Preface

Lymphoma is a group of malignant diseases caused by the clonal proliferation of lymphocytes. Current treatment options include chemotherapy, radiotherapy, and bone marrow/stem cell transplantation. Development of new treatment options for cancer medications include small molecules and monoclonal antibodies for immunotherapy. In addition, the discovery of new phytochemical agents used in complementary and alternative medicine adds perspective to the treatment of lymphoma. Chapter 1, "Drugs and Drug Candidates for the Treatment of Lymphoma", highlights recent developments in the field.

Chapter 2, "Follicular Lymphoma", elaborates on general knowledge of follicular lymphoma, which is one of the most common types of indolent non-Hodgkin's lymphoma. Follicular lymphoma presents with lymphadenopathy and/or bone marrow involvement. It is a slow-growing tumor with frequent remission and relapses. Early-stage disease is usually treated with radiotherapy. Management of advanced stage depends on disease burden. Patients with advanced-stage disease may be observed in the case of low-burden disease and those with high disease load require treatment with chemo-immunotherapy. Chapter 3, "Primary Gastrointestinal Lymphoma", contributes to our understanding of a rare disease. Different regions of the gastrointestinal tract are involved in different subtypes of primary gastrointestinal lymphoma with various frequency that reflects the diversity of the causative agents and predisposing factors for each site and the subtype of primary gastrointestinal lymphoma. This chapter discusses the epidemiology of all subtypes of primary gastrointestinal lymphoma, factors and disorders contributing to their development, non-inherited and inherited conditions associated with a higher risk of the disease, diagnostic difficulties and pitfalls, and novel treatment strategies.

Chapter 4, "Splenic B-Cell Lymphoma/Leukemia, Unclassifiable", discusses the low-grade B-cell lymphoproliferative disorders that do not fit into any other splenic lymphoid neoplasm at two provisional entities: splenic diffuse red pulp small B-cell lymphoma and hairy-cell leukemia. Chapter 5, "Testicular Lymphoma: Primary and Secondary Involvement", explores testicular involvement in lymphoma and covers the epidemiology, diagnosis, treatment, and prognosis of primary testicular lymphoma. Furthermore, the chapter addresses the epidemiology and management of secondary involvement of the testis by lymphoma. Chapter 6, "Hydroa Vacciniforme-Like Cutaneous T-Cell Lymphoma", discusses a controversial skin pathology. Hydroa vacciniforme-like cutaneous T-cell lymphoma appears to be just like a vacciniform hydroa but others progress to cutaneous T-cell lymphoma, with or without angiocentricity. They are usually associated with infections by Epstein-Barr viruses and NK cell lymphomas. Clinical management can be difficult and accompanied by a high index of malignancy, thus early diagnosis is essential. Chapter 7, "Clinical and Laboratory Data Which Are Not Typical of De Novo Diffuse Large B-Cell Lymphoma", discusses this heterogeneous group of diseases of the lymphatic system, which are represented by *de novo* and secondary tumors resulting from the transformation of indolent lymphomas. In the absence of a long history of the disease at the stage of histological transformation, it is

difficult to distinguish between *de novo* and secondary diffuse large B-cell lymphoma. The chapter provides a key analysis of diffuse large B-cell lymphoma. Chapter 8, "Primary Intraocular Lymphoma: The Masquerade Syndrome", provides a comprehensive overview of primary intra-ocular lymphoma and a correct clinical approach towards this rare condition to avoid delays in diagnosis, which is considered the most important prognostic factor. In fact, a primary intra-ocular lymphoma arises with no specific symptoms and can mimic both inflammatory and non-inflammatory ocular conditions. This ocular malignant condition has a strong bond with primary central system lymphoma. Diagnosis is achieved through cytology, flow cytometry, immunohistochemistry, molecular analysis, and cytokines assay. Treatment of this condition has been completely revolutionized with the introduction of monoclonal antibodies directed against specific proteins present on the surface of lymphomatous cells.

The next three chapters are part of a section on special topics.

Chapter 9, "Primary Central Nervous System Lymphoma: Focus on Indian Perspective", investigates treatment methods for primary CNS lymphoma. Early suspicion, withholding steroids, stereotactic biopsy, and high-dose methotrexate are essential for the treatment of this disease, making its management in lower-middle income countries challenging. Novel radiological methods, clinician awareness about the disease, and utilization of drugs like thiotepa and ibrutinib, which can be given on an outpatient basis, may allow better management of these patients in resource-poor settings. The aforementioned challenges combined with the late-presenting demographic results in poorer treatment outcomes in the Indian subcontinent as compared to its western counterparts. This chapter presents the current standard of care for primary CNS lymphoma as well as potential modifications or research areas that may potentially improve outcomes in lower-middle income countries. Chapter 10, "Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL): Breast Imaging Perspective", examines this rare disease. Most cases present with rapid and dramatic breast swelling resulting from the peri-implant fluid collection. Palpable mass, pain, and skin lesions also occur. The combination of clinical history, physical exam findings, and appropriate imaging workup can lead to a timely and accurate diagnosis. The disease has an excellent prognosis when it is diagnosed at an early stage and complete surgery is performed. Radiologists, particularly those involved in breast imaging, play an essential role in early diagnosis. This chapter presents an overview of the disease, including relevant imaging findings. Finally, Chapter 11, "Lymphoma and the Microenvironmental Cross-Talk between Sex Hormone Receptors and Epstein-Barr Virus in Predicting Lymphoma Clinical Status", covers lymphoma in general with a focus on unique features linking the interaction of Epstein-Barr virus with sex steroid hormones in lymphoma cells.

> **Yusuf Tutar** Department of Basic Pharmaceutical Sciences, Division of Biochemistry, Hamidiye Faculty of Pharmacy,

University of Health Sciences-Turkey, Istanbul, Turkey Section 1
