Presentation

The features at presentation reflect a spectrum from low grade lymphoma (widely disseminated at diagnosis but with an indolent course; nondestructive growth patterns) to high grade lymphoma (short history of localised rapidly enlarging lymphadenopathy ± constitutional upset with drenching night sweats, >10% weight loss and/or fever; destructive growth patterns).

In Europe and the USA almost 75% of adults present with nodal disease, usually superficial painless lymphadenopathy. 25% are extranodal (~50% in the Far East) and may present with oropharyngeal involvement (5-10%), GI involvement (l5%), CNS involvement (5-10%, esp. high grade NHL) skin involvement (esp. T-cell lymphomas) or autoimmune cytopenias. Patients with GI involvement have a higher frequency of oropharyngeal involvement (Waldeyer's ring) and vice versa. Hepatosplenomegaly is common in advanced disease.

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