Lymphoma

Overview

Lymphoma is a cancer of the lymphatic system, which is part of the body’s germ-fighting network.

The lymphatic system includes the lymph nodes (lymph glands), spleen, thymus gland and bone marrow. Lymphoma can affect all those areas as well as other organs throughout the body.

Many types of lymphoma exist. The main subtypes are:

  • Hodgkin’s lymphoma (formerly called Hodgkin’s disease)
  • Non-Hodgkin’s lymphoma

What lymphoma treatment is best for you depends on your lymphoma type and its severity. Lymphoma treatment may involve chemotherapy, immunotherapy medications, radiation therapy, a bone marrow transplant or some combination of these.

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Symptoms

Signs and symptoms of lymphoma may include:

  • Painless swelling of lymph nodes in your neck, armpits or groin
  • Persistent fatigue
  • Fever
  • Night sweats
  • Shortness of breath
  • Unexplained weight loss
  • Itchy skin

Causes

Doctors aren’t sure what causes lymphoma. But it begins when a disease-fighting white blood cell called a lymphocyte develops a genetic mutation. The mutation tells the cell to multiply rapidly, causing many diseased lymphocytes that continue multiplying.

The mutation also allows the cells to go on living when other normal cells would die. This causes too many diseased and ineffective lymphocytes in your lymph nodes and causes the lymph nodes, spleen and liver to swell.

Risk factors

Factors that can increase the risk of lymphoma include:

  • Your age. Some types of lymphoma are more common in young adults, while others are most often diagnosed in people over 55.
  • Being male. Males are slightly more likely to develop lymphoma than are females.
  • Having an impaired immune system. Lymphoma is more common in people with immune system diseases or in people who take drugs that suppress their immune system.
  • Developing certain infections. Some infections are associated with an increased risk of lymphoma, including the Epstein-Barr virus and Helicobacter pylori infection.

When to see a doctor

Make an appointment with your doctor if you have any persistent signs or symptoms that worry you.

Diagnosis

Tests and procedures used to diagnose lymphoma include:

  • Physical exam. Your doctor checks for swollen lymph nodes, including in your neck, underarm and groin, as well as a swollen spleen or liver.
  • Removing a lymph node for testing. Your doctor may recommend a lymph node biopsy procedure to remove all or part of a lymph node for laboratory testing. Advanced tests can determine if lymphoma cells are present and what types of cells are involved.
  • Blood tests. Blood tests to count the number of cells in a sample of your blood can give your doctor clues about your diagnosis.
  • Removing a sample of bone marrow for testing. A bone marrow aspiration and biopsy procedure involves inserting a needle into your hipbone to remove a sample of bone marrow. The sample is analyzed to look for lymphoma cells.
  • Imaging tests. Your doctor may recommend imaging tests to look for signs of lymphoma in other areas of your body. Tests may include CT, MRI and positron emission tomography (PET).

Other tests and procedures may be used depending on your situation.

Many types of lymphoma exist and knowing exactly which type you have is key to developing an effective treatment plan. Research shows that having a biopsy sample reviewed by an expert pathologist improves the chances for an accurate diagnosis. Consider getting a second opinion from a specialist who can confirm your diagnosis.

Treatment

Which lymphoma treatments are right for you depends on the type and stage of your disease, your overall health, and your preferences. The goal of treatment is to destroy as many cancer cells as possible and bring the disease into remission.

Lymphoma treatments include:

  • Active surveillance. Some forms of lymphoma are very slow growing. You and your doctor may decide to wait to treat your lymphoma when it causes signs and symptoms that interfere with your daily activities. Until then, you may undergo periodic tests to monitor your condition.
  • Chemotherapy. Chemotherapy uses drugs to destroy fast-growing cells, such as cancer cells. The drugs are usually administered through a vein, but can also be taken as a pill, depending on the specific drugs you receive.
  • Radiation therapy. Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells.
  • Bone marrow transplant. A bone marrow transplant, also known as a stem cell transplant, involves using high doses of chemotherapy and radiation to suppress your bone marrow. Then healthy bone marrow stem cells from your body or from a donor are infused into your blood where they travel to your bones and rebuild your bone marrow.
  • Other treatments. Other drugs used to treat lymphoma include targeted drugs that focus on specific abnormalities in your cancer cells. Immunotherapy drugs use your immune system to kill cancer cells. A specialized treatment called chimeric antigen receptor (CAR)-T cell therapy takes your body’s germ-fighting T cells, engineers them to fight cancer and infuses them back into your body.