Non-Hodgkin's Lymphoma

Lymphomas are cancers of the lymphatic system, which drains fluid from tissues and interacts with the circulatory system to distribute immune cells and other substances throughout the body. Lymphomas include Hodgkin’s disease and non-Hodgkin’s lymphoma. Because of improving treatment, death rates from Hodgkin’s disease have fallen noticeably since the early 1970s.

What is non-Hodgkin lymphoma?

Non-Hodgkin disease is a type of lymphoma, which is a cancer in the lymphatic system. The American Cancer Society estimates that there will be 72,240 new cases of non-Hodgkin lymphoma in 2017. NHL is the third most common cancer in childhood.

Non-Hodgkin lymphoma causes the cells in the lymphatic system to abnormally reproduce, eventually causing tumors to grow. Non-Hodgkin lymphoma cells can also spread to other organs.

There are several types of non-Hodgkin lymphoma, which are classified by how quickly they spread.

What are the symptoms of non-Hodgkin lymphoma?

The following are the most common symptoms of non-Hodgkin lymphoma. However, each individual may experience symptoms differently.

Symptoms may include:

  • painless swelling of lymph nodes in neck, underarm, and groin
  • fever
  • night sweats
  • fatigue
  • weight loss
  • itching of the skin
  • recurring infections
The symptoms of non-Hodgkin lymphoma may resemble other blood disorders or medical problems, such as influenza or other infections. Always consult your physician for a diagnosis.

What are the risk factors for non-Hodgkin lymphomas?

Suggested risk factors for non-Hodgkin lymphomas include the following:
  • genetic disease of the immune system
  • exposure to radiation
  • exposure to chemicals such as benzene and herbicides
  • organ transplantation
  • infections with human immunodeficiency virus (HIV) or human T-cell leukemia/lymphoma virus (HTLV-1)
  • infections with the parasite that causes malaria
  • history of infectious mononucleosis (caused by an infection with the Epstein-Barr virus)
  • Helicobacter pylori (H. pylori) bacterium, which has been identified as a cause of stomach ulcers

What causes non-Hodgkin lymphoma?

No specific cause has been identified.

How is non-Hodgkin lymphoma diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for non-Hodgkin lymphoma may include the following:
  • additional blood tests and other evaluation procedures
  • x-rays of the chest, bones, liver, and spleen - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • lymph node biopsy - a procedure performed to remove tissue or cells from the body for examination under a microscope.
  • bone marrow aspiration and/or biopsy - a procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.
  • lymphangiograms - x-rays of the lymphatic system.
  • computed tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
  • ultrasound (Also called sonography.) - a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
  • positron emission tomography (PET) - a type of nuclear medicine procedure. This means that a tiny amount of a radioactive substance, called a radionuclide (radiopharmaceutical or radioactive tracer), is used during the procedure to assist in the examination of the tissue under study. Specifically, PET studies evaluate the metabolism of a particular organ or tissue, so that information about the physiology (functionality) and anatomy (structure) of the organ or tissue is evaluated, as well as its biochemical properties. Thus, PET may detect biochemical changes in an organ or tissue that can identify the onset of a disease process before anatomical changes related to the disease can be seen with other imaging processes such as computed tomography (CT) or magnetic resonance imaging (MRI).

Treatment for non-Hodgkin lymphoma

Specific treatment for non-Hodgkin lymphoma will be determined by your physician based on:
  • your age, overall health, and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference
Treatment may include:
  • radiation therapy
  • chemotherapy
  • biologic (immune) therapy or peripheral blood stem cell transplantation
  • surgery
  • high-dose chemotherapy with bone marrow transplant or peripheral blood stem cell
  • transplantation