Non-Hodgkin lymphoma (NHL) is a cancer of the lymphatic system. It occurs when tumors develop from the lymphocytes. A lymphocyte is a type of white blood cell. NHL is more common than Hodgkin’s lymphoma.
The main difference between Hodgkin’s lymphoma and NHL is the presence of a type of abnormal cell called the Reed-Sternberg cell. This type of abnormal cell is only present in Hodgkin’s lymphoma. Hodgkin’s lymphoma and NHL have very different treatment options.
Many types of cancers can spread to the lymph nodes. However, only cancers that start in the lymph tissue are considered lymphomas.
The symptoms of NHL may include:
- abdominal pain or swelling
- chest pain
- difficulty breathing
- swollen lymph nodes
- a fever
- night sweats
- weight loss
You should always see your doctor anytime you experience persistent symptoms that concern you.
Doctors and researchers don’t know what causes NHL. It occurs when the body makes too many abnormal lymphocytes. These abnormal cells don’t die. They continue to grow and divide. This enlarges the lymph nodes.
Many people with NHL have no obvious risk factors. It’s also possible to have multiple risk factors and never develop NHL. Some factors that may increase NHL risk include:
- older age, since most people are aged 60 or older when diagnosed
- the use of immunosuppressant drugs
- an infection, particularly with HIV, Epstein-Barr virus, or Helicobacter pylori
- exposure to certain chemicals, such as weed and insect killers
Physical exams can be used to check the size and condition of your lymph nodes. They can also find an enlarged liver or spleen. A number of tests can be used to diagnose NHL.
Your lymph nodes will swell any time your body is fighting an infection. Your doctor may order blood and urine tests to determine what type of infection your body is fighting.
Imaging tests such as the following can be used to help your doctor look for tumors and stage the cancer:
- CT scans
- PET scans
A biopsy can remove a portion of the lymph node for testing. This can definitively identify NHL. A bone marrow biopsy can help your doctor determine if the disease has spread.
There are many different types of NHL, and they’re categorized by how the cells look under a microscope. Most types of NHL are categorized as either B-cell lymphoma or T-cell lymphoma.
The American Cancer Society (ACS) estimates that 85 percent of NHL cases are B-cell lymphomas. The most common types of B-cell lymphomas are diffuse, large B-cell lymphoma, which accounts for 1 out of every 3 cases in the United States and follicular lymphoma, which accounts for 1 out of every 5 cases in the United States.
The less common types of B-cell lymphoma include:
- Burkitt’s lymphoma
- extranodal marginal zone B-cell lymphoma
- lymphoplasmacytic mantle cell lymphoma
- mediastinal large B-cell lymphoma
- marginal zone B-cell lymphoma
- small lymphocytic lymphoma
The ACS estimates that T-cell lymphomas make up 15 percent of lymphomas in the United States.
Treatment for NHL depends on your age, the type of NHL you have, and the stage of NHL you have.
Immediate treatment isn’t always necessary. Your doctor may just monitor NHL that’s growing slowly and isn’t causing symptoms. Treatment can wait until the disease progresses.
More aggressive forms of NHL can be treated in several ways:
- Chemotherapy can be given orally or by injection. It kills cancer cells. Chemotherapy may be used alone or with other treatments.
- Radiation involves the use of high-powered beams of energy to kill cancer cells and get rid of tumors. Radiation can be used alone or with other treatments.
- A stem cell transplant allows your doctor to use higher doses of chemotherapy. This treatment kills stem cells as well as cancer cells. Then, your doctor uses a transplant to return healthy cells to the body. Your doctor can transplant either your own cells or they can use donor cells. Your cells must be harvested in advance and frozen if your cells are going to be used in the transplant.
- Medications can be used to enhance the immune system. They can also be used to deliver radioactive isotopes that bind to cancerous cells.
Survival rates for NHL vary. Your outlook will depend on:
- your age
- your overall health
- the type of NHL you have
- how soon the NHL is discovered
People with slower growing cancers can live a long time.
Sometimes, NHL isn’t found until it’s in the advanced stages. Aggressive forms of NHL can usually be treated, but cancer found in later stages can be difficult to treat. The cancer may be fatal before treatment has time to take effect.
There’s no known way to prevent NHL. However, it may be possible to reduce your risk for the disease by avoiding known risk factors such as obesity and HIV.