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What to know about lymphoma

Medically reviewed by Christina Chun, MPH — Written by Adam Felman on August 22, 2019
Types
Symptoms
Treatment
Risk factors
Diagnosis
Outlook
Lymphoma is a cancer of the lymphatic system. It develops in lymphocytes, which are a type
of white blood cell. These cells help fight disease in the body and play an essential role in
the body’s immune defenses.

As this type of cancer is present in the lymph system, it can quickly metastasize, or spread,
to different tissues and organs throughout the body. Lymphoma most often spreads to the
liver, bone marrow, or lungs.

People of any age can develop lymphoma, but it is among the most common causes of
cancer in children and young adults aged 15–24 years. It is often treatable.

In this article, we look at the symptoms of lymphoma, how to treat it, and the risk factors for
the different types.

Types
There are two main types of lymphoma: Hodgkin and non-Hodgkin lymphoma. Within these,
there are many subtypes.

Non-Hodgkin lymphoma
Swollen glands that do not go away can be a sign of lymphoma.
Non-Hodgkin lymphoma, which is the most common type, typically develops from B and T
lymphocytes (cells) in the lymph nodes or tissues throughout the body. Tumor growth in
non-Hodgkin lymphoma may not affect every lymph node, often skipping some and growing
on others.

It accounts for 95% of lymphoma cases.

According to the National Cancer Institute (NCI), non-Hodgkin lymphoma accounts for
4.2%Trusted Source of all cancers in the United States, and a person’s lifetime risk of
developing it is about 2.2%.
Hodgkin lymphoma
Hodgkin lymphoma is a cancer of the immune system, and doctors can identify it by the
presence of Reed-Sternberg cells, which are abnormally large B lymphocytes. In people with
Hodgkin lymphoma, the cancer usually moves from one lymph node to an adjacent one.

The NCI estimate that Hodgkin lymphoma accounts for 0.5%Trusted Source of all cancers
and approximately 0.2% of people in the U.S. will receive a diagnosis in their lifetime.

Symptoms
The symptoms of lymphoma are similar to those of some viral diseases, such as the
common cold. However, they typically continue for a more extended period.

Some people will not experience any symptoms. Others may notice a swelling of the lymph
nodes. There are lymph nodes all around the body. Swelling often occurs in the neck, groin,
abdomen, or armpits.

The swellings are often painless. They may become painful if the enlarged glands press on
organs, bones, and other structures. Some people confuse lymphoma with back pain.

Lymph nodes can also swell during common infections, such as a cold. In lymphoma, the
swelling does not resolve. Pain is also more likely to accompany the swelling if it has
occurred due to an infection.

The overlap of symptoms can lead to misdiagnosis. Anyone who has persistently swollen
glands should see their doctor for a consultation.

Other symptoms of both types of lymphoma may include:

ongoing fever without infection

night sweats, fever, and chills
weight loss and reduced appetite
unusual itching
persistent fatigue or a lack of energy
pain in lymph nodes after drinking alcohol
Some additional symptoms of non-Hodgkin lymphoma include:

persistent coughing
shortness of breath
pain or swelling in the abdomen
Pain, weakness, paralysis, or altered sensation may occur if an enlarged lymph node
presses against spinal nerves or the spinal cord.

Lymphoma can spread rapidly from the lymph nodes to other parts of the body through the
lymphatic system. As cancerous lymphocytes spread into other tissues, the immune system
cannot defend against infections as effectively.

Treatment
Chemotherapy is one of the possible treatments that doctors may use to treat lymphoma.
The course of treatment depends on the type of lymphoma a person has and the stage it has
reached.

Indolent, or slow growing lymphoma may not need treatment.

Watchful waiting may be enough to make sure the cancer does not spread.

If treatment is necessary, it may involve the following:

Biologic therapy: This is a drug treatment that stimulates the immune system to attack the
cancer. The drug achieves this by introducing living microorganisms into the body.
Antibody therapy: A medical professional inserts synthetic antibodies into the bloodstream.
These respond to the cancer’s toxins.
Chemotherapy: A healthcare team administers aggressive drug treatment to target and kill
cancer cells.
Radioimmunotherapy: This delivers high powered radioactive doses directly into cancerous
B cells and T-cells to destroy them.
Radiation therapy: A doctor may recommend this type of therapy to target and destroy small
areas of cancer. Radiation therapy uses concentrated doses of radiation to kill cancerous
cells.
Stem cell transplantation: This can help restore damaged bone marrow following high dose
chemotherapy or radiation therapy.
Steroids: A doctor may inject steroids to treat lymphoma.
Surgery: A surgeon may remove the spleen or other organs after the lymphoma has spread.
However, a cancer specialist, or oncologist, will more commonly request surgery to obtain a
biopsy.
Read more about the most severe stage of lymphoma.

