What is Lymphoma?

Lymphoma is a type of cancer that arises from a lymphocyte, a type of white blood cell, and affects the lymphatic system. There are two main types of lymphoma: non-Hodgkin (NHL) and Hodgkin. 

Hodgkin lymphoma arises from cancer in a lymphocyte, a type of white blood cell that helps to fight infection. Hodgkin lymphoma is distinguished from Non-Hodgkin lymphoma (NHL) by the presence of Reed-Sternberg cells (named for the scientists who first identified them). Based on characteristics of the disease, Hodgkin lymphoma is divided into two main subtypes, classical Hodgkin lymphoma and Nodular lymphocyte-predominant Hodgkin lymphoma. Approximately 95% of persons diagnosed with Hodgkin lymphoma have classical Hodgkin lymphoma. 

Non-Hodgkin lymphoma also arises from cancer of a lymphocyte and develops in the lymph nodes, lymphatic tissues, or bone marrow and blood. Non-Hodgkin lymphoma can be characterized as either slow-growing (indolent) or fast-growing (aggressive). NHL is further characterized by the type of lymphocyte that is affected, B lymphocyte, T lymphocyte, or Natural killer cells. The majority, approximately 85%, of NHL cases start in B lymphocytes. In both cases, the cancerous lymphocyte multiplies and begins to crowd out normal white blood cells. These cancerous cells can grow and form masses throughout our bodies in the lymphatic system.

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of lymphoma. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Symptoms of lymphoma depend upon how advanced the cancer is and can include:

• Abdominal pain
• Cough
• Drenching night sweats, 
• Enlarged spleen or liver
• Feeling of bloating or fullness
• Fever and chills
• Itchiness
• Loss of appetite
• Painless, enlarged lymph nodes in the neck, groin or armpit
• Persistent fatigue
• Rashes or skin lumps
• Shortness of breath
• Stomach pain that does not go away
• Weight loss without cause

Diagnosis

If lymphoma is suspected, we perform a physical examination and ask questions about symptoms. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Common diagnostic procedures can include:

Blood test: Blood is examined for cancer cells.

Bone marrow test: During this test, a local anesthetic is used to numb the area where the sample of bone marrow will be taken, typically from the hip. A small incision is made and a thin, hollow needle goes into the bone to collect a small portion of marrow to examine for cancer cells.

Imaging tests: Imaging tests such as chest X-ray, MRI, CT scans, and PET scans are often used to see if cancer has spread to other parts of the body.

Lymph node biopsy: In this test, a thin needle is inserted into a lymph node in the neck, armpit or groin and a small sample of cells is removed and examined for cancer.

In certain subtypes of lymphoma, other diagnostic studies, such as spinal tap or colonoscopy, may be necessary. 

Risk Factors

Risk factors that can contribute to lymphoma include:

Age: Most people diagnosed with Hodgkin lymphoma are between ages 15 and 30 or older than 55. The majority of those diagnosed with NHL are over the age of 60. 

Being male: lymphoma is diagnosed more often in men than women.

Exposure to herbicides and pesticides: A higher incidence of NHL has been noted in farming communities suggesting that exposure to certain chemicals in herbicides and pesticides may contribute to the development of NHL. 

Family history: Scientists are studying if people with a parent or sibling with Hodgkin lymphoma are at higher risk for the condition.

Radiation treatment: People treated for cancer with radiation are more likely to get lymphoma than those not treated.

Viral Infection: Persons infected with human immunodeficiency virus (HIV), H Pylori, Hepatitis C, Human t-cell lymphotropic virus-1, or Epstein-Bar virus are at an increased risk of developing lymphoma.

Weak immune system: Those with a weak immune system either because of an acquired immunodeficiency like HIV or solid organ transplant, or those with an autoimmune disease may be at an increased risk for lymphoma.

Prognosis

The prognosis for people with lymphoma depends upon the person’s age and the type of lymphoma. But advances in diagnosis and treatment of lymphoma give people with this type of cancer a chance for full recovery.

Treatment and Recovery

Lymphoma treatment depends on a person’s overall health and whether the cancer is Hodgkin on non-Hodgkin lymphoma. 

The main treatments for non-Hodgkin lymphoma are:

Chemotherapy

Special drugs designed to kill cancer cells can be given as a pill or injected into the bloodstream. 

Immunotherapy 

This treatment uses a synthetic version of immune system cells that are designed to help the body boost its natural defenses to fight the cancer.

Radiation Therapy

High-energy radiation is administered to affected lymph nodes in order to kill cancer cells. Most often, radiation treatments are given five days a week for several weeks.

Stem Cell Transplant 

Before the transplant, a patient receives high doses of chemotherapy or radiation to destroy cancer cells. Then, the patient receives an infusion of healthy blood-forming stem cells either from a donor or one’s own stem cells. The stem cells travel to the bone marrow and begin producing new blood cells.

Watch and Wait 

Your doctor may determine that a watch-and-wait protocol is best. During this time, your doctor will monitor your condition with exams and lab tests.

The main treatments for Hodgkin lymphoma are:

Chemotherapy

Special drugs designed to kill cancer cells can be given as a pill or injected into the bloodstream. 

Radiation Therapy

High-energy radiation is administered in order to kill cancer cells. Most often, radiation treatments are given five days a week for several weeks.

Stem Cell Transplant

 Before the transplant, a patient receives high doses of chemotherapy or radiation to destroy cancer cells. Then, the patient receives an infusion of healthy blood-forming stem cells either from a donor or one’s own stem cells. The stem cells travel to the bone marrow and begin producing new blood cells.

Complications

Complications of lymphoma stem from the depletion of normal blood cells, as well as side effects of treatment, and may include:

Frequent infections: Because lymphoma affects the lymphocyte cells which fight infection, your immune system may be weak and make you prone to infection.

Second cancer: Because treatment can damage healthy cells, a person treated for lymphoma is at risk for developing a second cancer.

Heart and lung disease: People with lymphoma have a higher risk of also developing heart and lung disease.