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What is Lymphoma?

Lymphoma occurs when abnormal white blood cells (lymphocytes) over-multiply and overwhelm the lymphatic system, which is part of the immune system.

Doctors diagnose about 75,000 people in the United States with lymphoma each year.

Lymphoma often begins in the lymph nodes. But, because lymph tissue is present in many organs and structures, it can arise from nearly any location in the body.

Types of Lymphoma

The two main types of lymphoma are Hodgkin’s and non-Hodgkin’s.

People of any age can get either type, but:

  • Hodgkin’s tends to affect younger people between the ages of 15 and 35.
  • Non-Hodgkin’s affects mainly those over 60 years of age.

Hodgkin’s lymphoma

The classic type of Hodgkin’s lymphoma accounts for about 95 percent of all cases. It's the result of the invasion of the lymph nodes by large, abnormal lymphocytes — called Reed-Sternberg cells.

Classic Hodgkin’s lymphoma includes four subtypes, which differ in the location of origin.

Nodular lymphocyte predominant Hodgkin’s disease is rare.

This type of Hodgkin’s lymphoma often begins in the lymph nodes in the neck or underarm. It affects more men than women.

Non-Hodgkin’s lymphoma

Several subtypes of this lymphoma stem from abnormalities in different white blood cells — B cells, T cells, and NK cells.

The most common forms of non-Hodgkin’s lymphoma begin in B cells:

  • Diffuse large B cell lymphoma progresses rapidly.
  • Follicular lymphoma is a slow-growing cancer.

Two types of non-Hodgkin’s lymphoma begin in the white blood cells of the skin: mycosis fungoides and Sézary syndrome.

A very rare type of non-Hodgkin’s lymphoma — called primary central nervous system lymphoma — begins in the white blood cells of the:

  • Eye
  • Brain
  • Spinal cord

Lymphoma Prognosis

Prognosis depends on:

  • The lymphoma type.
  • How early doctors detect the disease.
  • Your response to treatment.

Lymphomas tend to form slowly, meaning that people can live for years without showing symptoms. By the time doctors discover the cancer, a person may be quite ill.

Early detection and treatment of lymphoma can mean a better outcome.

Risk Factors for Lymphoma

Common risk factors for lymphoma include:

  • Age — people between 15 to 35 years old and those over 55 may be at increased risk for Hodgkin’s lymphoma. People over the age of 60 may be at risk for non-Hodgkin’s lymphoma.
  • Weakened immune system — low immune functioning (due to a medical condition or from immunosuppressant drugs after organ transplant) can increase risk.
  • Certain viruses — viruses like Epstein-Barr or HIV can increase lymphoma risk.

How is Hodgkin’s Lymphoma Diagnosed?

Often, when people visit the doctor for symptoms of Hodgkin’s lymphoma, neither they nor their doctors suspect cancer at first.

Many lymphoma symptoms — like enlarged lymph nodes — can be the result of an infection or other health issue. Your doctor may try antibiotics or another conservative approach to see if the symptoms go away.

If your doctor does suspect you have Hodgkin’s lymphoma, he or she will order a biopsy.

Depending on your situation, you doctor may recommend:

  • Excisional or incisional biopsy.
  • FNA or core needle biopsy.

The lab will study your biopsy samples. During the staging phase, you may need to have a bone marrow biopsy.

How is Non-Hodgkin’s Lymphoma Diagnosed?

Blood tests cannot reveal the presence of non-Hodgkin’s lymphoma. A biopsy is the only way to detect this disease.

Your doctor will order the type of biopsy that best suits your blood disease:

  • Excisional or incisional biopsy.
  • FNA or core needle biopsy.

After a diagnosis of non-Hodgkin's lymphoma, your care team may order other tests to stage your cancer and track your progress.

These include:

  • Bone marrow biopsy.
  • Spinal tap.
  • Pleural or peritoneal fluid sampling.
  • Lab tests (immunohistochemistry, flow cytometry, cytogenetics, moleculargenetic tests).
  • Imaging tests.

Contact Us About Lymphoma Care

To reach the Mario Lemieux Center for Blood Cancers at UPMC Hillman Cancer Center, call 412-864-6600.