Non-Hodgkin lymphoma
Lymphoma - non-Hodgkin; Lymphocytic lymphoma; Histiocytic lymphoma; Lymphoblastic lymphoma; Cancer - non-Hodgkin lymphoma
Non-Hodgkin lymphoma (NHL) is cancer of the lymph tissue. Lymph tissue is found in the lymph nodes, spleen, and other organs of the immune system.
White blood cells called lymphocytes are found in lymph tissue. They help prevent infections. Most lymphomas start in a type of white blood cell called the B lymphocyte, or B cell.
Causes
For most people, the cause of NHL is unknown. But lymphomas may develop in people with weakened immune systems, including people who have had an organ transplant or people with HIV infection.
NHL most often affects adults. Men develop NHL more often than women. Children can also develop some forms of NHL.
There are many types of NHL. One classification (grouping) is by how fast the cancer spreads. The cancer may be low grade (slow growing), intermediate grade, or high grade (fast growing).
NHL is further grouped by how the cells look under the microscope, what type of white blood cell it originates from, and whether there are certain DNA changes in the tumor cells themselves.
Symptoms
Symptoms depend on what area of the body is affected by the cancer and how fast the cancer is growing.
Symptoms may include:
- Drenching night sweats
-
Fever
and chills that come and go
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
- Itching
-
Swollen lymph nodes
in the neck, underarms, groin, or other areas
Swollen lymph nodes
Lymph nodes are present throughout your body. They are an important part of your immune system. Lymph nodes help your body recognize and fight germ...
- Weight loss
- Coughing or shortness of breath if the cancer affects the thymus gland or lymph nodes in the chest, putting pressure on the windpipe (trachea) or its branches
- Abdominal pain or swelling, leading to loss of appetite, constipation, nausea, and vomiting
-
Headache, concentration problems, personality changes, or
seizures
if the cancer affects the brain
Seizures
A seizure is the physical findings or changes in behavior that occur after an episode of abnormal electrical activity in the brain. The term "seizure...
Exams and Tests
The doctor will perform a physical exam and check body areas with lymph nodes to feel if they are swollen.
The disease may be diagnosed after biopsy of suspected tissue, usually a lymph node biopsy .
Lymph node biopsy
A lymph node biopsy is the removal of lymph node tissue for examination under a microscope. The lymph nodes are small glands that make white blood ce...
Other tests that may be done include:
- Blood test to check protein levels, liver function, kidney function, and uric acid level
-
Complete blood count
(CBC)
Complete blood count
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
-
CT scans
of the chest, abdomen and pelvis
CT scans
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
- Bone marrow biopsy
-
PET
(positron emission tomography) scan
PET
A positron emission tomography scan is a type of imaging test. It uses a radioactive substance called a tracer to look for disease in the body. A po...
If tests show you have NHL, more tests will be done to see how far it has spread. This is called staging. Staging helps guide future treatment and follow-up.
Treatment
Treatment depends on:
- The specific type of NHL
- The stage when you are first diagnosed
- Your age and overall health
- Symptoms, including weight loss, fever, and night sweats
You may receive chemotherapy , radiation therapy , or both. Or you may not need immediate treatment. Your doctor can tell you more about your specific treatment.
Chemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancerShrink the cancerPrevent the cancer from ...
Radiation therapy
Radiation therapy uses high-powered x-rays, particles, or radioactive seeds to kill cancer cells.
Radioimmunotherapy may be used in some cases. This involves linking a radioactive substance to an antibody that targets the cancerous cells and injecting the substance into the body.
A type of chemotherapy called targeted therapy may be tried. It uses a drug to zero in on specific targets (molecules) in or on cancer cells. Using these targets, the drug disables the cancer cells so they cannot spread.
Targeted therapy
Molecularly targeted anticancer agents; MTAs; Chemotherapy-targeted; Vascular endothelial growth factor-targeted; VEGF-targeted; VEGFR-targeted; Tyro...
High-dose chemotherapy may be given when NHL recurs or fails to respond to the first treatment administered. This is followed by an autologous stem cell transplant (using your own stem cells) to rescue the bone marrow after the high-dose chemotherapy. With certain types of NHL, these treatment steps are used at first remission to try and achieve a cure.
Stem cell transplant
A bone marrow transplant is a procedure to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Bone marrow is the soft, fat...
Blood transfusions or platelet transfusions may be required if blood counts are low.
