Lymphoma

What is lymphoma?

Lymphoma refers to a group of cancers that affect a type of white cells called lymphocytes. Lymphomas are the most common blood cancers worldwide.

What are the types of lymphomas?

There are two main broad types of lymphoma: Hodgkin and non-Hodgkin. These 2 broad types of lymphoma are further subdivided into specific subtypes based on specific additional characteristics. According to the World Health Organization Classification, Hodgkin lymphoma is broadly grouped into Classical Hodgkin Lymphoma (cHL) and Nodular Lymphocyte-Predominant Hodgkin Lymphoma (NLPHL). The cHL also have further subtypes based on the features of the cells seen under the microscope during the diagnostic tests and these subtypes have been shown to predict the severity of the lymphoma and the response to treatment. The Non-Hodgkin lymphomas are a much larger group and the subtypes are classified based on the type of lymphocytes affected (B- or T- lymphocytes) and other specific characteristics of the lymphoma cells. It is important to know the specific subtype of lymphoma a person is diagnosed with because this is important to determine the specific treatment to be given.

What are the signs and symptoms of lymphomas?

Lymphomas usually present with swellings of glands called lymph nodes, which are areas where lymphocytes stay to help the body fight infection. There could also be enlargement of organs involved in the development or function of lymphocytes such as the spleen and thymus. There could also be swellings in any part of the body including the skin because lymphocytes are present in all parts of the body.

There could be bone pains if the lymphoma spreads to the bone. If there is spread to the bone marrow, it can prevent the development of the blood cells leading to anemia (fatigue, breathlessness) or low platelet count (bleeding).

How are lymphomas diagnosed?

To diagnose a lymphoma, a piece of the swelling or mass noted is usually taken through a surgical process called biopsy. The sample collected is then analysed in the laboratory and viewed under the microscope to identify the lymphoma cells. The diagnoses is usually confirmed by identification of specific proteins on the surface of the lymphoma by use of special stains in a process called immunophenotyping.

How are lymphomas staged?

There is a general staging system for all lymphomas to determine the spread of the disease. It ranges from a localised disease (Stage I) to a widely spread state (Stage IV). However, in some specific subtypes of lymphoma, other staging systems that have been shown from clinical trials to be more predictive of the extent of the disease and the response to treatment are used.

What are the treatment modalities for lymphomas?

To learn more about lymphoma, please check out the excellent information resources in the links below:

https://www.lls.org/lymphoma

https://www.lymphomacoalition.org/lymphomas

https://www.cancer.net/sites/cancer.net/files/asco_answers_nhl.pdf