it can over time become resistant or turn into a more aggressive form of large cell lymphoma.

Chronic lymphocytic leukemia is virtually identical to lymphocytic lymphoma, but while the LL is characterized by cancer cells initially located in the lymph nodes, the LLC is characterized by cells Initially located in the blood. These two forms are the same disease but doctors will use either of the two terms depending on the location of cancer cells. About 20% of cases may evolve to a higher grade such as large cell lymphoma (Richter syndrome). This can happen after several years.

3. The lymphomas of the marginal zone
The tumors of the marginal zone are indolent B-cell lymphomas. They can take birth either in the lymph nodes or outside of them. They are distinguished in two categories depending on the location of the lymphoma.

The lymphomas of the lymphoid tissue associated with the mucous membranes (MALT) are a form of lymphoma of the marginal zone that affects areas outside the lymph nodes, such as the digestive tract (the stomach in particular), the thyroid gland, the Salivary glands, lungs and skin. When these lymphomas are present in the stomach, they are often associated with Helicobacter pylori (H. pylori) infection. Other bacteria may also be involved in other forms of MALT lymphoma.

B-cell lymphomas of the ganglion marginal zone are rare. The average age of patients with this type of lymphoma is 65 years.

The marginal area lymphomas can also reach the spleen and the blood.

4. The Waldenstrom of Macroglobulinemia (also known as lymphoma Lymphoplasmocytaire or immunoctytome)

This B-cell lymphoma is rare. This disease usually affects people over 60 years of age and is characterized by a proliferation of cancer cells at the level of the bone marrow at the time of diagnosis. These cells produce a protein, called monoclonal immunoglobulin, found in the blood by an examination called Électrophérèse of the proteins.

5. T-Cell cutaneous lymphoma

T-cell cutaneous lymphoma encompasses a broad spectrum of T-cell lymphomas that appear in the skin. The most common form is Mycosis Fungoïde, which is often of low malignancy. The skin may have nodules, localized and slightly reddish. When T cells are found in the blood, the disease is more aggressive and is then called Sezary syndrome. T-cell cutaneous lymphoma is 2-3% of NHL. The average age of patients is generally between 55 and 60 years.

2. Aggressive or high malignancy NON-Hodgkin lymphomas

1. Diffuse lymphoma with large B cells

Large B-cell diffuse lymphoma is the most common lymphoma (it accounts for 30 to 40% of the NHL). The average age of patients is 55 to 60 years. Although they are more likely to affect adults, large-cell lymphomas can also occur in children. These aggressive lymphomas may arise in the lymph nodes or in extra-ganglion places such as the gastrointestinal tract, testicles, thyroid, skin, breast, central nervous system or bones. These lymphomas are either localized or disseminated (i.e. distributed throughout the organism).

2. Mantle cell lymphomas

Mantle cell lymphomas are B-cell lymphomas and represent 5 to 10% of NHL cases. Most often they affect men over 50 years of age and the disease is often at an advanced stage at the time of diagnosis. In general, patients with mantle cell lymphoma have multiple ganglionic attacks. One or more organs (especially the digestive tract) and bone marrow may also be affected. This lymphoma is generally more aggressive than most low-malignancy lymphomas. However, new therapies still under test have shown an efficacy on the disease.

3. Burkitt lymphoma, lymphoma  "type Burkitt " (Small cells not cleaved)

Burkitt lymphoma, a B-cell lymphoma of high malignancy, has been described for the first time in Africa where it has been called endemic Burkitt lymphoma. When he was diagnosed in other parts of the world, such as in the United States or Europe, he was named the sporadic Burkitt lymphoma. It concerns both adults and children. It is also one of the lymphomas diagnosed in HIV-infected patients. All forms of Burkitt lymphoma are more likely to affect men. Burkitt lymphoma and lymphomas  "type Burkitt " Behave the same way and are all spontaneously very aggressive. However, the prognostic after treatment is generally favorable.

4. Peripheral T-Lymphomas

Peripheral T-Lymphomas accounted for 10 – 15% of NHL in adults. The term peripheral T-lymphoma is based on the fact that they are tumors composed of T cells (not B) and that these cells are mature. Most peripheral T lymphomas have a high malignancy with the exception of Mycosis Fungoïde (see T-cell cutaneous lymphoma). Peripheral T-lymphomas originate at the level of lymph nodes, such as T-angio-immunoblastic lymphoma or large-cell anaplastic lymphoma. They may also occur in extra-ganglion sites, such as subcutaneous T-lymphoma, or t/NK nasal lymphoma or intestinal t-lymphoma. These tumors are most often extended from diagnosis and difficult treatment.

3. Other lymphomas

1. HIV-associated Lymphomas

Lymphomas that suffer from HIV-positive patients are generally of high malignancy. It is estimated that almost 10% of HIV-positive patients develop lymphoma. The most common lymphomas in this population are large B-cell diffuse lymphomas, Burkitt lymphomas, and Burkitt-type lymphomas and primitive central nervous system lymphomas.

2. Primary central nervous system lymphoma (PCNSL)

The primary lymphoma of the central nervous system is a cancer that affects only the brain and the spinal cord. An increasing number of such lymphomas have been observed in patients with AIDS and individuals with autoimmune disease. Apart from HIV infection, the central nervous system's primary lymphomas mainly affect people over the age of 60.

3. The child's lymphomas

The child's lymphomas represent 5% of the NHL. The most common forms are lymphoblastic lymphoma, Burkitt lymphoma, large B-cell diffuse lymphoma, and large-cell anaplastic lymphoma. Lymphoblastic lymphoma is closely related to the lymphoblastic leukemia of the child. Large cell anaplastic lymphoma is a form of T lymphoma often diagnosed in children and young adults. Among all T lymphomas, he is the one with the highest cure rate. Unfortunately, the number of children with NHL is growing.