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The lymph system is a network of nodes and veins that transport lymph fluid throughout the body. Lymph fluids carry white blood cells that combat infections. To prevent infection from spreading, lymph nodes work as filters, collecting and eliminating germs and viruses.
While the lymph system normally defends your body, lymphocytes, which are lymph cells, can become malignant.
Lymphoma is a broad word for cancer that begins in the lymph system. Lymphoma is classified into two types: Hodgkin lymphoma and non-Hodgkin lymphoma.
Researchers have grouped more than 70 forms of lymphoma into these two categories. Lymphomas can affect any part of the lymphatic system, including the following:
- bone marrow
- thymus
- spleen
- tonsils
- lymph nodes
WHAT ARE THE TYPES OF LYMPHOMA?
Hodgkin’s lymphoma and non-lymphoma, Hodgkin’s or NHL, are the two most common kinds of lymphoma. Dr. Thomas Hodgkin, a pathologist in the 1800s, identified the cells in what is now known as Hodgkin’s lymphoma.
Reed-Sternberg (RS) cells are big malignant cells found in people with Hodgkin’s lymphoma. These cells do not exist in NHL patients.
Non-Hodgkin lymphoma
NHL is more frequent than Hodgkin’s lymphoma, accounting for 4% of all cancers, according to the American Cancer Society (ACS).
Many lymphoma kinds fall within each of these categories. Doctors classify NHL kinds based on the cells they damage and whether the cells grow quickly or slowly. NHL develops in either the immune system’s B cells or T cells.
Most NHL forms, according to the ACS, affect B cells. Among the several types are:
- B-cell lymphoma: The most aggressive kind of NHL is diffuse large B-cell lymphoma (DLBCL). This rapidly expanding lymphoma is caused by aberrant B cells in the blood. It is curable if treated, but if left untreated, it can be fatal. The stage of DLBCL influences your prognosis.
- T-cell lymphoma: T-cell lymphoma is less prevalent than B-cell lymphoma, accounting for only 15% of all NHL cases. There are several forms of T-cell lymphoma.
- Burkitt’s lymphoma: Burkitt’s lymphoma is an uncommon form of NHL that is aggressive and more common in persons who have weakened immune systems. This kind of lymphoma is more frequent in children in Sub-Saharan Africa, but it can occur everywhere.
- Follicular lymphoma: Follicular lymphoma accounts for approximately one-fifth of all lymphomas diagnosed in the United States. This kind of NHL, which begins in the white blood cells, is more common among the elderly. The typical age of diagnosis is 60 years old. Because this lymphoma is likewise slow-growing, treatment begins with vigilance.
- Mantle cell lymphoma: This aggressive kind of lymphoma is uncommon, accounting for just around 6% of all NHL cases. Mantle cell lymphoma is also more typically discovered later in its progression, and it usually occurs in or affects the gastrointestinal tract or bone marrow.
- Primary mediastinal B cell lymphoma: This form of B-cell lymphoma accounts for nearly 10% of DLBCL patients. It primarily affects women in their twenties and thirties.
- Small lymphocytic lymphoma: Small lymphatic lymphoma (SLL) is a kind of lymphoma that grows slowly. SLL cancer cells are typically detected in lymph nodes. SLL is the same as chronic lymphocytic leukemia (CLL), although the majority of cancer cells in CLL are detected in the blood and bone marrow.
- Waldenstrom’s macroglobulinemia (lymphoplasmacytic lymphoma): Lymphoplasmacytic lymphoma (LPL) is an uncommon kind of malignancy that accounts for just around 2% of all lymphomas. It primarily affects the elderly. LPL has a subtype called Waldenstrom macroglobulinemia. It results in aberrant antibody production.
- Hodgkin’s lymphoma: Hodgkin’s lymphoma usually begins in RS cells. While the exact etiology of Hodgkin’s lymphoma is unknown, certain risk factors can raise your chances of having the disease.
Hodgkin’s lymphoma
Types of Hodgkin’s lymphoma include:
- Hodgkin’s illness with lymphocyte deficiency: This rare, aggressive kind of lymphoma affects about 1% of lymphoma cases and is most typically diagnosed in people in their 30s. Doctors will detect normal lymphocytes with an abundance of RS cells in diagnostic tests.
Patients with weakened immune systems, such as those with HIV, are more susceptible to develop this kind of lymphoma.
- Lymphocyte-rich Hodgkin’s disease: This kind of lymphoma is more frequent in men, accounting for around 5% of Hodgkin’s lymphoma occurrences. Lymphocyte-rich Hodgkin’s disease is often detected at an early stage, and diagnostic tests detect both lymphocytes and RS cells.
- Mixed cellularity Hodgkin’s lymphoma: Mixed cellularity, like lymphocyte-rich Hodgkin’s disease, Lymphocytes and RS cells are both present in Hodgkin’s lymphoma. It’s more common — nearly a quarter of all Hodgkin’s lymphoma cases are of this type — and more common in older adult men.
