Non-Hodgkin lymphoma (NHL) is a cancer in the lymphatic system. The American Cancer Society estimates that there will be 65,540 new cases of non-Hodgkin lymphoma in 2010. Although NHL is the third most common cancer in childhood, more than 95 percent of cases occur in adults.
Non-Hodgkin lymphoma causes the cells in the lymphatic system to abnormally reproduce, eventually causing tumors to grow. Non-Hodgkin lymphoma cells can also spread to other organs.
There are several types of non-Hodgkin lymphoma, which are classified by how quickly they spread.
The following are the most common symptoms of non-Hodgkin lymphoma. However, each individual may experience symptoms differently. Symptoms may include:
- Painless swelling of lymph nodes in neck, underarm, and/or groin
- Night sweats
- Weight loss
- Itching of the skin
- Recurring infections
- Swelling in the abdomen
- Swelling in the face and arms
The symptoms of non-Hodgkin lymphoma may resemble other blood disorders or medical problems, such as influenza or other infections. In fact, many of these symptoms are more liklely to be caused by something other than lymphoma. Always consult your physician for a diagnosis.
Suggested risk factors for non-Hodgkin lymphomas include the following:
- Older age
- Male gender
- Immune system deficiency
- Autoimmune diseases
- Exposure to radiation
- Exposure to chemicals such as benzene and herbicides
- Organ transplantation
- Infections with human immunodeficiency virus (HIV), hepatitis C virus, or human T-cell leukemia/lymphoma virus (HTLV-1)
- History of infectious mononucleosis (caused by an infection with the Epstein-Barr virus)
- Infection with Helicobacter pylori (H. pylori) bacterium, which has been identified as a cause of stomach ulcers
No specific cause has been identified.
In addition to a complete medical history and physical examination, diagnostic procedures for non-Hodgkin lymphoma may include the following:
- Blood tests and other evaluation procedures
- X-ray of the chest - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
- Lymph node biopsy - a procedure performed to remove tissue or cells from the body for examination under a microscope.
- Bone marrow aspiration and/or biopsy - a procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.
- Computed tomography scan (Also called a CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
- Magnetic Resonance Imaging (also called and MRI scan) - MRIs use radio waves and magnets. The energy from the readio waves creates patterns formed by different types of tissue and diseases. This produces detailed cross-sectional pictures that look like slices of the body. This test is helpful in examining your brain and spinal cord. Or, it may be used if the results of an X-ray or CT scan aren't entirely clear.
- Ultrasound (Also called sonography) - a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
- Positron emission tomography (PET) - a type of nuclear medicine procedure. For this test, you get injected with a small amount of radioactive glucose. Then you lie still on a table that is pushed into the PET scanner, which rotates around you, taking pictures. Glucose use is a sign of active, quickly dividing cells, such as lymphoma. The images from a PET scan are not finely detailed like a CT or a MRI scan, but they can show areas of increased cellular activity anywhere in the body, even if they don't show up on other tests. Many medical centers now have machines that combine PET and CT scans (PET/CT scanners), which are able to compare the information from the PET scan with the detailed image of the CT scan.
Specific treatment for non-Hodgkin lymphoma will be determined by your physician based on:
- Your age, overall health, and medical history
- The type and extent of the disease
- Your tolerance for specific medications, procedures, or therapies
- Expectations for the course of the disease
- Your opinion or preference
Treatment may include:
- Radiation therapy
- Biologic (immune) therapy
- High-dose chemotherapy with bone marrow or peripheral blood stem cell transplantation