Lymph nodes are small bean-shaped structures found all over the body. The main function of the lymph nodes is to filter the substances that travel through the lymphatic fluid and help the body fight against infection and diseases [1]. The lymphatic system of the body includes lymph nodes, spleen, bone marrow, and thymus glands.
Lymphoma is a cancer of the lymphatic system which affects the lymph nodes, spleen, bone marrow, and thymus glands. It can also affect the other organs of the body.
Types of lymphoma
There are several forms of lymphoma, but the major subtypes of lymphoma include:
- Hodgkin’s lymphoma– It is a less common type of lymphoma, compared to non-Hodgkin’s lymphoma. The major difference between Hodgkin’s and Non-Hodgkin’s lymphoma is the presence of Reed Sternberg cells (they are abnormally large B-lymphocytes) present in Hodgkin’s lymphoma. They can spread from one lymph node to the other in an orderly manner.
- Non-Hodgkin’s lymphoma- It is considered as the most common type of lymphoma cancer. It accounts for about 95% of lymphoma cases. It most commonly affects late adulthood (ages 60-80 years). It is developed from the B-lymphocytes (cells) and T-lymphocytes in the lymph nodes or throughout the body. The prognosis of non-Hodgkin’s lymphoma is poorer compared to Hodgkin’s lymphoma. They can spread through the lymph nodes in a non-orderly manner [2].
Causes and risk factors of lymphoma
The exact cause of lymphoma is not known. However, research studies are carried on regarding the exact cause of lymphoma. There are a few risk factors that can increase the chances of causing lymphoma. A few of the risk factors are listed below:
- Age- Non-Hodgkin’s lymphoma is generally seen to affect people aged in their 60s, whereas Hodgkin’s lymphoma is seen to affect people aged between 15-40 years or above 55 years.
- Gender- The incidence is slightly higher in males compared to females
- Immune system- People who are having a weak immune system have an increased chance of developing lymphoma.
- Family history- The incidence rate is high in people who have a family history of lymphoma.
- Recurrence- People who have been treated for Non-Hodgkin’s or Hodgkin’s lymphoma in the past
- Exposure to certain chemicals
- Radiation exposure- Patients who have undergone any radiation therapy for any other cancer in the past [3].
- Autoimmune diseases
The signs and symptoms of lymphoma are listed below:
- Swollen and painless lymph nodes found in the stomach, chest, armpit, or groin.
- Fever
- Night sweats
- Breathlessness (shortness of breath)
- Unexplained weight loss
- Fatigue [4]
Diagnosis of lymphoma
Whenever the patient approaches the doctor, the doctor initially will do a physical examination of the patient. The doctor will examine the patient thoroughly. The doctor will record the medical and family history of the patient. In order to confirm the disease, the doctor will advise the patient to undergo a couple of tests, which include:
- Blood tests
- Investigational scans- which include
- a) CT scans
- b) MRI scans
- c) PET scans
- d) Ultrasonography
- e) X-ray imaging of the chest, abdomen, and pelvis.
- Biopsy- During this procedure, a small sample of tissue is taken from the lymph node and sent to a pathological lab for further evaluation and testing.
- Bone marrow testing
- Lumbar puncture- to analyze the CSF
- Molecular tests- This test will help us find changes in the genes, proteins, and other substances which can help us diagnose the type of lymphoma.
Treatment of lymphomas
The treatment modality of lymphomas depends upon several factors such as the subtype of lymphoma, its severity, and the overall condition of the patient. Treatment measures include:
The treatment options for Hodgkin’s lymphoma are:
- Chemotherapy
- Radiation therapy
- Immunotherapy- drugs included are pembrolizumab and nivolumab.
The treatment options available for non-Hodgkin’s lymphoma are:
- Targeted drug therapy
- High-dose chemotherapy
- Stem cell transplantation
- Radiation therapy
- Immunotherapy
- Bone marrow replacement [5].
Side effects associated with lymphoma treatment
The side effects associated with lymphoma treatment are listed below:
- Recurrence
- Extreme fatigue
- Nausea and vomiting
- Hair loss due to chemotherapy or radiation therapy
- Poor immune-compromised state
- Headache
- Skin rashes due to radiation exposure
- Infertility in a few cases
- Peripheral neuropathy (due to nerve damage)
Prognosis of lymphoma
The overall prognosis of lymphoma depends upon the subtype of lymphoma and its severity. The prognosis of Hodgkin’s lymphoma has a better prognosis compared to non-Hodgkin’s lymphoma. According to the National Cancer Institute’s surveillance, they have estimated that the relative 5-year survival rate of non-Hodgkin’s lymphoma is about 73.2%, whereas the relative 5-year survival rate of Hodgkin’s lymphoma is about 88.3% [6].
FAQ
- What happens if lymphoma is left untreated?
Early diagnosis and treatment of lymphomas have an overall good prognosis, while if left untreated it can result in causing severe breathlessness, chest pain, significant weight loss, and can cause life-threatening complications.
- When to contact the doctor or hospital/ How to identify the emergency or complications?
Whenever the patient notices any kind of abnormalities in the body, one should seek medical advice immediately. A few of the warning signs include:
- Breathlessness
- Long-standing history of fever
- Severe unexplained weight loss
- Extreme fatigue
- Swelling of the lymph glands
- Suggested clinical specialists/ departments to consult for this condition
Lymphoma is a lymphatic system-related cancer, it is usually treated by a medical oncologist or hematologist, a radiation oncologist, and a bone marrow replacement surgeon. They can identify this condition and suggests the right treatment.
Consult Best Haematologists in Vijayawada to know about measures that can be taken to improve symptoms and prevent complications.
