Lymphoma is a group of cancers that begins in cells of the lymphatic system. The two major categories are Hodgkin lymphoma and non-Hodgkin lymphoma, which contain many different subtypes.
Lymphoma is a broad term for cancers arising from cells of the lymph system. Hodgkin lymphoma and non-Hodgkin lymphoma are the two major categories. Non-Hodgkin lymphoma includes many B-cell, T-cell and other subtypes that may behave as indolent or aggressive disease.
The lymphatic system includes lymph nodes, lymphatic vessels, spleen, thymus and other lymphoid tissues. Lymphocytes are immune cells that normally help recognize and fight infection.
Lymphoma develops after genetic or molecular changes cause a lymphocyte to grow or survive abnormally. The altered cells can accumulate in lymph nodes or other lymphoid and non-lymphoid tissues.
Abnormal lymphocytes grow and survive when they should not. They may accumulate in lymph nodes or other tissues, form masses and sometimes spread to organs outside the lymphatic system.
Lymphoma is first broadly divided into Hodgkin lymphoma and non-Hodgkin lymphoma. Hodgkin lymphoma includes classic Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. Non-Hodgkin lymphoma contains numerous B-cell, T-cell and other subtypes classified by pathology, immunophenotype, genetics and clinical behavior.
Major categories include Hodgkin lymphoma and non-Hodgkin lymphoma. Hodgkin lymphoma includes classic subtypes and nodular lymphocyte-predominant Hodgkin lymphoma. Non-Hodgkin lymphoma includes indolent and aggressive B-cell and T-cell lymphomas such as diffuse large B-cell lymphoma, follicular lymphoma and mantle cell lymphoma.
Painless swollen lymph nodes in the neck, armpit or groin
Unexplained fever
Drenching night sweats
Unexplained weight loss
Persistent fatigue
Itchy skin
Cough or breathing difficulty when chest lymph nodes are involved
Chest discomfort or pressure
Abdominal fullness or pain
Bone pain or localized discomfort
Reduced appetite
Recurrent infections in selected cases
The exact cause of most lymphomas is not known. Risk can be influenced by immune-system disorders, certain infections, inherited susceptibility, autoimmune disease, immunosuppressive treatment and other biological factors depending on the subtype.
Increasing age for many non-Hodgkin lymphomas
Certain immune-system disorders
Organ transplantation and immunosuppressive medicines
HIV or other significant immune deficiency
Certain viral infections such as Epstein-Barr virus
Certain bacterial infections such as Helicobacter pylori for selected lymphomas
Autoimmune disease
Family history of lymphoma
Previous cancer treatment or other selected exposures
Diagnosis generally involves medical history and physical examination followed by tissue biopsy. Blood tests, CT, PET-CT, MRI or other investigations may be used for classification, staging and assessment of organ involvement.
Painless enlarged lymph nodes
Fever without an obvious infection
Drenching night sweats
Unexplained weight loss
Pallor or signs of anemia
Enlarged spleen or liver
Skin changes or lesions in selected lymphomas
Respiratory findings when chest disease is present
Abdominal fullness or tenderness
General weakness or fatigue
Complete blood count with differential
Peripheral blood smear when clinically indicated
Comprehensive metabolic panel
Lactate dehydrogenase (LDH)
Uric acid and other tumor-lysis-related chemistry when appropriate
Erythrocyte sedimentation rate in selected Hodgkin lymphoma evaluations
Viral testing such as HIV, hepatitis B or hepatitis C when relevant to treatment planning
Bone marrow examination when indicated
Pathology and immunophenotyping of biopsy tissue
CT scan of involved body regions
FDG PET-CT
MRI for selected sites or neurologic concerns
Ultrasound for selected superficial or abdominal findings
Chest imaging when thoracic involvement is suspected
Excisional or core lymph-node biopsy with expert pathology review
Immunohistochemistry and immunophenotyping
Flow cytometry
Cytogenetic and molecular testing
Bone marrow biopsy in selected patients
Lumbar puncture and cerebrospinal-fluid testing in selected high-risk situations
Reactive lymph-node enlargement from infection
Tuberculosis or other chronic infections
Viral infections such as infectious mononucleosis
Autoimmune or inflammatory diseases
Metastatic solid cancer involving lymph nodes
Leukemia
Benign lymphoid disorders
Many lymphomas are staged using systems based on the distribution of disease, including Ann Arbor/Lugano concepts. Hodgkin lymphoma is commonly categorized into stages I through IV, with additional descriptors such as A/B symptoms and bulky disease. Staging approaches differ among lymphoma subtypes.