Risk factors
Different risk factors can increase the risk of both types of lymphoma.

Non-Hodgkin lymphoma
Risk factors for non-Hodgkin lymphoma include:

Age: Most lymphomas occur in people aged 60 years and older. However, some types are
more likely to develop in children and young adults.
Sex: Some types are more likely in women. Men have a higher risk of other types.
Ethnicity and location: In the U.S., African American and Asian American people have a
lower risk for non-Hodgkin lymphoma than white people. Non-Hodgkin Lymphoma is more
common in developed nations.
Chemicals and radiation: Nuclear radiation and certain agricultural chemicals have links to
non-Hodgkin lymphoma.
Immunodeficiency: A person with a less active immune system has a higher risk. This may
be due to anti-rejection medications following an organ transplant or HIV.
Autoimmune diseases: This type of disease occurs when the immune system attacks the
body’s own cells. Examples include rheumatoid arthritis and celiac disease.
Infection: Certain viral and bacterial infections that transform lymphocytes, such as the
Epstein-Barr virus (EBV), increase the risk. This virus causes glandular fever.
Breast implants: These can lead to anaplastic large cell lymphoma in the breast tissue.
Body weight and diet: The American Cancer Society (ACS) has suggested that overweight
and obesity may have some involvement in the development of lymphoma. However, more
research is necessary to confirm the link.
Hodgkin lymphoma
Risk factors for Hodgkin lymphoma include:

Infectious mononucleosis: The Epstein-Barr virus (EBV) can cause mononucleosis. This
disease increases the risk of lymphoma.
Age: People aged 20–30 years and those 55 years of age have a higher risk of lymphoma.
Sex: Hodgkin lymphoma is slightly more common in males than females.
Family history: If a sibling has Hodgkin lymphoma, the risk is slightly higher. If the sibling is
an identical twin, this risk increases significantly.
HIV infection: This can weaken the immune system and increase the risk of lymphoma.

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Diagnosis
A doctor may request imaging scans to help diagnose lymphoma.
There are no routine screenings for lymphoma. If a person has persistent viral symptoms,
they should seek medical consultation.

The doctor will ask about the person’s individual and family medical history and try to rule
out other conditions.

They will also carry out a physical examination, including an inspection of the abdomen and
chin, neck, groin, and armpits, where swellings may occur.

The doctor will look for signs of infection near lymph nodes since this can account for most
cases of swelling.

Tests for lymphoma

Tests will confirm whether lymphoma is present.

Blood tests and biopsies: These can detect the presence of lymphoma and help a doctor
distinguish between different types.

A biopsy involves a surgeon taking a sample of lymph tissue. The doctor will then send it for
examination in a laboratory. The surgeon may remove a small section or all of a lymph node.
In some cases, they might use a needle to take a tissue sample.
It might be necessary to carry out a bone marrow biopsy. This may require a local
anesthetic, a sedative, or a general anesthetic.

Biopsies and other tests can confirm the stage of the cancer to see whether it has spread to
other parts of the body.

Imaging tests: A doctor may request imaging scans, such as:

a CT scan
an MRI scan
a PET scan
X-ray imaging of the chest, abdomen, and pelvis
ultrasound
A spinal tap: In this procedure, a surgeon uses a long, thin needle to remove and test spinal
fluid under local anesthetic.

Staging of the cancer depends on the type, growth rate, and cellular characteristics. In stage
0 or 1, the cancer stays in a confined area. By stage 4, it has spread to more distant organs,
and doctors find it more challenging to treat.

A doctor may also describe lymphoma as indolent, meaning that it remains in one place.
Some lymphomas are aggressive, which means they spread to other parts of the body.

Outlook
With treatment, more than 72%Trusted Source of people with a diagnosis of non-Hodgkin
lymphoma will survive for at least 5 years.

With Hodgkin lymphoma, 86.6%Trusted Source of people who receive treatment will survive
for at least 5 years.

The chances of a good outcome decrease as lymphoma progresses. It is essential to seek

medical attention for any symptoms of cold or infection that continue for an extended period.
Early diagnosis can improve a person’s chances of successful treatment.

Q:
Where does lymphoma spread to?

A:
When someone has stage 3-4 lymphoma, it means that the cancer has spread to other
areas of the body beyond the lymphoma nodes. Lymphoma most often spreads to the liver,
bone marrow, or lungs.

Depending on the subtype, these types of lymphoma are common, still very treatable and
often curable.

Trusted Source
Answers represent the opinions of our medical experts. All content is strictly informational
and should not be considered medical advice.
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Last medically reviewed on August 22, 2019

LymphomaBlood / HematologyCancer / Oncology

12 sourcescollapsed

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