DRG Category: 824

Mean LOS: 8.6 days

Description SURGICAL: Lymphoma and Non-Acute Leukemia with Other O.R. Procedure with CC

DRG Category: 841

Mean LOS: 6.7 days

Description MEDICAL: Lymphoma and Non-Acute Leukemia with CC

classification section:



Malignant lymphoma, also called lymphosarcoma or non-Hodgkin's lymphoma (NHL), is a diffuse group of neoplastic diseases characterized by rampant proliferation of lymphocytes. Lymphomas fall into two main categories: Hodgkin's and non-Hodgkin's lymphomas, based primarily on the presence or absence of the Reed-Sternberg cell; when the cells are absent, the disease is classified as NHL (Table 2).

Comparison of Hodgkin's Disease and Non-Hodgkin's Lymphoma

CHARACTERISTIC	HODGKIN'S	LOW-GRADE NON-HODGKIN'S	ALL OTHER NON-HODGKIN'S
Site(s) of origin nodal distribution	Nodal axial (centripetal)	Extranodal, about 10% centrifugal	Extranodal, about 35% centrifugal
Nodal spread	Contiguous	Noncontiguous	Noncontiguous
Central nervous system involvement	Rare, < 1%	Rare, < 1%	Uncommon, < 10%
Hepatic involvement	Uncommon	Common, > 50%	Uncommon, < 10%
Bone marrow involvement	Uncommon, < 10%	Common, > 50%	Uncommon
Marrow involvement adversely affects prognosis	Yes	No	Yes
Curable by chemotherapy	Yes	No	Yes

Of the more than 60,000 new cases of lymphoma diagnosed each year in the United States, approximately 55,000 of them will be NHL. In the past 30 years, the incidence of NHL has increased by more than 80%, making it one of the largest increases of any cancer. This increase is unexpected and is only partially explained by earlier detection because of improved diagnostic techniques or HIV-associated lymphomas.

Malignant lymphoma, or NHL, is a heterogeneous grouping of several disease types that range from the aggressive, rapidly fatal diffuse histiocytic lymphoma to the indolent nodular varieties. Still, all have a less promising prognosis than Hodgkin's disease. NHL can be divided in two groups based on prognosis: indolent lymphomas and aggressive lymphomas. Indolent lymphomas have a comparatively good prognosis with a survival time of up to 10 years. Most are nodular (or follicular) in nature. People with aggressive lymphoma have a poor overall prognosis, although a number of these patients can be cured with chemotherapy. Complications of NHL include hypercalcemia, increased uric acid levels, meningitis, and anemia. As tumors grow, they may compress the vital organs and cause organ dysfunction; problems from organ compression include complications such as increased intracranial pressure.