Talk:Lymphoma

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[edit] External Links

I ordered the links somewhat to put more primary information towards the top. There is always going to be jockeying for top position as patients & loved ones will probably click the first link 95% of the time. Thus http://www.lymphoma-net.org/, which is a Roche sponsored commercial page has been at the top and does not contain primary information. Also, it is in small print at the bottom that it is NOT for people in the US although it does not carry an .eu top level domain name. Open to talk on this. Mikebar 08:05, 26 May 2007 (UTC)

[edit] WF Classifications vs. WHO

The Working Formulation is outdated. Does anyone has a staightforward description of the WHO classification? JFW | T@lk 16:05, 27 September 2005 (UTC)

Indeed, the Working Formulation is outdated. However, we code our patients with SNOMED, which requires a WF diagnosis. Also, the National Cancer Institute of Canada compiles national statistics as HL and NHL. Otherwise, it would be impossible to follow historical incidence rates. In the US, the NIH still uses the HL vs NHL division. Under the NHL heading, they mention the WF and the REAL classifications (the REAL is the mother of the WHO).
Not only are we condemned to repeat history, we are also slaves of our history. For this reason, I give two diagnoses for each case: WF and WHO.
As for a straightforward description of the WHO classification, forget about it: there is nothing straighforward about it! The introduction of the 2001 book takes two pages to explain how their classification is complex, but so were the previous classifications. They finish with the promise of more complexity in the future. Frankly, it is not their fault: nature is much more complex than we wish.
Emmanuelm 18:12, 24 October 2005 (UTC)

[edit] WHO Classification

There seems to be a much better list at the National Cancer Institute than the one we've got. It ties much better to the actual publication (the same 11 sections, in the same order). I'd like to replace that section in this article -- any objections? --Arcadian 01:14, 29 December 2005 (UTC)

Not a problem. Perhaps we can also insert the relative incidence as published in this month's Blood here. JFW | T@lk 13:17, 29 December 2005 (UTC)
I've made the update. I've included template links to a source that supports looking up information by ICD-O code, but it doesn't recognize all the codes on the page, so I'll look for a more flexible source. (And JFW -- your idea sounds like a good one, but I can't get access to that data.) --Arcadian 16:19, 29 December 2005 (UTC)
No access to Blood? What kinda med school are ya in? JFW | T@lk 16:57, 29 December 2005 (UTC)
I don't start until August 2006. --Arcadian 16:57, 30 December 2005 (UTC)
Can Arcadian tell me why he/she included the leukemia classification to this lymphoma page? It is not even listed in the leukemia page! I vote for dividing the WHO classification into 4 parts in 4 distinct pages: leukemia, lymphoma, histocytic and mastocytic neoplasms. Only the relevant part of the classification should be listed in each page. Wiki links will lead to the other pages. Remember, Wikipedia is not a technical text, it is meant to be readable by all. Let me know what you think before I delete the non-lymphoma parts. Emmanuelm 14:34, 23 January 2006 (UTC)
Emmanuelm, aren't you the person who added those other categories on 6 July 2005? --Arcadian 15:04, 23 January 2006 (UTC)
Arcadian, I added only the lymphoma portion of the WHO classification, as shown on the page you link. You added the leukemias on Dec 29th. Would you mind moving the leukemia portion to the leukemia page? Emmanuelm 20:23, 23 January 2006 (UTC)
Oh, and please note that I would be very comfortable with a "cross-coverage" of lymphocytic leukemias (both CLL and ALL) in both pages. My comment is really about myeloid, histiocytic and mast cell neoplasms who share no real relationship with lymphomas. Emmanuelm 20:23, 23 January 2006 (UTC)
To simplify the discussion, I have restored that section to your version from 6 July 2005, including the section you added on Histiocytic and Dendritic Cell Neoplasms. You may make any further edits you would like, and I will have no objection. --Arcadian 21:13, 23 January 2006 (UTC)

The full list should be on hematological malignancy, and the lymphoma part can be copied over here. It would be defendable to list ALL and CLL here. They are neighbours of lymphoblastic lymphoma and small lymphocytic lymphoma and fall under the lymphoproliferative disorders. JFW | T@lk 21:57, 23 January 2006 (UTC)

[edit] Non-sequitur?

The article says:

Because the lymphatic system is part of the body's immune system, patients with weakened immune system, such as from HIV infection or from certain drugs or medication, also have a higher incidence of lymphoma.

Why does belonging to the immune system lead to higher incidence of lymphoma? It would be better to either explain that connection or just start the phrase at "Patients with weakened etc...".

response
It's because having a weakened immune system leads to a weakened ability to kill cells that have gone off of their programming because the immune system is focused elsewhere. I get your point, it's not a non sequitur however. The article provides enough information for the person who has some knowledge of human biology already, but could be a little bit clearer for those who don't have such a founding.
Perhaps it could read: "As the lymphatic system is a part of the body's immune system, a weakened or compromised immune system such as is caused by, for example: HIV, steroids and infection, would lead to a higher than usual incidence of lymphoma in those people as the immune system's natural ability to suppress such cancer formation is weakened also."
What do you think? Fr33kMan 17:43, 20 February 2007 (UTC)

[edit] monocytes or lymphocytes in the Reticuloendothelial system?

