6.5.5Unclassifiable NHL

•Approximately 5% of NHL

•Localization: abdomen, less frequently other locations

•Histology: polymorphic, histiocytic, or follicular forms

•Immunophenotype: predominantly T-cell characteristics

6.6Clinical Manifestations

6.6.2.1 Abdomen

•Especially the ileocecal region, mesentery, retroperitoneum, ovaries:

–Painful spasms, vomiting

–Obstipation, intussusception: in children more than 6 years of age, suggestive of NHL

–Appendicitis-like

–Ileus

–Ascites

–Disturbed micturition

6.6.2.2 Mediastinum

•Mostly in the anterior or middle part of the mediastinum (thymus area):

–Cough

–Stridor

–Dyspnea

–Wheezing

•Edema of the neck and face with marked dyspnea may indicate superior vena cava syndrome

•Pain of the back or abdomen

•Pleural effusion

•Involvement of adenoid and tonsils, nasopharyngeal lymph nodes, parotid gland swelling, laryngeal compromise with respiratory disturbance

6.6.2.3 Peripheral Lymph Nodes

•Mostly cervical, supraclavicular, and inguinal

•Lymph nodes are firm, not usually tender, but involving multiple lymph nodes that usually occur unilaterally