Lymphoma is a cancer of the lymphatic system. There are two main types of lymphoma. They develop and are treated in different ways. They are: Hodgkin lymphoma non-Hodgkin lymphoma (NHL). A doctor can only find out your lymphoma type by collecting some lymphoma cells and testing them in a laboratory. If the sample contains a type of cell called Reed-Sternberg cells, the lymphoma is usually Hodgkin lymphoma. If there are no Reed-Sternberg cells, it is non-Hodgkin lymphoma. There are many different types of NHL. The causes of lymphoma are mostly unknown. But some things may increase the risk of developing it, such as having a weakened immune system. These are called risk factors. Having one or more of these risk factors does not mean you will get lymphoma. Many people with lymphoma do not have any risk factors.
Symptoms of lymphoma
Some people have other symptoms, depending on where the lymphoma is in their body. Local symptoms may include the following: If the lymphoma is in the chest area, symptoms include a cough, difficulty swallowing or breathlessness. If the lymphoma is in the stomach or bowel, symptoms include indigestion, tummy pain or weight loss. Pain caused by pressure from swollen lymph nodes. For example, pain in an area such as the tummy (abdomen). This is not common. Occasionally, and only in Hodgkin lymphoma, aching or painful swollen lymph nodes soon after drinking alcohol. Lymphoma can also cause symptoms that affect the whole body, including: heavy, drenching sweats, especially at night high temperatures over 38˚C (100.4˚F) that come and go without any obvious cause unexplained weight loss tiredness itching all over the body that does not go away. Some people do not have any of these symptoms and the lymphoma is found during tests for other conditions.
Diagnosis of lymphoma
If you have symptoms, you usually start by seeing your GP. They may arrange for you to have blood tests or scans. Your doctor will refer you to hospital for tests and for specialist advice and treatment. At the hospital, the doctor will ask about any symptoms, your general health and any illnesses you have had. They will also examine you. Biopsy for lymphoma The most important test for diagnosing lymphoma is a biopsy. A doctor or nurse removes a small piece of tissue or a sample of cells from the affected area. The most common place to take a biopsy from is an enlarged lymph node. You may have all or part of the lymph node removed. The tissue is examined under a microscope by a doctor called a pathologist. They look for lymphoma cells and do different tests on the cells. You will have more tests before you start treatment for lymphoma. Some tests help to show the stage of the lymphoma. You may have other tests, such as blood tests or x-rays to check your general health and how well your heart, lungs, liver and kidneys are working. For example, your doctor will do blood tests to check the levels of different blood cells in your blood. They may also talk to you about having blood tests to check for certain viruses, such as HIV and hepatitis.
staging of lymphoma
Knowing the extent of the lymphoma helps your doctor plan the right treatment. This is called staging.
Grade of non-Hodgkin lymphoma
Non-Hodgkin lymphoma is also grouped as either low grade or high grade. Low grade lymphomas grow very slowly. High grade lymphomas grow more quickly. The grade of NHL is important in deciding your treatment. The stage of a lymphoma is usually described using numbers from 1 to 4. Stages 1 and 2 are sometimes called early stage (limited or localised lymphoma). Stages 3 and 4 are sometimes called advanced lymphoma. In some situations, stage 2 lymphoma that is large (bulky) is treated as advanced disease.
Staging of Hodgkin lymphoma
Stage 1
The lymphoma is either: in a single lymph node, one group of lymph nodes, or in one organ of the lymphatic system, such as the tonsils or in another part of the body outside the lymph system (extra-nodal).
Stage 2
The lymphoma is either: in two or more groups of lymph nodes or in another part of the body (extra-nodal) and in one group of lymph nodes.
Stage 3
Lymphoma in two groups of lymph nodes
Stage 4
There are areas of lymphoma outside and separate from the lymphatic system. For example, this could be in organs such as the bone marrow, lungs or liver.
Stage and grade of non-Hodgkin lymphoma
Stage 1
The lymphoma is either: in a single lymph node, one group of lymph nodes, or in one organ of the lymphatic system, such as the tonsils or in another part of the body outside the lymph system (extra-nodal)
Stage 2
The lymphoma is either: in two or more groups of lymph nodes or in another part of the body (extra-nodal) and in one group of lymph nodes.
Stage 3
Lymphoma in two groups of lymph nodes
Stage 4
The lymphoma is more widespread and may also affect organs such as the bone marrow, lungs or liver
Lymphoma treatment
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT). Your doctor or cancer specialist nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions.
The treatment you have will depend on: the type and stage of the lymphoma
- its grade (if you have non-Hodgkin lymphoma)
- the symptoms you have
- which parts of your body are affected
- your general health your preferences.
Source: Lymphoma - symptoms, causes and treatment | Macmillan Cancer Support