What does Lymphoma look like? OK, lets look at those lumps you called about… WHOA!!! Stuff to do when you have cancer… #16 Use a tennis ball to see if your oncologist has a sense of humour…

Presenting features of Lymphoma Lymphadenopathy Hepatosplenomegaly Systemic ‘B’ symptoms Pruritis Other symptoms like fatigue, anorexia and EtOH induced nodal tenderness Symptoms due to involvement of other organs

Diagnosis of Lymphoma Hodgkin’s (HL) and NHL rely on a few activities for diagnosis including Full medical history, physical examination, blood work and different imaging studies: Lymph node biopsy FBC ESR LFT’s LDH Uric acid CXR CT Bone marrow aspirate and trephine biopsy Sometimes PET NHL may also affect U&E’s due to ureteric obstruction secondary to intra- abdominal/ pelvic lymphadenopathy. NHL is also more likely to produce paraproteins, so an elevated serum Ig level would strengthen diagnosis.

Differential Diagnosis of lymphadenopathy EBV Infective mononucleosis (risk factor for lymphoma) Toxoplasmosis HIV (risk factor for lymphoma) Cat-scratch Viral hepatitis Rubella CMV Leukaemia/ Lymphoma Secondary malignancy

Differential Diagnosis of Splenomegaly Portal hypertension Extra-medullary hematopoiesis Myeloproliferative disease

Epidemiology of lymphoma In 2001, NHL was the 6 th most common cancer in men and 5 th most common in women… and 3 rd most common in children under 14yrs. NHL is the 6 th most common cause of cancer death with the percentage increasing steadily in both genders – no-one knows why. At any one time, 30,000 Australians and accounts for 4% of newly diagnosed cancer. HL is not as common has NHL, with younger people falling victim when compared to NHL.

Epidemiology of lymphoma Incidence of NHL steadily rising whilst HL stays relatively stable.