Staging or grading systems differ between diseases. The information here is educational and should be interpreted by a qualified healthcare professional in the context of the individual case.
Treatment depends on the exact lymphoma subtype, stage, symptoms and risk characteristics. Options may include watchful waiting for selected indolent disease, chemotherapy, radiation therapy, immunotherapy, targeted therapy, antibody-based treatment, cellular therapy and stem-cell transplantation.
Chemotherapy combinations selected according to lymphoma subtype
Rituximab or other anti-CD20 antibody therapy for appropriate B-cell lymphomas
Brentuximab vedotin for selected CD30-positive lymphomas
Immune checkpoint inhibitors for selected Hodgkin lymphoma and other indications
Targeted therapies selected according to lymphoma subtype and molecular features
Supportive antibiotics, antivirals, antifungals or growth-factor treatment when clinically indicated
Corticosteroids as components of selected lymphoma treatment regimens
Medicines listed here are for educational information only. Do not start, stop, or change a medicine without professional medical advice.
Complications may result from lymphoma itself, organ involvement, immune dysfunction or treatment. These can include severe infection, compression of organs, airway or vascular obstruction, cytopenias, tumor lysis syndrome, blood clots and treatment-related toxicity.
Fever during chemotherapy or significant immune suppression
Severe difficulty breathing or rapidly worsening chest pressure
New confusion, seizure, severe headache or sudden neurologic symptoms
Uncontrolled bleeding or vomiting blood
Rapidly worsening weakness, fainting or severe dizziness
Severe abdominal pain, rapidly increasing swelling or inability to pass urine
If symptoms are severe, rapidly worsening, or life-threatening, seek emergency medical care immediately.
The outlook varies greatly among lymphoma subtypes. Some lymphomas are highly treatable or curable, while others may behave chronically or aggressively. Prognosis depends on subtype, stage, biology, age, general health and treatment response.
Survival statistics describe outcomes in groups of people and cannot predict exactly what will happen to one individual. Prognosis depends on factors such as cancer stage, tumor biology, treatment response, overall health, and follow-up.
Lymphoma can occur at any age. Hodgkin lymphoma has characteristic age peaks, while many non-Hodgkin lymphomas become more common with increasing age. Epidemiology differs substantially between individual subtypes.
Most lymphomas cannot be completely prevented. General risk reduction includes avoiding tobacco, following occupational safety measures and reducing avoidable exposure to harmful chemicals or radiation. Some infection-related risks can be reduced through appropriate prevention and medical care.
What exact lymphoma subtype has been diagnosed?
Was the biopsy reviewed by a lymphoma-experienced pathologist?
What stage and risk category does the lymphoma have?
Are there specific genetic or molecular findings?
What treatment is recommended and why?
Is observation appropriate or should treatment begin now?
Will PET-CT be used to assess treatment response?
What side effects require immediate medical attention?
Should radiation, targeted therapy, immunotherapy or transplantation be considered?
What follow-up tests and schedule will be required?
BimariDur provides educational health information to help people understand diseases, symptoms, tests, and treatment concepts. It does not replace examination, diagnosis, or treatment by a qualified healthcare professional.
Do not delay professional medical care because of information read on BimariDur.