According to this introduction, lymphocytes are participating in the Reticuloendothelial system, but according to the introduction on Reticuloendothelial system, the monocytes are participating in the Reticuloendothelial system. It is clear on Image:Illu_blood_cell_lineage.jpg that they aren't the same thing. So which one is present there? Perhaps both? Mikael Häggström 17:33, 3 June 2007 (UTC)

I made some own research at [1] and [2] and found that: Histiocytes and monocytes, not histiocytes and lymphocytes, form the reticuloendothelial system. This page is now corrected. Mikael Häggström 07:22, 4 June 2007 (UTC)

[edit] Histiocytic and dendritic cell neoplasms

are not lymphomas--this should be placed elsewhere

[edit] Genetics

There are alot of sources for genetics and lymphoma (although I am not saying it is purely genetics that causes lymphomas). We should expand this section. Mikebar 07:22, 31 July 2007 (UTC)

Yes, there are definite links for NHL, less so perhaps for Hodgkin's. The question is whether we should address the genetics here, or in the subarticles (non-Hodgkin lymphoma and Hodgkin lymphoma). MastCell Talk 16:32, 8 August 2007 (UTC)

[edit] Non-malignant lymphoma?

Is a lymphoma malignant by definition. The linked German article is for "malignant lymphoma". The German "Lymphoma" article distinguishes between malignant and non-malignant types and then redirects accordingly. Is this a difference in the way the term is used in that country - or should the English article also include non-malignant forms? 172.173.51.149 07:57, 7 August 2007 (UTC)

  • All lymphomas are malignant. There were some lymphoid conditions that were not considered specifically malignant lumped in lymphoma but that has pretty much disappeared in the WHO model to my knowledge. Mikebar 13:08, 8 August 2007 (UTC)
Yup. The term "malignant lymphoma" is still sometimes used in English, but it's redundant. MastCell Talk 16:31, 8 August 2007 (UTC)

[edit] External links

External links to patient support groups (especially online chat boards), blogs, and fundraising groups normally not accepted on Wikipedia. Please read the external links policy and the specific rules for medical articles before adding more external links. WhatamIdoing (talk) 00:41, 13 January 2008 (UTC)

[edit] Let's get rid of NHL

Quick opinion survey. How many here would support the downgrading/demotion of the "non-Hodgkin lymphoma" concept and nomenclature, limiting it to paragraphs discussing the Working Formulation? This implies shortening the long, obsolete but surprisingly active Non-Hodgkin lymphoma article, redirecting the readers to Lymphoma. Your opinion? (please be clear)

  • I agree to downgrade the NHL concept, limiting it to historical discussions. Emmanuelm (talk) 17:30, 14 April 2008 (UTC)
  • Weak disagreement. Average readers use NHL. WhatamIdoing (talk) 02:44, 15 April 2008 (UTC)
  • Disagree. I entirely sympathise with Emmanuelm's point, but WhatamIdoing is correct: virtually everyone uses NHL as a term, and it will be confusing to get rid of this. Using the same logic, one would get rid of "Cancer" as a single page. Better to keep the collective NHL page and educate from within.Jellytussle (talk) 21:19, 18 April 2008 (UTC)

[edit] comments

Please read my straw-poll vote as very weak disagreement, based entirely on the notion that Wikipedia reflects the world instead of leading it. Actually, Emmanuelm, the world's bad habit of talking about "NHL" as if it were a single disease is one of my pet peeves. You are entirely in the right of it. However, I think we need to reform the world before we change Wikipedia.

Having said that, if you want to (for example) substitute more precise language here and there, and if it "just happens" that the term NHL gets removed in the process, then I will support that effort. For example, I see no reason why ==Diagnosis, etiology, staging, prognosis, and treatment== couldn't point to more than two pages. I also see no reason why any information that is in the NHL page but is specific to (for example) T cell lymphomas couldn't be moved to the relevant article, even if that process happens to shorten the NHL article. (I favor moving the information to specific types of lymphomas instead of trying to unify it here: surely if you have Diffuse large B cell lymphoma, then you don't much care about the prognosis for "lymphomas in general" any more than you care about "lymphomas in general, except for Hodgkins".)

If, several years from now, NHL ends up as a redirect to Lymphoma, then you will get no complaint from me. However, if we do this now, and especially if we do this all at once, then (given the state of the world's stubborn and underinformed use of NHL) I think we'll have a whole lot of people unhappy with us. WhatamIdoing (talk) 02:44, 15 April 2008 (UTC)

WIAD, you are right but you are also forgetting the primary function of an encyclopedia, including WP, which is to educate. Emmanuelm (talk) 12:57, 18 April 2008 (UTC)
JellyTussle, currently the article states under "Causes": Age/sex. The likelihood of getting non-Hodgkin's lymphoma increases with age. Burkitt's lymphoma is NHL; need I say more? As it stands, the article is misleading and it is our responsibility to correct this. Emmanuelm (talk) 14:09, 20 April 2008 (UTC)
I think that NHL needs to discuss only the fact that lymphomas were previously divided between Hodgkin's and NHL on the basis of histological features (Reed-Sternberg cells). Now that immunohistochemistry allows us to subtype cells to a great level of detail, the old classification is not only unnecessary but also mixes high- and low-grade diseases with utterly different epidemiologies, risk factors and prognoses. JFW | T@lk 21:31, 11 May 2008 (UTC)

Technical note: this discussion is transcluded in Talk:lymphoma, Talk:Non-Hodgkin lymphoma, Talk:Cancer, Wikipedia talk:WikiProject Pathology. Comments posted here will be shown in all.