Malignant Lymphoma Overview

    Cancerous cells that have the ability to spread are called malignant cells. Our bodies have what is called a lymph system, which runs throughout our bodies. It is composed of lymphoid tissue, vessels, and fluid. Lymphoid tissue contains lymph nodes, which are part of the immune system. The immune system's job is to produce blood cells and protect against harm from invading germs. Cancers that start anywhere in the lymphatic system are lymphomas.

    Cancers that begin in other organs and tissues and spread to the lymphatic system are not lymphomas. Lymphoma can, however, spread to other parts of the body. 

    The two main types of lymphoma are Hodgkin and non-Hodgkin lymphoma (NHL). Treatment options include chemotherapy and radiation. In many cases, lymphomas are curable.

    Who Gets Malignant Lymphoma?

    Anyone can get malignant lymphoma. Doctors can't always be certain what causes someone to get lymphoma, but there are some factors that seem to increase your risk.

    Both children and adults can get Hodgkin lymphoma. The risk may be higher in early or late adulthood and the disease occurs at a slightly higher rate in males.

    Your chances of developing NHL may increase as you grow older. Other risk factors include exposure to radiation, previous cancer treatment, or a weakened immune system. NHL is not common in children.

    Symptoms of Malignant Lymphoma

    Symptoms can be mild and easily overlooked. The most obvious and common sign of lymphoma is swollen lymph nodes. These may be found in the neck, upper chest, under the arm, abdomen, or groin. Other symptoms may include:

    • cough
    • shortness of breath
    • feeling tired
    • night sweats
    • itchy skin, rash
    • fever
    • weight loss 

    If you believe you have swollen lymph nodes, it doesn't mean you have lymphoma. Lymph node inflammation has many causes. Make an appointment to see your doctor.

    Diagnosing Malignant Lymphoma

    If you have swollen lymph nodes your doctor will want to determine the cause. If no obvious cause can be found upon physical examination, your doctor may order blood tests or other diagnostic testing. A lymph node biopsy, in which cells are removed from a lymph node and examined under a microscope, may be necessary.

    This will determine if the cells are malignant or noncancerous.

    A biopsy can also detect the difference between Hodgkin lymphoma and NHL, as well as their various sub-types. Along with imaging and blood tests, the biopsy results will help your doctor determine your course of treatment.

    Types of Malignant Lymphoma

    The two main types of malignant lymphoma are Hodgkin lymphoma (also known as Hodgkin disease) and NHL. The two types spread in different ways and respond differently to treatment. When lymphoma is of a slow-growing variety, it is referred to as low-grade. Aggressive, fast-growing types are called high-grade.

    Hodgkin Lymphoma

    A lymphoma is classified as Hodgkin when there is an abnormal cell called Reed-Sternberg present. According to The American Cancer Society, about 95 percent of lymphoma patients are diagnosed with classic Hodgkin lymphoma, and nodular lymphocyte predominant Hodgkin disease makes up the remaining five percent (ACS).

    Non-Hodgkin Lymphoma

    All other types of lymphomas are classified as NHL. NHL is due to injury to the DNA of a lymphocyte progenitor and cannot be inherited. The Leukemia and Lymphoma Society reports that about 85 percent of NHL patients have a B-cell type (LLS, 2011).

    Another type of NHL, Waldenström macroglobulinemia (also called lymphoplasmacytic lymphoma), starts in white blood cells. Our skin also harbors lymphocytes (a type of white blood cell) and sometimes NHL can begin on the skin. This is called lymphoma of the skin, or cutaneous lymphoma. Cancer that began elsewhere and spreads to the skin is not lymphoma of the skin.

    There are approximately 60 subtypes of NHL.

    Treatment for Malignant Lymphoma

    Treatment will depend on the type of lymphoma, level of aggressiveness, stage at diagnosis, and other medical problems that may exist. Among the treatment options are:

    • chemotherapy
    • radiation therapy
    • immunotherapy
    • stem cell transplant

    Therapies may be given individually or in combination.

    Prognosis for Malignant Lymphoma Patients

    The sooner you begin treatment, the better your outlook. Your individual prognosis will depend on many factors, such as the type and stage of lymphoma, which treatments you choose, and how well your body responds. Chemotherapy and radiation treatment can be very successful, although these treatments come with many potential side effects. 

    Additional considerations for prognosis are age, other medical conditions, and level of follow-up care. Treatment can result in remission and even cure lymphomas. Hodgkin lymphoma is one of the more curable types of cancer, especially in children and young adults.

    Only your doctor can provide insight into your prognosis.