You and your healthcare provider may need to manage other concerns during your leukemia treatment, including:
-
Having chemotherapy at home
Having chemotherapy at home
Home intravenous antibiotic therapy; Central venous catheter - home; Peripheral venous catheter - home; Port - home; PICC line - home; Infusion thera...
-
Managing your pets
during chemotherapy
Managing your pets
People with weakened immune systems may be advised to give up their pets to avoid getting diseases from the animals. People in this category include...
-
Bleeding problems
Bleeding problems
Cancer treatment - bleeding; Chemotherapy - bleeding; Radiation - bleeding; Bone marrow transplant - bleeding; Thrombocytopenia - cancer treatment...
-
Dry mouth
Dry mouth
Chemotherapy - dry mouth; Radiation therapy - dry mouth; Transplant - dry mouth; Transplantation - dry mouth
-
Eating enough calories
Eating enough calories
Getting more calories - adults; Chemotherapy - calories; Transplant - calories; Cancer treatment - calories
-
Safe eating
during cancer treatment
Safe eating
Cancer treatment - eating safely; Chemotherapy - eating safely; Immunosuppression - eating safely; Low white blood cell count - eating safely; Neutro...
Support Groups
You can ease the stress of illness by joining a cancer support group . Sharing with others who have common experiences and problems can help you not feel alone.
Cancer support group
The following organizations are good resources for information on cancer:American Cancer Society -- www. cancer. orgCancerCare -- www. cancercare. or...
Outlook (Prognosis)
Low-grade NHL often cannot be cured by chemotherapy alone. Low-grade NHL progresses slowly and may take many years before the disease gets worse or even requires treatment. The need for treatment is usually determined by symptoms, how fast the disease is progressing, and if blood counts are low.
Chemotherapy may cure many types of high-grade lymphomas. If the cancer does not respond to chemotherapy, the disease can cause rapid death.
Possible Complications
NHL itself and its treatments can lead to health problems. These include:
-
Autoimmune hemolytic anemia
Autoimmune hemolytic anemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to the body's tissues. Red blo...
- Infection
- Side effects of chemotherapy drugs
Keep following up with a doctor who knows about monitoring and preventing these complications.
When to Contact a Medical Professional
Call your health care provider if you develop symptoms of this disorder.
If you have NHL, call your provider if you experience persistent fever or other signs of infection.
References
National Cancer Institute: PDQ adult non-Hodgkin lymphoma treatment. Bethesda, MD: National Cancer Institute. Updated January 25, 2016. cancer.gov/cancertopics/pdq/treatment/adult-non-hodgkins/HealthProfessional . Accessed March 17, 2016.
National Cancer Institute: PDQ childhood non-Hodgkin lymphoma treatment. Bethesda, MD: National Cancer Institute. Updated January 26, 2015. cancer.gov/cancertopics/pdq/treatment/child-non-hodgkins/HealthProfessional . Accessed March 17, 2016.
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: non-Hodgkin lymphomas. Version 2.2016. www.nccn.org/professionals/physician_gls/pdf/nhl.pdf . Accessed March 17, 2016.
Roschewiski MJ, Wilson WH. Non-Hodgkin lymphoma. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology . 5th ed. Philadelphia, PA: Elsevier; 2014:chap 106.
-
Lymphoma, malignant - CT scan - illustration
This abdominal CT scan shows tumor masses (malignant lymphomas) in the area behind the peritoneal cavity (retroperitoneal space).
Lymphoma, malignant - CT scan
illustration
-
Immune system structures - illustration
The immune system protects the body from potentially harmful substances. The inflammatory response (inflammation) is part of innate immunity. It occurs when tissues are injured by bacteria, trauma, toxins, heat or any other cause.
Immune system structures
illustration
-
Lymphoma, malignant - CT scan - illustration
This abdominal CT scan shows tumor masses (malignant lymphomas) in the area behind the peritoneal cavity (retroperitoneal space).
Lymphoma, malignant - CT scan
illustration
-
Immune system structures - illustration
The immune system protects the body from potentially harmful substances. The inflammatory response (inflammation) is part of innate immunity. It occurs when tissues are injured by bacteria, trauma, toxins, heat or any other cause.
Immune system structures
illustration
-
Non-Hodgkin's lymphoma
(In-Depth)
-
Lymphoma
(Alt. Medicine)
-
Hodgkin disease
(In-Depth)
Review Date: 2/1/2016
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.