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Non-Hodgkin Lymphoma

Non-Hodgkin lymphoma, much as it sounds, doesn’t show the classic Reed-Sternberg or Hodgkin cells found in Hodgkin lymphoma. Non-Hodgkin lymphoma is the more common of the two types, with over 80% of all lymphomas being diagnosed as non-Hodgkin.1 Much like Hodgkin lymphoma, non-Hodgkin lymphoma usually starts in the lymph nodes and affects white blood cells that normally would fight infection.

If your healthcare provider suspects you have non-Hodgkin lymphoma, he or she will need to perform a biopsy of your lymph node. A biopsy can sometimes be done with a needle, although at other times your healthcare provider may need to remove either part or all of a suspected lymph node.

Non-Hodgkin Lymphoma is not one condition, but a collection of blood cancers. There are over 60 different types of Non-Hodgkin Lymphoma, some which are fast growing (aggressive) and others that are slow growing (indolent). Trained pathologists utilize many different types of diagnostic tests to determine which subtype of non-Hodgkin lymphoma is present so your healthcare provider can provide the most appropriate treatment.

What are the Symptoms?

Signs and symptoms of lymphoma may include:

  • Painless swelling of lymph nodes in your neck, armpits or groin
  • Persistent fatigue
  • Fever
  • Night sweats
  • Shortness of breath
  • Unexplained weight loss

Who is at Risk?

A risk factor is anything that changes your chance of getting a disease like cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed, others can’t, like a person’s age or family history.

Having a risk factor, or even many risk factors, does not mean that you will get cancer. Many people who get cancer may have few or no known risk factors.

  • Age – most lymphomas occur in people in their 60s or older, although some types of lymphoma are more common in younger people.
  • Gender – the risk of non-Hodgkin lymphoma is higher in men than in women, but there are certain types of non-Hodgkin lymphoma that are more common in women.
  • Race – In the United States, Caucasians are more likely than African-Americans and Asian-Americans to develop non-Hodgkin lymphoma.
  • Family history – Having a first-degree relative (parent, child, or sibling) with non-Hodgkin lymphoma increases your risk.
  • Radiation therapy for other cancers – Recipients have a slightly increased risk of developing non-Hodgkin lymphoma later in life. This risk is greater for patients treated with both radiation therapy and chemotherapy.
  • Having a weakened immune system – People with weakened immune systems have an increased risk for non-Hodgkin lymphoma. For example:
    • People who receive organ transplants are treated with drugs that suppress their immune system to prevent it from attacking the new organ.
    • People infected with human immunodeficiency virus (HIV) are at increased risk of NHL.2
  • Certain infections – Some types of infections may raise the risk of non-Hodgkin lymphoma in different ways.
    • Infections that directly transform lymphocytes
    • Infection with the Epstein-Barr virus (EBV) – In the United States, EBV is more often linked with lymphomas in people also infected with HIV, the virus that causes AIDS. EBV has also been linked with some less common types of lymphoma.
    • Human herpes virus 8 (HHV-8) can also infect lymphocytes, leading to a rare type of lymphoma called primary effusion lymphoma. This lymphoma is most often seen in patients who are infected with HIV. HHV-8 infection is also linked to another cancer, Kaposi sarcoma. For this reason, another name for this virus is Kaposi sarcoma-associated herpes virus (KSHV).
    • Infections that weaken the immune system
    • Infection with human immunodeficiency virus (HIV), also known as the AIDS virus, can weaken the immune system and be a risk for primary CNS lymphoma, Burkitt lymphoma, and diffuse large B-cell lymphoma.
    • Infections that cause chronic immune stimulation
    • Helicobacter pylori, a type of bacteria known to cause stomach ulcers, has also been linked to mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach.
    • Chlamydophila psittaci (formerly known as Chlamydia psittaci) is a type of bacteria that can cause a lung infection called psittacosis. It has been linked to MALT lymphoma in the tissues around the eye (called ocular adnexal marginal zone lymphoma).
    • Infection with the bacterium Campylobacter jejuni has been linked to a type of MALT lymphoma called immunoproliferative small intestinal disease. This type of lymphoma, which is also sometimes called Mediterranean abdominal lymphoma, typically occurs in young adults in eastern Mediterranean countries.
    • Long-term infection with the hepatitis C virus (HCV) seems to be a risk factor for certain types of lymphoma, such as splenic marginal zone lymphoma.

References

  1. American Cancer Society. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2019/cancer-facts-and-figures-2019.pdf. Accessed September 10, 2019.
  2. American Cancer Society. https://www.cancer.org/cancer/cancer-causes/infectious-agents/hiv-infection-aids.html. Accessed April 16, 2019.