Description
Lymphoma is a cancer that begins in cells of the lymphatic system. The lymphatic system includes lymph nodes, the spleen, bone marrow, thymus and lymphatic tissue throughout the body, and it plays an important role in immune defence. Lymphoma can occur in lymph nodes in the neck, armpit or groin, as well as in the gastrointestinal tract, skin, bone marrow or other organs.
There are many lymphoma subtypes, and their growth rate and treatment can differ greatly. Some indolent lymphomas progress slowly, while aggressive lymphomas grow quickly and need prompt treatment. Painless enlarged lymph nodes, persistent fever, drenching night sweats and unexplained weight loss are important symptoms to recognise.
Types
Hodgkin Lymphoma:Identified by characteristic cells on pathology. It often begins in one group of lymph nodes and spreads to adjacent areas.
Non-Hodgkin Lymphoma (NHL):A broad group that includes many B-cell, T-cell and NK-cell lymphomas.
Indolent Lymphoma:Usually grows slowly, and some patients can be monitored closely before treatment is required.
Aggressive Lymphoma:Grows quickly, although several aggressive subtypes can respond well to systemic treatment.
Stages
Lymphoma is commonly staged from I to IV using the Lugano or Ann Arbor system. Doctors also assess “B symptoms”, including fever, drenching night sweats and unexplained weight loss.
Risk Factors
The following factors may increase the risk, but having one or more risk factors does not mean that a person will develop cancer:
A weakened immune system, including immunosuppressive medicines after organ transplantation
HIV infection or certain chronic infections
EBV, Helicobacter pylori and other infections associated with specific subtypes
Autoimmune diseases
Increasing age, although some types are more common in younger people
Family history of lymphoma or certain inherited factors
Previous treatment with some chemotherapy medicines or radiation therapy
Symptoms
Early disease may not cause obvious symptoms. Medical evaluation is recommended when any of the following symptoms persist, recur, or gradually worsen:
Painless enlarged lymph nodes in the neck, armpit or groin
Persistent unexplained fever
Drenching night sweats
Unintentional weight loss over six months
Persistent fatigue
Itching or skin rash
Chest tightness, cough or shortness of breath
Abdominal fullness, pain or feeling full quickly
Diagnosis
Diagnosis usually combines medical history, physical examination, imaging, laboratory tests, and pathology. The exact tests are selected by the doctor according to the individual case.
Clinical and Blood Assessment
Examination of lymph nodes and the size of the liver and spleen
Full blood count, liver and kidney function, LDH and other tests
Imaging
CT or PET-CT to assess lymph nodes and organ involvement
MRI or ultrasound when indicated
Pathological Diagnosis
Excisional or core-needle lymph node biopsy is usually more useful than fine-needle aspiration for defining the subtype
Immunohistochemistry, flow cytometry and molecular tests
Staging Assessment
Bone marrow examination for selected patients
Symptoms, imaging and pathology are combined to determine stage and risk group
Facts (FAQ)
Q: Does every enlarged lymph node mean lymphoma?
A: No. Infection, inflammation and other benign conditions are more common. A node that keeps enlarging, feels hard or occurs with systemic symptoms should be investigated.
Q: Is lymphoma contagious?
A: No. Lymphoma itself is not contagious. Some infections can increase the risk of specific lymphomas, but the cancer cannot spread from one person to another.
Q: Can lymphoma be cured?
A: Some Hodgkin lymphomas and aggressive non-Hodgkin lymphomas can achieve long-term remission or cure. Outcomes depend on subtype, stage and treatment response.
Q: Why is a lymph node biopsy important?
A: There are many lymphoma subtypes with very different treatments. Pathology and immune-marker testing are essential for an accurate classification.
Q: Why are some indolent lymphomas observed before treatment?
A: Certain indolent lymphomas progress slowly. When there are no symptoms or threatened organs, close monitoring may avoid unnecessary early treatment and side effects.
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*Disclaimer: The effect of treatment varies from person to person. The information on the website of Modern Cancer Hospital Guangzhou is for reference only, and cannot be used as the basis for medical diagnosis and treatment, nor can it replace the doctor's diagnosis and treatment. For more details, please review the Liability Clause.