- Nodular lymphocyte-predominant Hodgkin’s disease: Nodular lymphocyte-predominant Hodgkin’s lymphoma (NLPHL) is a form of Hodgkin’s lymphoma that affects roughly 5% of persons with lymphoma and is distinguished by the absence of RS cells.
NLPHL is most common in adults aged 30 to 50, and it is more common in men. NLPHL rarely progresses or becomes into a type of aggressive NHL.
- Nodular sclerosis Hodgkin’s lymphoma: This kind of lymphoma is found in 70% of Hodgkin’s cases and is more common in young people than in any other age group. This kind of lymphoma develops in lymph nodes that include scar tissue, also known as sclerosis.
This kind of lymphoma, fortunately, is readily treated and has a high cure rate.
WHAT ARE THE SIGNS AND SYMPTOMS OF LYMPHOMA?
In its early stages, lymphoma may not always create symptoms. Rather, swollen lymph nodes may be discovered via a physical examination by a clinician. Under the skin, these may feel like little, soft nodules. A person may feel lymph nodes in the following areas:
- neck
- upper torso
- armpit
- stomach
- groin
Similarly, many early lymphoma symptoms are nonspecific. As a result, they are simple to overlook. These are some of the most prevalent early symptoms of lymphoma:
- chills
- cough
- fatigue
- a spleen that has grown in size
- fever
- sweating during night
- Rashes that are itchy
- Breathing difficulty
- Itching on the skin
- stomach ache
- Appetite loss
- weight loss that is unexplained
Because lymphoma signs are frequently missed, it can be difficult to detect and diagnose it at an early stage. It’s critical to understand how symptoms may begin to change as the cancer progresses.
WHAT ARE THE CAUSES OF LYMPHOMA?
Lymphoma is caused by an unknown factor, according to doctors. However, it all starts with a genetic mutation in a disease-fighting white blood cell called a lymphocyte. The mutation instructs the cell to multiply fast, resulting in a large number of sick lymphocytes that continue to multiply.
The mutation also causes the cells to survive when other normal cells would have died. This creates an overabundance of defective and inefficient lymphocytes in your lymph nodes, causing swelling of the lymph nodes, spleen, and liver.
WHAT ARE SOME OF THE RISK FACTORS FOR LYMPHOMA?
The majority of lymphoma instances have no recognized cause. Some people, however, are thought to be at a higher risk.
Risk factors for non-lymphoma Hodgkin’s
NHL risk factors include:
- Immunodeficiency: This could be caused by HIV’s weakened immune system or by taking an immuno-suppressing medicine after an organ transplant.
- Autoimmune disease: People with autoimmune diseases such as rheumatoid arthritis and celiac disease are more likely to develop lymphoma.
- Age: Lymphoma is more common in older people. Some varieties, however, are more common in children and newborns.
- Sex: Men have a higher overall risk of NHL than women, however specific forms of NHL are more likely to develop in women.
- Ethnicity: White people in the United States are more likely than African Americans or Asian Americans to get some kinds of lymphoma.
- Infection: People who have experienced infections such as the human T-cell leukemia/lymphotropic virus (HTLV-1), Heliobacter pylori, hepatitis C, or the Epstein-Barr virus (EBV) are at a higher risk.
- Chemical and radiation exposure: People who are exposed to chemicals found in pesticides, fertilizers, and herbicides are at a higher risk. Nuclear radiation can potentially raise the chances of developing NHL.
- Body size: Obese people may be at a higher risk of acquiring lymphoma, but more research is needed to understand this putative risk factor.
Risk factors for Hodgkin’s lymphoma
The following are risk factors for Hodgkin’s lymphoma:
- Age: People between the ages of 20 and 30 and those over the age of 55 are more likely to be diagnosed with the disease.
- Sex: Men are more prone to get this kind of lymphoma than women.
- Family history: If a sibling has been diagnosed with this type of cancer, your chances of developing it are increased.
- Infectious mononucleosis: Mononucleosis can be caused by an EBV infection. This infection has been linked to an increased risk of lymphoma.
- Immunodeficiency: People living with HIV are more likely to acquire lymphoma.
HOW IS LYMPHOMA DIAGNOSED?
If a doctor suspects lymphoma, he or she will usually do a biopsy. This entails removing cells from a swollen lymph node. A hematopathologist will study the cells to see if lymphoma cells are present and what type of cell they are.
If the hematopathologist discovers lymphoma cells, additional testing can determine how far the malignancy has spread. These examinations may involve
- an X-ray of the chest
- Blood testing to determine white and red blood cell counts, as well as examination of surrounding lymph nodes or tissues
- a bone marrow aspiration, in which a small amount of liquid from the bone marrow is extracted and examined
- a lumbar puncture (spinal tap), which involves the removal and testing of a tiny volume of fluid from the spine
- an ultrasonography of the abdomen
CT or MRI scans, for example, may detect new cancers or enlarged lymph nodes.
