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Lymphoma

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Lymphoma is a group of tumors that develop within the blood and the lymphatic system. These tumors arise from lymphocytes, which are a specific type of white blood cell used by the body to fight infection. While the term is often used to describe cancerous growths, it can refer to various types of tumors in the hematopoietic and lymphoid tissues. Lymphoma is a significant medical condition that affects how the body's immune cells function.

Diagram showing the lymph nodes lymphoma most commonly develops in CRUK 311
Diagram showing the lymph nodes lymphoma most commonly develops in CRUK 311

When lymphoma develops, it often presents through specific physical signs. The most common sign is lymphadenopathy, which is the swelling of the lymph nodes. This swelling is typically painless. Patients may also experience what are called B symptoms. These systemic symptoms include fever, drenching night sweats, and unintended weight loss. Other possible symptoms include itching, fatigue, anemia, and respiratory distress, known as dyspnea.

Lymphoma macro
Lymphoma macro

To diagnose lymphoma, doctors must examine the tissue closely. An initial step might involve a "touch prep." In this process, a glass slide is pressed against excised lymphoid tissue. The tissue is then stained, usually with H&E stain, to be viewed under a light microscope.

Touch prep on a lymph node
Touch prep on a lymph node

A definitive diagnosis requires a lymph node biopsy. This involves removing a partial or total section of a lymph node for histopathological examination. Doctors may also use blood, urine, or bone marrow tests. Medical imaging helps determine if the cancer has spread to organs like the lungs, liver, or brain.

DIagram showing where lymphoma can spread in the body CRUK 382
DIagram showing where lymphoma can spread in the body CRUK 382

Scientists classify lymphomas into two main categories based on their biological characteristics. Hodgkin lymphoma (HL) accounts for about 10% to 15% of cases. It is specifically identified by the presence of Reed-Sternberg cells. The other category is non-Hodgkin lymphoma (NHL), which makes up the remaining 85% to 90% of cases. NHL is a very diverse group. It includes many subtypes that vary in their causes, the specific cells involved, and how they progress.

Hodgkin lymphoma, nodular lymphocyte predominant - low power view - H&E - by Gabriel Caponetti
Hodgkin lymphoma, nodular lymphocyte predominant - low power view - H&E - by Gabriel Caponetti

Subtypes of lymphoma are further organized by the World Health Organization (WHO). This classification system groups lymphomas by the specific cell type that the tumor most resembles. Some lymphomas are described as indolent, meaning they grow slowly and may allow for a long life even without immediate treatment. Others are aggressive, meaning they cause rapid deterioration. However, many aggressive forms respond well to medical treatment and can be cured. Researchers use advanced tools like DNA-microarray analysis to study these differences.

DNA-microarray analysis
DNA-microarray analysis

This method allows scientists to see which genes are overexpressed or underexpressed in the cells.

Risk factors vary depending on the specific type of lymphoma. For Hodgkin lymphoma, risks include infection with the Epstein-Barr virus and family history. For many non-Hodgkin lymphomas, risks include autoimmune diseases, HIV/AIDS, or certain pesticides. Some studies suggest that smoking and eating large amounts of red meat may also increase risk. In certain non-Hodgkin cases, the lymphoma produces too much protein. This makes the blood thick, requiring a procedure called plasmapheresis to remove the excess protein.

The impact of lymphoma is measured through survival rates and global statistics. In the United States, the five-year survival rate for all Hodgkin lymphoma subtypes is 89%. For non-Hodgkin lymphomas, the rate is 74%. In 2012, lymphomas developed in 566,000 people worldwide and caused 305,000 deaths. Lymphomas make up 3% to 4% of all cancers, ranking as the seventh-most-common form. In children, lymphoma is the third-most-common cancer.

Lymphomas, multiple myeloma world map-Deaths per million persons-WHO2012
Lymphomas, multiple myeloma world map-Deaths per million persons-WHO2012

Treatment options are tailored to the specific subtype and stage of the disease. Doctors may use chemotherapy, radiation therapy, or proton therapy to target the cells. Surgery is another option for certain cases. Some doctors may also use targeted therapy. For some specific types, a strategy called watchful waiting is used. This means doctors monitor the patient closely instead of starting treatment immediately. The ultimate outcome for a patient depends heavily on the correct classification of their specific lymphoma subtype.

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🖼️ Images & Media (8)
File:Diagram showing the lymph nodes lymphoma most commonly develops in CRUK 311.svg
Diagram showing the lymph nodes lymphoma...
File:Touch prep on a lymph node.jpg
Touch prep on a lymph node.jpg
File:Hodgkin lymphoma, nodular lymphocyte predominant - low power view - H&E - by Gabriel Caponetti.jpg
Hodgkin lymphoma, nodular lymphocyte...
File:Lymphoma macro.jpg
Lymphoma macro.jpg
File:DNA-microarray analysis.jpg
DNA-microarray analysis.jpg
File:DIagram showing where lymphoma can spread in the body CRUK 382.svg
DIagram showing where lymphoma can spread...
File:Lymphomas, multiple myeloma world map-Deaths per million persons-WHO2012.svg
Lymphomas, multiple myeloma world...
File:Thomas Hodgkin photo.jpg
Thomas Hodgkin photo.jpg
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