20. Non Hodgkin's Lymphoma | USMLE Step 1 Pathology

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Non-Hodgkin's Lymphoma (NHL) for USMLE Step 1 Pathology

Non-Hodgkin's Lymphoma (NHL) encompasses a heterogeneous group of lymphoid malignancies characterized by the proliferation of abnormal lymphocytes. Unlike Hodgkin's lymphoma, NHL lacks the characteristic Reed-Sternberg cells. This diverse group of diseases originates from B cells, T cells, or natural killer (NK) cells, each with distinct clinical presentations, histological features, and treatment modalities. Common subtypes include diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, and mantle cell lymphoma. The pathogenesis of NHL involves genetic alterations, including chromosomal translocations, gene mutations, and dysregulation of cellular pathways involved in lymphocyte proliferation and survival. Risk factors for NHL include immunodeficiency states, viral infections (e.g., Epstein-Barr virus, human T-cell lymphotropic virus), exposure to ionizing radiation, and certain chemical agents. Diagnosis relies on histopathological examination of lymph node or extranodal tissue biopsies, immunophenotyping, and molecular studies to classify the subtype accurately. Treatment strategies vary depending on the subtype, stage, and patient factors but may include chemotherapy, immunotherapy, targeted therapy, and stem cell transplantation. Prognosis varies widely among NHL subtypes, with some exhibiting aggressive behavior requiring prompt intervention, while others follow an indolent course with a more favorable prognosis. Understanding the epidemiology, pathology, clinical features, and management of NHL is essential for medical students preparing for the USMLE Step 1 examination, as it represents a common topic in pathology and oncology. 📚💻

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