WHAT ARE THE TREATMENTS FOR LYMPHOMA?
Typically, a team of medical experts will work together to treat lymphoma:
- Hematologists are specialists who specialize in problems of the blood, bone marrow, and immune cells.
- Cancerous tumors are treated by oncologists.
- Pathologists may collaborate with these doctors to help with treatment planning and determining if a particular treatment is effective.
Treatment regimens are determined by a number of factors, including the individual’s age and overall health, the type of lymphoma, and the stage of the malignancy.
A tumor is staged by doctors to indicate how far the malignant cells have spread. A stage 1 tumor affects only a few lymph nodes, but a stage 4 tumor has spread to other organs such as the lungs or bone marrow.
Doctors also evaluate NHL tumors based on how quickly they grow. Among these terms are:
- low grade or slow
- aggressive or moderate grade
- high quality or extremely aggressive
Hodgkin’s lymphoma treatment
Radiation therapy is commonly used to shrink and kill malignant cells in Hodgkin’s lymphoma patients. Chemotherapy drugs may also be prescribed by doctors to eliminate malignant cells.
Immunotherapy therapy medications such as nivolumab (Opdivo) and pembrolizumab (Keytruda), which assist the body’s T cells target cancer, are also being used in newer treatments.
Non-lymphoma Hodgkin’s Treatment
NHL is also treated with chemotherapy and radiation. Biological therapy that specifically target malignant B cells can also be successful. Nivolumab is an example of this type of medication (Opdivo).
CAR T cell therapy is part of the treatment for some people, such as those with large B-cell lymphoma (DLBCL). CAR T cell therapy treats cancer by using the body’s own cells: immune cells are extracted from the body, imbued with new proteins in a lab, and then reintroduced into the body.
A bone marrow or stem cell transplant may be utilized to build up healthy immune system cells in some cases of Hodgkin’s lymphoma and NHL. Before initiating chemotherapy or radiation treatments, doctors may collect these cells or tissues. Relatives may also be eligible to donate bone marrow.
WHAT ARE THE STAGES OF LYMPHOMA?
NHL and Hodgkin’s lymphoma are both divided into four phases. The stage of lymphoma is defined by the location of the tumor and how far it has spread or has not spread.
Stage 1: Cancer has spread to a single lymph node or organ.
Stage 2: cancer is found in two lymph nodes that are close to each other and on the same side of the body, or cancer is found in one organ and surrounding lymph nodes.
Stage 3: Cancer has spread to lymph nodes on both sides of the diaphragm at this time.
Stage 4: The cancer has gone beyond local lymph nodes and may be in an organ. It is possible that NHL will spread as time goes on. The liver, bone marrow, and lungs are the most prevalent locations for advanced NHL.
While lymphoma in stage 4 is advanced, it is still curable.
PROGNOSIS OF LYMPHOMA
The prognosis of a person following a lymphoma diagnosis is determined by the stage and type of lymphoma. Many kinds of lymphoma are curable and treated.
Some kinds of lymphoma grow slowly or indolently. In this scenario, doctors may choose not to treat because the long-term prognosis, even with cancer, is still favorable.
According to the American Cancer Society, the 5-year survival rate for stage 1 Hodgkin’s lymphoma is 91%; for stage 4, it is 81%.
According to the ACS, the 5-year survival rate for NHL is 73%, while the 10-year survival rate is 57%.
LYMPHOMA IN CHILDREN
Many of the same risk factors for lymphoma in children also exist in adults, but specific forms of lymphoma are more common in children.
Hodgkin’s lymphoma, for example, is more common in children aged 15 and younger, although the type of NHL that occurs in children is often aggressive and rapidly expanding.
Children with immune system defects, such as HIV, or those who use immune-suppressing medicines are more likely to develop lymphoma. Similarly, children who have had radiation therapy or chemotherapy are more likely to acquire this type of cancer.
CONCLUSION
Lymphoma is a type of cancer that begins in the lymphatic system.
Lymphoma is divided into two types: Hodgkin lymphoma and non-Hodgkin lymphoma, or NHL. There are around 70 different varieties within these categories. Many kinds of lymphoma are treatable and curable, depending on the stage of the illness, the individual’s age and health, and a few other criteria.
Hodgkin’s lymphoma, according to the Leukemia & Lymphoma Society, is highly treatable – depending on a few outside circumstances.
According to the ACS, NHL is also curable, with an overall 5-year survival rate of 70% for NHL patients. The 10-year survival rate is 60%.
Individuals diagnosed with lymphoma frequently have a team of experts on their side, as well as a treatment plan tailored to their specific situation.
