How does non-Hodgkin lymphoma typically present and how is it treated?

• A. Lymphadenopathy with possible B-symptoms; treatment depends on subtype and often includes chemo-immunotherapy
• B. Skin rash; treated with antibiotics
• C. Primary bone lesions; treated with surgery only
• D. Hypercalcemia; treated with bisphosphonates

Answer: (A)

Non-Hodgkin lymphoma most often presents as painless enlarged lymph nodes and can be accompanied by systemic symptoms such as fever, night sweats, and weight loss. Because NHL is diverse with many subtypes, the approach to treatment is tailored to the specific histology and stage. In many B-cell non-Hodgkin lymphomas, the standard therapy combines chemotherapy with immunotherapy, such as a regimen that includes rituximab. This chemo-immunotherapy strategy targets malignant lymphoid cells throughout the body and is used rather than relying on surgery alone, since NHL is typically systemic rather than confined to a single site. Some localized or indolent subtypes may be treated with radiation or other less intensive approaches, but the general principle remains: treatment is subtype- and stage-dependent, with chemo-immunotherapy forming a common cornerstone.

Skin rash is not the typical presenting feature for most NHLs, though cutaneous lymphomas exist as distinct entities. Primary bone lesions are not the usual presentation and are not treated with surgery alone in the context of lymphoma. Hypercalcemia can occur in various cancers but does not define the typical presentation or standard treatment approach for non-Hodgkin lymphoma.