Non-Hodgkin lymphoma is best described as what?

• A. A diverse group of B-cell, T-cell, and NK-cell lymphomas that typically spreads noncontiguously.
• B. A single disease with uniform cell type and contiguous spread.
• C. Reed-Sternberg cell–driven lymphoma with contiguous spread.
• D. Always originates in the bone marrow and spreads hematogenously.

Answer: (A)

Non-Hodgkin lymphoma is a heterogeneous group of lymphoid cancers that can arise from B cells, T cells, or NK cells. Because of this diversity, there isn’t a single uniform disease. Many NHL subtypes spread in a noncontiguous pattern, meaning malignant cells can move through the lymphatic system or the bloodstream to involve distant lymph nodes and extranodal sites rather than just advancing stepwise to neighboring nodes. This contrasts with Hodgkin lymphoma, which is driven by Reed-Sternberg cells and typically shows contiguous spread from one lymph node region to the next. NHL can present in nodal or extranodal sites and ranges from indolent to very aggressive, with bone marrow involvement possible but not universal. The origin isn’t restricted to the bone marrow, since many subtypes arise in lymph nodes or extranodal tissues such as the stomach, skin, or CNS.