What is Non-Hodgkin's lymphoma?

Non-Hodgkin's lymphoma

What is non-Hodgkin's lymphoma?

Non-Hodgkin's lymphoma is a type of cancer. The cancer starts in your lymphatic system, a part of your body that helps fight infections. There are lots of different kinds of non-Hodgkin's lymphomas. Many of them can be cured, even when the cancer has spread.

The information here is for adults with a type of fast-growing non-Hodgkin's lymphoma called diffuse large B-cell lymphoma.

Key points about fast-growing non-Hodgkin's lymphoma

There are many different kinds of non-Hodgkin's lymphomas (see Types of non-Hodgkin's lymphomas). It's important for doctors to find the exact type of lymphoma you have so that you get the right treatment.
Make sure you're treated by doctors who are used to treating people with non-Hodgkin's lymphoma.
Non-Hodgkin's lymphoma can be cured, especially if it's caught early.
Even if your cancer is large or has spread, there's still a chance that it can be cured.
Many thousands of Americans are alive after being treated for non-Hodgkin's lymphoma.

Source:
American Cancer Society.
Cancer Facts and Figures 2005.
Available at http://www.cancer.org (accessed on 17 January 2008).

¹

Your lymphatic system

The

lymphatic system
The lymphatic system is the body's way of clearing and cleaning unwanted materials from the blood and tissues. It includes an interconnected network of lymph nodes that filter these materials to see if there is an infection that will require response by the immune system.

lymphatic system is a part of your

immune system
The immune system is made up of the parts of the body that are devoted to fighting infection. The body is constantly being threatened by infections from things like bacteria, viruses and parasites. The immune system fights these infections in different ways. At the microscopic level, the immune system uses antibodies and white blood cells, which travel in the blood and target infectious agents, such as bacteria. These microscopic parts of the immune system either kill the infectious agent directly, or take it to other parts of the body, like the spleen, where it can be dealt with. The lymph nodes are another important part of the immune system. Within them, white blood cells filter through the foreign material that has entered the blood, to see if there are any infections. When you have a swollen gland during a cold, this is actually a lymph node that is reacting to the infection. Unfortunately, it is possible for the immune system to become confused and to use its destructive powers to target healthy parts of the body. Diseases that result from this type of situation are called autoimmune diseases.

immune system. It makes cells that help to clear away waste fluid from your body. It also helps your body fight infections.

A swollen gland in the neck can be a sign of non-Hodgkin's lymphoma or an infection.

Your lymphatic system consists of several parts.

Source:
Martini FH.
The lymphatic system and immunity.
In: Ober WC, Garrison CW, Welch K, et al. Fundamentals of anatomy and physiology 5th edition. Prentice Hall, Upper Saddle River, U.S.A.; 2001.

Source:
Guyton AC, Hall JE.
Textbook of medical physiology.
10th edition. WB Saunders, Philadelphia, U.S.A.; 2001.

The lymph nodes and lymphatic vessels are part of your lymphatic system.

Lymphatic vessels. These are narrow tubes that reach every part of your body. They are a bit like your blood vessels. They collect fluid (called

lymph
Lymph is a clear or whitish liquid that is collected from all over the body and flows through the lymphatic vessels and lymph nodes (also called glands). It contains proteins and fats, some red blood cells, and many white blood cells, especially lymphocytes. Lymphocytes help the body fight infection.

lymph) from all over your body and empty it into your bloodstream. This keeps the balance of fluid in your body just right
Special cells called lymphocytes. These cells find and kill

bacteria
Bacteria are tiny organisms. There are lots of different types. Some are harmful and can cause disease. But some bacteria live in your body without causing any harm.

bacteria and

viruses
Viruses are microbes (tiny organisms) that need the cells of humans or other animals to exist. They use the machinery of cells to reproduce. Then they spread to other cells in the body.

viruses that get into your body and make you sick. When you have a lymphoma, these cells turn cancerous. There are different types of lymphocytes. To learn more, see Lymphocytes and what they do
Lymph nodes. These are small lumps that are packed with lymphocytes. Groups of lymph nodes are found at certain places in your body, such as in your neck, armpits and groin. Lymph nodes clean (filter) fluid from your tissues before it goes into your blood. If the lymph nodes find any bacteria or viruses, they make more lymphocytes to help fight off the infection. This makes them swell up, which is why the lymph nodes in your neck can swell up if you get an infected tooth or a sore throat. And if you cut your elbow and it becomes infected, the lymph nodes in your armpit will swell up
Tissues that help make or store lymphocytes. These include your bone marrow (the spongy tissue in the middle of long bones).

What happens in non-Hodgkin's lymphoma?

When your body's cells are healthy, they grow and divide to form new cells as your body needs them. When cells grow old and die, new cells take their place.

Sometimes this process breaks down. New cells form too quickly, when the body doesn't need them, and old cells don't die when they should. The extra cells can form a mass called a growth or tumor.

