Lymphoma is a type of cancer that begins in the lymphatic system, which is a part of the body’s immune system. It primarily affects lymphocytes, a type of white blood cell that plays a crucial role in fighting infections. Lymphoma causes these cells to grow uncontrollably, forming tumors that can spread to other parts of the body.

There are two main categories of lymphoma: Hodgkin lymphoma (formerly known as Hodgkin’s disease) and non-Hodgkin lymphoma (NHL). Each type has multiple subtypes and different characteristics.

1. Hodgkin Lymphoma (HL):

  • Characteristics: It is distinguished by the presence of Reed-Sternberg cells, which are abnormal large B lymphocytes. HL is relatively rare compared to non-Hodgkin lymphoma.
  • Types:
    • Classical Hodgkin Lymphoma: The most common type, subdivided into four subtypes, including nodular sclerosis and mixed cellularity.
    • Nodular Lymphocyte-Predominant Hodgkin Lymphoma: A rarer subtype that tends to grow more slowly.
  • Symptoms:
    • Swollen lymph nodes (usually painless), often in the neck, armpits, or groin.
    • Fever and night sweats.
    • Unexplained weight loss.
    • Persistent fatigue.
    • Itching or pain after alcohol consumption.
  • Treatment:
    • Chemotherapy: The main treatment for most Hodgkin lymphomas.
    • Radiation Therapy: Used for localized tumors or in conjunction with chemotherapy.
    • Immunotherapy: Targeting the immune system to fight the cancer, especially in advanced cases.
    • Stem Cell Transplant: Used in cases where the lymphoma is resistant to initial treatment.
  • Prognosis: Hodgkin lymphoma is considered one of the most treatable cancers, especially when caught early, with high survival rates.

2. Non-Hodgkin Lymphoma (NHL):

  • Characteristics: NHL encompasses a larger and more diverse group of lymphomas that affect either B-cells or T-cells. Unlike Hodgkin lymphoma, NHL does not have Reed-Sternberg cells.
  • Subtypes:
    • Diffuse Large B-Cell Lymphoma (DLBCL): The most common aggressive NHL subtype.
    • Follicular Lymphoma: A slower-growing or “indolent” type of lymphoma.
    • Mantle Cell Lymphoma.
    • Burkitt Lymphoma: A very aggressive form but with high cure rates in children and young adults.
    • Peripheral T-Cell Lymphomas: A less common and often more aggressive group of T-cell lymphomas.
    • Primary Central Nervous System (CNS) Lymphoma: Affects the brain, spinal cord, or eyes.
  • Symptoms:
    • Enlarged lymph nodes (painless swelling in the neck, armpits, or groin).
    • Fever, night sweats, and unexplained weight loss.
    • Fatigue.
    • Abdominal pain or swelling.
    • Chest pain, coughing, or trouble breathing (if lymphoma is in the chest).
    • Frequent infections or bleeding.
  • Treatment:
    • Chemotherapy: Often a combination of drugs (e.g., the CHOP regimen: Cyclophosphamide, Doxorubicin, Vincristine, Prednisone).
    • Radiation Therapy: Used for localized lymphoma or to shrink tumors before other treatments.
    • Targeted Therapy: Drugs that target specific molecules involved in the growth of cancer cells (e.g., rituximab for B-cell lymphomas).
    • Immunotherapy: Boosts the immune system’s ability to destroy cancer cells.
    • CAR T-Cell Therapy: Genetically engineered T-cells designed to target cancer cells, used in advanced or resistant NHL.
    • Stem Cell Transplant: A possible treatment for some types of NHL, especially after chemotherapy.
  • Prognosis: NHL prognosis varies widely depending on the subtype and stage. Indolent lymphomas may not require immediate treatment but can persist for years, while aggressive types need prompt treatment but may have higher cure rates if treated effectively.

3. Symptoms of Lymphoma:

  • Swollen, painless lymph nodes in the neck, armpits, or groin.
  • Fever, chills, and night sweats.
  • Unexplained weight loss.
  • Persistent fatigue.
  • Itching (especially in Hodgkin lymphoma).
  • Shortness of breath or cough (if lymphoma affects the chest).
  • Abdominal swelling or pain (if affecting lymph nodes in the abdomen).
  • Frequent infections.

4. Diagnosis:

Diagnosis involves various tests to determine the type and stage of lymphoma:

  • Physical Exam: To check for enlarged lymph nodes, spleen, or liver.
  • Biopsy: A sample of the affected lymph node or tissue is examined to confirm the presence of lymphoma and its subtype.
  • Imaging: CT, PET, or MRI scans to check for the spread of lymphoma.
  • Blood Tests: To check for signs of cancer, organ function, and overall health.
  • Bone Marrow Biopsy: Sometimes needed to check for lymphoma in the bone marrow.

5. Staging:

Lymphoma is classified into stages based on the extent of its spread:

  • Stage I: Involves a single lymph node region or a single organ outside the lymph nodes.
  • Stage II: Involves two or more lymph node regions on the same side of the diaphragm or an organ and nearby lymph nodes.
  • Stage III: Lymph nodes are involved on both sides of the diaphragm.
  • Stage IV: Lymphoma has spread to one or more organs outside of the lymphatic system, such as the liver, lungs, or bone marrow.

6. Treatment Options:

Treatment varies depending on the type and stage of lymphoma but generally includes:

  • Watchful Waiting: For indolent (slow-growing) lymphomas, treatment may be delayed until symptoms develop.
  • Chemotherapy: Often the first-line treatment.
  • Radiation Therapy: Effective for localized lymphomas.
  • Targeted and Immunotherapy: Drugs that specifically attack cancer cells or boost the immune response.
  • Stem Cell Transplant: Considered for relapsed or refractory cases.

Prognosis:

Lymphoma prognosis depends on the type, stage, and individual patient factors, but many types of lymphoma are treatable, especially with advances in targeted therapies. Hodgkin lymphoma tends to have a better overall prognosis than many forms of non-Hodgkin lymphoma, particularly when diagnosed early.

At Precious Medical Group (PMG), we are here to assist you further. Please feel free to contact us for any enquiry.