Lymphoma Lymphoma
  • What is lymphoma?
  • What are the causes of lymphoma?
  • What are the symptoms of lymphoma?
  • How is lymphoma diagnosed?
  • How is lymphoma treated?

What is lymphoma?

Lymphoma is a type of blood cancer that affects lymphocytes, the white blood cells that form part of the immune system to help fight infections.

In lymphoma, either the B lymphocytes (B-cells) or T lymphocytes (T-cells) undergo a harmful change and grow out of control. These abnormal lymphocytes crowd out the healthy cells, affecting the normal functioning of the immune system.

The main subtypes of lymphoma are:

  • Hodgkin's lymphoma – common in young adults 15 – 30 years old and adults over 50
  • Non-Hodgkin's lymphoma – common in older people

Lymphoma can affect the lymphatic system, which includes the lymph nodes (lymph glands), spleen, thymus gland and bone marrow, as well as other organs in the body.

Hodgkin's lymphoma:

Several types of Hodgkin's lymphoma exist, which may include rarer forms that are difficult to identify. The subtypes of lymphoma include:

  • Nodular sclerosis – more common in young adults than in other age groups
  • Lymphocyte-rich – more common in men
  • Lymphocyte-depleted – more rare and aggressive
  • Mixed cellularity – more prevalent in adult men

In developing a treatment plan, accurate diagnosis and staging are important in shaping a treatment plan. The general stages of lymphoma are:

  • Stage 1 – Lymphoma occurs in 1 lymph node, a group of lymph nodes, or 1 organ
  • Stage 2 – Lymphoma occurs in 2 or more lymph node regions, or when it has invaded an organ and the nearby lymph nodes. The cancer sites are still limited to the same side of the diaphragm.
  • Stage 3 – Cancer occurs on both sides of the diaphragm
  • Stage 4 – Cancer occurs in several sites in 1 or more organs and tissues. This is the most advanced stage of Hodgkin's lymphoma and affects not only the lymph nodes but also other parts of the body, such as the liver, lungs or bones.

Non-Hodgkin's lymphoma:

This is a heterogeneous group of malignancies of the lymphoid system. The most common non-Hodgkin's lymphoma is the diffuse large B-cell lymphoma.

The staging of non-Hodgkin’s lymphoma is similar to Hodgkin’s lymphoma.


What are the causes of lymphoma?

While the exact cause of lymphoma is unknown, some risk factors may include:

  • Age – some types of lymphoma are more common in young adults, while others are most often diagnosed in people aged 5 and above
  • Being male
  • Having an impaired immune system
  • Infections (eg. Epstein-Barr virus and Helicobacter pylori infection)
  • Genetic disorders (eg. Wiskott-Aldrich syndrome)

Lymphoma occurs when a lymphocyte undergoes mutation and causes the lymphoid cells to behave abnormally and to multiply and expand uncontrollably.

Lymphoid cells are autonomously proliferating cells, and have longer life spans as compared to normal cells. They also have the tendency to invade into the surrounding normal tissue and are capable of metastasizing to other parts of the body.


What are the symptoms of lymphoma?

While the signs and symptoms of lymphoma may not be easily noticeable, some common symptoms include:

  • Enlarged (swollen) lymph glands
  • Chronic tiredness
  • Fever
  • Night sweats
  • Shortness of breath
  • Unexplained weight loss
  • Skin irritation or itchiness

How is lymphoma diagnosed?

Your doctor may recommend the following tests and procedures to diagnose Hodgkin lymphoma:

  • Physical examination – to check for swollen lymph nodes.
  • Blood tests – to look for irregularities in your blood that suggest the possibility of cancer.
  • Imaging tests – which may include x-rays and CT scans.
  • Lymph node biopsy – to remove a lymph node to see if abnormal cells (Reed-Sternberg cells) are found in the lymph node.
  • Bone marrow biopsy – to remove a sample of bone marrow to search for Hodgkin lymphoma cells.

How is lymphoma treated?

Lymphoma treatment is dependent on the type of lymphoma diagnosed and its severity. Treatment options include:

  • Chemotherapy
  • Immunotherapy medications
  • Radiation therapy
  • Targeted therapy
  • CAR-T cell therapy
  • Bone marrow transplant