Some tumors are benign. This means they don't spread and they don't cause cancer (they are not cancerous).
Some tumors are malignant. This means they spread and they are cancerous.

Here's what we know about non-Hodgkin's lymphoma.

Source:
O'Reilly SE, Connors JM.
Non-Hodgkin's lymphoma: characterisation and treatment.
BMJ. 1992; 304: 1682-1686.

⁴

Non-Hodgkin's lymphoma starts in cells called lymphocytes. These cells help your body to fight infections. For more, see Lymphocytes and what they do.
A single lymphocyte loses control and divides over and over again. Eventually, a solid lump of lymphocytes forms. This lump is the cancer called non-Hodgkin's lymphoma.
Most non-Hodgkin's lymphomas start in lymph nodes.
Lymph nodes are normally too small to feel. But cancerous lymph nodes can grow big enough to feel through your skin.
Non-Hodgkin's lymphomas can grow in lymph nodes near your skin, such as those in your neck, groin and armpit.

Source:
National Cancer Institute.
What you need to know about non-Hodgkin's lymphoma.
Available at http://www.cancer.gov/cancertopics/wyntk/non-hodgkins-lymphoma (accessed on 16 January 2008).

⁵
They can also grow in lymph nodes deep inside your body where you can't feel them, such as those in your chest or abdomen.
Non-Hodgkin's lymphomas can also grow outside lymph nodes.

Source:
O'Reilly SE, Connors JM.
Non-Hodgkin's lymphoma: characterisation and treatment.
BMJ. 1992; 304: 1682-1686.

⁴

Source:
Mounter PJ, Lennard AL.
Management of non-Hodgkin's lymphomas.
Postgraduate Medical Journal. 1999; 75: 2-6.

⁶

Source:
Theodossiou C, Schwarzenberger P.
Non-Hodgkin's lymphomas.
Clinical Obstetrics and Gynecology. 2002; 45: 820-829.

⁷ A common place to find these is the stomach or intestines.

Source:
Armitage J, Mauch PM, Harris NL.
Lymphomas.
In: DeVita V, Hellman S, Rosenberg S (editors). Cancer: Principles and Practice of Oncology. 6th edition. Lippincott Williams and Wilkins, New York, USA; 2001.

⁸
They can also grow in the brain,

thyroid gland
Your thyroid gland is a small organ that sits in your neck, just in front of your windpipe. It sends out a hormone called thyroxine. This acts on receptors within cells. By acting on the receptors it gives the cells a message to speed up their metabolism and work harder.

thyroid gland, lungs, bone, bone marrow, testicles, sinuses and breast.

Before doctors can plan your treatment, they need to find out:

What type of lymphoma you have (see Types of non-Hodgkin's lymphomas)
Whether your lymphoma has spread and how far it has spread. This is called the stage of your lymphoma (see Stages of non-Hodgkin's lymphoma).

Why me?

We don't know what causes non-Hodgkin's lymphoma. You can't catch it from other people. But there are certain things that increase your chances of getting this type of cancer. Doctors call these things risk factors.

The main risk factor for non-Hodgkin's lymphoma is being over 60 years old. Another important risk factor for this type of cancer is having a problem with your immune system.

It's important to remember that even if you have a risk factor for a condition it doesn't mean you're going to get it. After all, not everyone over 60 gets non-Hodgkin's lymphoma. Having a risk factor just means that you have a higher chance of getting the condition than someone who doesn't have any risk factors.

To learn more, see Risk factors for non-Hodgkin's lymphoma.

Sources for the information on this page:

American Cancer Society.Cancer Facts and Figures 2005. Available at http://www.cancer.org (accessed on 17 January 2008).

Martini FH.The lymphatic system and immunity.In: Ober WC, Garrison CW, Welch K, et al. Fundamentals of anatomy and physiology 5th edition. Prentice Hall, Upper Saddle River, U.S.A.; 2001.

Guyton AC, Hall JE.Textbook of medical physiology.10th edition. WB Saunders, Philadelphia, U.S.A.; 2001.

O'Reilly SE, Connors JM.Non-Hodgkin's lymphoma: characterisation and treatment.BMJ. 1992; 304: 1682-1686.

National Cancer Institute. What you need to know about non-Hodgkin's lymphoma.Available at http://www.cancer.gov/cancertopics/wyntk/non-hodgkins-lymphoma (accessed on 16 January 2008).

Mounter PJ, Lennard AL.Management of non-Hodgkin's lymphomas.Postgraduate Medical Journal. 1999; 75: 2-6.

Theodossiou C, Schwarzenberger P.Non-Hodgkin's lymphomas.Clinical Obstetrics and Gynecology. 2002; 45: 820-829.

Armitage J, Mauch PM, Harris NL.Lymphomas.In: DeVita V, Hellman S, Rosenberg S (editors). Cancer: Principles and Practice of Oncology. 6th edition. Lippincott Williams and Wilkins, New York, USA; 2001.

This information was last updated on Jan 08, 2009

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.

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