Lymphoma

Lymphoma
Classification and external resources

Lymphoma

Lymphoma is a group of blood and lymph tumors that develop from lymphocytes, a type of white blood cell. The term "lymphoma" generally refers to the cancerous forms of these tumors, rather than all such tumors. Signs and symptoms may include enlarged lymph nodes, fever, drenching night sweats, unintended weight loss, itching, and constant fatigue. The enlarged lymph nodes are usually painless, and the sweats typically occur at night.

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Diagram showing the lymph nodes

Signs and symptoms

The most common symptom of lymphoma is painless swelling of one or more lymph nodes, usually in the neck, armpits, or groin. Other symptoms, known as "B symptoms," may include:

• Fever
• Drenching night sweats
• Unintentional weight loss
• Itching (pruritus)
• Constant fatigue
• Loss of appetite
• Shortness of breath
• Chest pain

These symptoms can be caused by various conditions, and it is essential to consult a healthcare professional for a proper evaluation and diagnosis.

Nodular Mantle Cell Lymphoma

Types

Lymphomas are generally classified into two main types:

• Hodgkin lymphoma (HL): This type is characterized by the presence of Reed-Sternberg cells, large abnormal cells that form in lymphoid tissue. Hodgkin lymphoma is less common than non-Hodgkin lymphoma and typically affects younger individuals.
• Non-Hodgkin lymphoma (NHL): This category includes all other lymphomas that do not fall under the definition of Hodgkin lymphoma. There are more than 60 subtypes of non-Hodgkin lymphoma, which can be further divided into aggressive (fast-growing) and indolent (slow-growing) types.

Causes and risk factors

The exact cause of lymphoma is not entirely understood, but it is believed to result from genetic mutations and environmental factors that lead to the abnormal growth and proliferation of lymphocytes. Some risk factors for developing lymphoma include:

• Family history
• Certain infections (e.g., Epstein-Barr virus, HIV)
• Autoimmune diseases (e.g., rheumatoid arthritis, lupus)
• Exposure to certain chemicals and radiation
• A weakened immune system (e.g., from organ transplantation, immunosuppressive therapy)

Subtypes according to the WHO classification

Mature B-cell neoplasms

• Chronic lymphocytic leukemia/Small lymphocytic lymphoma
• B-cell prolymphocytic leukemia
• Lymphoplasmacytic lymphoma (such as Waldenström macroglobulinemia)
• Splenic marginal zone lymphoma
• Plasma cell neoplasms:
  • Plasma cell myeloma
  • Plasmacytoma
  • Monoclonal immunoglobulin deposition diseases
  • Heavy chain diseases
• Extranodal marginal zone B cell lymphoma, also called MALT lymphoma
• Nodal marginal zone B cell lymphoma (NMZL)
• Follicular lymphoma
• Mantle cell lymphoma
• Diffuse large B cell lymphoma
• Mediastinal (thymic) large B cell lymphoma
• Intravascular large B cell lymphoma
• Primary effusion lymphoma
• Burkitt lymphoma/leukemia

Mature T cell and natural killer (NK) cell neoplasms

• T cell prolymphocytic leukemia
• T cell large granular lymphocytic leukemia
• Aggressive NK cell leukemia
• Adult T cell leukemia/lymphoma
• Extranodal NK/T cell lymphoma, nasal type
• Enteropathy-type T cell lymphoma
• Hepatosplenic T cell lymphoma
• Blastic NK cell lymphoma
• Mycosis fungoides / Sezary syndrome
• Primary cutaneous CD30-positive T cell lymphoproliferative disorders
  • Primary cutaneous anaplastic large cell lymphoma
  • Lymphomatoid papulosis
• Angioimmunoblastic T cell lymphoma
• Peripheral T cell lymphoma, unspecified
• Anaplastic large cell lymphoma

Hodgkin Lymphoma

• Classical Hodgkin lymphomas:
  • Nodular sclerosis
  • Mixed cellularity
  • Lymphocyte-rich
  • Lymphocyte depleted or not depleted
• Nodular lymphocyte-predominant Hodgkin lymphoma

Immunodeficiency-associated lymphoproliferative disorders

• Associated with a primary immune disorder
• Associated with the Human Immunodeficiency Virus (HIV)
• Post-transplant
• Associated with methotrexate therapy
• Primary central nervous system lymphoma occurs most often in immuno-compromised patients, in particular those with AIDS, but it can occur in the immunocompetent as well. It has a poor prognosis, particularly in those with AIDS. Treatment can consist of corticosteroids, radiotherapy, and chemotherapy, often with methotrexate.

Diagnosis

A diagnosis of lymphoma is typically made using a combination of the following tests and procedures:

Physical examination: A healthcare professional will check for enlarged lymph nodes, liver, and spleen, as well as any other signs or symptoms of lymphoma.

• Biopsy: A small sample of tissue from an enlarged lymph node or other affected area is removed and examined under a microscope to determine the presence of cancerous cells and to identify the type of lymphoma.
• Blood tests: Blood tests can provide information on the overall health of the patient and help detect abnormalities that may suggest lymphoma.
• Imaging studies: Computed tomography (CT) scan, positron emission tomography (PET) scan, and magnetic resonance imaging (MRI) can help determine the extent and location of the lymphoma in the body.
• Bone marrow biopsy: A small sample of bone marrow is removed and examined for the presence of cancerous cells, which can help determine the stage of the lymphoma and guide treatment decisions.

Treatment

The treatment of lymphoma depends on the type, stage, and location of the cancer, as well as the patient's overall health and personal preferences. Treatment options may include:

• Chemotherapy: The use of drugs to kill cancer cells or prevent them from growing.
• Radiation therapy: The use of high-energy rays (such as X-rays) to kill cancer cells or shrink tumors.
• Immunotherapy: The use of substances that help the immune system recognize and attack cancer cells.
• Stem cell transplant: The replacement of damaged or destroyed bone marrow with healthy bone marrow stem cells, either from the patient (autologous transplant) or from a donor (allogeneic transplant).

Targeted therapy: The use of drugs or other substances that specifically target and attack cancer cells, usually causing less harm to normal cells.

Prognosis

The prognosis for lymphoma varies depending on the type, stage, and individual factors. Early detection and prompt treatment can significantly improve the prognosis. In some cases, lymphoma can be effectively managed with treatment, leading to periods of remission and a good quality of life.

See also

• Leukemia
• Multiple myeloma
• Hematopoietic stem cell transplantation

External links

• National Cancer Institute: Lymphoma
• Leukemia & Lymphoma Society: Lymphoma

Classification	ICD-10: C81 –C96 ICD-9-CM: 202.8 MeSH: D008223
External resources	MedlinePlus: 000580

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