Non-Hodgkin Lymphoma (NHL) is a group of cancers of the lymphatic system that involves all forms of lymphoma other than Hodgkin lymphoma. The cancer caused the development of lymphocytes, a certain type of white blood cell that guards the body against infections caused by fungus, viruses, and bacteria. The development of lymphoma is the result of abnormal lymphocytes (lymph node cells) that grow uncontrollably while invading healthy tissue in the body.
Non-Hodgkin lymphoma is classified into various subtypes depending on the characteristics and origin of the cell (T-cell, B-cell, and follicular lymphoma). The doctor will need to determine the subtype of lymphoma to ensure the patient responds well to specific treatment to achieve a desirable prognosis.
- Who Is at Risk for Non-Hodgkin Lymphoma?
- Common Symptoms
- Diagnosing Non-Hodgkin Lymphoma
- Treating the Condition
Who Is at Risk for Non-Hodgkin Lymphoma?
While there are certain risk factors associated with non-Hodgkin lymphoma, many individuals at risk never developed the disease. Alternatively, some individuals who developed non-Hodgkin lymphoma never had obvious signs of any of the associated risk factors. These risk factors include:
- Immune System Suppressing Medications – Patients of undergone organ transplant are highly susceptible to developing non-Hodgkin lymphoma because the immunosuppressive therapy is designed to diminish the body's capacity for fighting off illnesses.
- Chemical Exposure – Being exposed to certain chemicals, including weed killers and insecticides can increase the risk of developing non-Hodgkin lymphoma.
- Some Bacterial and Virus Infections – Many cases of non-lymphoma are the result of the patient suffering an infection involving certain bacteria and viruses including Epstein-Barr virus and HIV. Bacteria-related non-Hodgkin lymphoma cases include H. pylori bacteria that can cause stomach ulcers.
- Age – Individuals 60 years and older tend to be at greatest risk of developing non-Hodgkin lymphoma compared to younger men and women.
What Causes Non-Hodgkin Lymphoma?
Medical science knows that non-Hodgkin lymphoma produces excessive numbers of abnormal lymphocytes that fail to follow a predictable lifecycle of maturing, reproducing, and dying off to allow healthy new cells to replace old cells. Alternatively, non-Hodgkin lymphoma patients have an excessive amount of damage lymphocytes that continuously reproduced without dying. This oversupply of abnormal cells begins to crowd out healthy cells in the body's lymph nodes and causes them to swell.
The development of non-lymphoma usually occurs in B cells and T cells.
- B Cells – This type of cell is designed to fight infection in the body for the production of antibiotics that guarded against foreign invaders like bacteria, fungus, and viruses. Most non-Hodgkin lymphoma cases involve B cells.
- T Cells – This type of cell kills foreign invaders directly. However, only a small percentage of non-Hodgkin lymphoma cases are related to T cells.
Usually, the doctor can identify non-lymphoma by the presence of cancerous lymphocytes that are detected in the body's lymph nodes. However, if the disease is allowed the progress, can easily spread to other areas of the lymphatic system that include bone marrow, spleen, adenoids, thymus, tonsils, and lymphatic vessels. Sometimes, the lymphoma spreads to areas outside the lymphatic system, including in the body's organs.
While medical science has yet to determine the exact cause of non-lymphoma, there are certain medical conditions that are related to the disease. These include:
- Inherited immune deficiency
- Celiac disease
- Immune disorders including sober and syndrome, mature arthritis, and systemic lupus erythematosus
- Crohn's disease
- Inflammatory bowel disease
- Genetic syndromes including Klinefelter's syndrome and Down syndrome
- Viruses including hepatitis virus, Epstein virus, HHV-8, SP-40, HTLV-1, and HIV.
- Bacteria including H.pylori and Lyme's Disease
The most common symptoms associated with non-Hodgkin lymphoma include:
- Unexpected weight loss
- Painless, swollen l ymph nodes that develop in the groin and armpits
- Night sweats
- Low red blood cell count (in the)
- Chest pain
- Difficulty in breathing
- Loss of appetite
- Abdominal swelling or pain
- Tiredness or weakness
- Itchy skin
Diagnosing Non-Hodgkin Lymphoma
An accurate diagnosis of non-Hodgkin lymphoma can be difficult. The doctor will likely conduct a comprehensive physical examination while focusing on palpating the body's lymph nodes occur in the groin, underarms, or. If the lymph nodes are swollen, the physician will attempt to palpate (touch) the skin over the liver or spleen area to determine if one or both organs are swollen. Swollen lymph nodes are usually an indicator of the presence of infection. Because of that, the doctor will need to establish an underlying cause for the infection before ruling out a diagnosis of non-Hodgkin lymphoma.
Other parts of the diagnosis will include:
- Medical History – The patient will need to provide information about their medical history to see if any known risk factors for non-lymphoma are present.
- Blood Tests – The doctor will typically order a CDC (complete blood count) to identify the numbers of white blood cells in the bloodstream. The blood test might also include a lactate dehydrogenase level test and other tests to rule out a hidden infection that might be causing the lymph nodes to become swollen.
- Imaging Tests – The doctor may order a CT (computerized tomography) scan or chest x-ray to help identify the presence of tumors in the body. In addition, the test results can identify in large lymph nodes.
- Biopsy – The doctor may remove a small portion of the lymph node through an incisional biopsy procedure, or the entire node might be removed through an excisional biopsy to gather enough tissue to make an accurate diagnosis after a pathologist has evaluated the tissue sample under a microscope.
- Bone Marrow Biopsy – Taking a sample of bone marrow through a biopsy procedure can help determine whether the disease has spread to surrounding tissue or to distant sites in the body. A bone marrow procedure requires inserting a needle into the bone to withdraw a small sample of tissue to be analyzed and evaluated in a laboratory setting.
Once an accurate diagnosis for non-Hodgkin lymphoma has been verified, the doctor can stage the disease by determining its classification and whether it involves B or T cells. The doctor may also order a DNA test of the lymphoma to rule out any genetic defect that could affect the patient's prognosis or how they respond to one or more treatments.
Treating Non-Hodgkin Lymphoma
Treatment for non-lymphoma often involves an oncologist or hematologist (blood cancer specialist) who is on a larger team of health care providers. The specialized doctor will formulate a plan of treatment based on the type of lymphoma, how far it has progressed, if it has metastasized (spread) to other areas of the body, and other factors associated with the patient, including their age and preferences.
The treating doctor will also consider the patient's other health issues and the symptoms they are experiencing including night sweats and fever. The doctor has lots of treatment options including:
- Radiation therapy
- Stem cell transplantation procedures
- Biological medications
- Radioimmunotherapy drugs
If non-Hodgkin lymphoma is diagnosed in its early stages, the prognosis can be extremely good for the patient if they respond well to treatment. However, if the disease has spread to other areas of the body, any and all therapies might not produce the best outcome. That said, the five-year survival rate for non-Hodgkin lymphoma is more than 80% when the disease is confined to a primary site, 73% when it is spread to regional lymph nodes, and 61% if the lymphoma has metastasized to other areas of the body.