Lymphoma

What Is Lymphoma?

Lymphoma is a blood cancer that begins in lymphocytes, a type of white blood cell. Lymphocytes are part of the immune system and travel through the body to fight infection. They are found in the lymph nodes, spleen, thymus, bone marrow, and other areas.

There are two main types of lymphoma:

• Non-Hodgkin lymphoma. This is by far the more common type. It involves the lymphocytes known as B cells and T cells.
• Hodgkin lymphoma. This type is less common. It is defined by unusually large B cells called Reed-Sternberg cells, and it often spreads from one lymph node to the next.

Knowing the type matters, because it affects your treatment options.

Symptoms of Lymphoma

Lymphoma symptoms often resemble those of a cold, the flu, or a respiratory infection. The difference is that they persist. Common symptoms include:

• Swollen lymph nodes, often in the neck, armpits, or groin
• Ongoing tiredness or low energy
• Fever
• Chills
• Night sweats
• Unexplained weight loss
• Unusually itchy skin

Lymphoma Risk Factors

The exact cause of lymphoma is not known, and risk factors vary by type. General risk factors include:

• Age. Most cases occur in adults over 55, though some types are more common in young adults.
• Sex. Men are slightly more likely to develop lymphoma overall, but women are more likely to develop certain types.
• Immune system problems. The risk is higher for patients with immune system diseases or who take medicines that suppress the immune system, such as after an organ transplant.
• Infections. Epstein-Barr virus, which causes mononucleosis, and HIV may raise the risk.

How Lymphoma Is Diagnosed

Because there are no screening tests for lymphoma, many patients first see a doctor for what feels like a cold or the flu. A physician may suspect lymphoma after finding swollen lymph nodes during an exam. The next steps may include:

• Blood tests. These look at the type and number of your blood cells.
• Imaging. An MRI, CT scan, or PET scan.
• Lymph node biopsy. Part or all of a lymph node is removed and checked for lymphoma cells.
• Bone marrow biopsy. A needle is used to collect a sample of bone marrow, which is checked for lymphoma cells.

Lymphoma Staging

After a diagnosis, doctors determine whether the lymphoma has spread and how far. The stage helps show how serious the lymphoma is and guides treatment. According to the American Cancer Society, non-Hodgkin lymphoma in adults is staged from I to IV:

• Stage I. The lymphoma is in one lymph node area or one lymphoid organ, or in one area of a single organ outside the lymph system.
• Stage II. It is in two or more groups of lymph nodes on the same side of the diaphragm, or in lymph nodes and one nearby organ.
• Stage III. It is in lymph nodes on both sides of the diaphragm, or in lymph nodes above the diaphragm and in the spleen.
• Stage IV. It has spread widely to at least one organ outside the lymph system, such as the bone marrow, liver, or lung.

Imaging results are usually the most important part of staging. Read about lymphoma stages from the American Cancer Society.

Lymphoma Treatment Options

Treatment plans are tailored to each patient and to the type of lymphoma. A slow growing lymphoma may be watched closely instead of being treated right away. Treatment options include:

• Chemotherapy
• Targeted therapy
• Radiation therapy
• Immunotherapy
• Stem cell transplant. A bone marrow or stem cell transplant may be recommended for some lymphomas.
• CAR T-cell therapy. Offered for certain non-Hodgkin lymphomas. Your immune cells are removed, modified to fight cancer more effectively, and returned to your body.
• Clinical trials. Trials of CAR T-cell therapy and targeted immunotherapy may be an option for some patients with non-Hodgkin lymphoma.

Many patients receive a combination of these. Learn more about medical oncology and clinical trials at ACC.

Lymphoma Care Through Northside

The lymphoma team at Northside Hospital Cancer Institute includes experts in hematology, blood and marrow transplant, CAR T-cell therapy, pathology, medical oncology, and radiation oncology. Research nurses help determine whether a patient is eligible for a clinical trial.

Northside’s Blood and Marrow Transplant and CAR T-cell therapy programs are among the largest in the Southeast. Its transplant program is the only one in the United States whose survival outcomes for donor transplants have been significantly above the expected rate for 17 reporting cycles in a row, from 2009 to 2025.

Visit the Northside lymphoma program.

Lymphoma Support and Survivorship

Support continues during and after lymphoma treatment. At ACC, our oncology social workers help patients and their families with counseling, community resources, transportation, financial concerns, and more. You can also learn about supportive care at ACC.

Through Northside Hospital Cancer Institute, support services include:

• Cancer genetics
• Oncology nutrition
• Oncology social work and behavioral health
• Rehabilitation services
• Network of Hope peer support

See all of Northside’s support and survivorship services.

Common Questions About Lymphoma

Is lymphoma a blood cancer?

Yes. Lymphoma is a blood cancer that begins in lymphocytes, a type of white blood cell that is part of the immune system.

What is the difference between Hodgkin and non-Hodgkin lymphoma?

Non-Hodgkin lymphoma is much more common and involves B cells and T cells. Hodgkin lymphoma is less common and is defined by unusually large B cells called Reed-Sternberg cells.

Is there a screening test for lymphoma?

No. There are no screening tests for lymphoma. It is often suspected when a physician finds swollen lymph nodes during an exam.

Does lymphoma always need treatment right away?

Not always. A slow growing lymphoma may be monitored closely instead of being treated immediately.