Non-Hodgkin’s Lymphoma Facts
Risk Factors
Doctors do not know what causes lymphoma. There are several factors that may increase risk. But most people who have lymphoma have none of these risk factors.
Non-Hodgkin's lymphoma is more common in men than in women, and the risk increases with age. Also, you may be at higher risk for non-Hodgkin's lymphoma if any of these is true:
The symptoms of lymphoma can be caused by other non-cancer conditions. So it’s important to see a doctor if you have symptoms that concern you.
These are possible symptoms of lymphoma:
Diagnosis
Your doctor will do a physical exam first to look for signs of lymphoma. The doctor will also ask about your health history.
If the doctor thinks that you may have lymphoma, the doctor will probably perform a biopsy next to confirm the diagnosis. To perform a biopsy, a doctor removes a small sample of tissue to examine under a microscope. This may mean removing part or all of a lymph node or some tissue by surgery.
Another method is to take a sample of fluid or tissue using a needle, called needle biopsy or fine needle aspiration. This type of biopsy may be done to check the bone marrow or the fluid around the lungs (pleural fluid) or in the membrane around the abdominal organs (peritoneal fluid).
Your doctor may also want you to have imaging studies, such as a chest X-ray, computed tomography (CT) scan or PET scan, to see pictures of the inside of your body. This allows the doctor to look for enlarged lymph nodes, tumors or areas of cancer activity.
Doctors may do further tests to detect whether the cancer has spread around the lymph system or to other areas. This helps your doctor determine the stage of your cancer, which will be important when it’s time to make decisions about your treatment. You may need these or other tests:
Doctors do not know what causes lymphoma. There are several factors that may increase risk. But most people who have lymphoma have none of these risk factors.
Non-Hodgkin's lymphoma is more common in men than in women, and the risk increases with age. Also, you may be at higher risk for non-Hodgkin's lymphoma if any of these is true:
- Your immune system is weakened by an inherited disease, autoimmune disease, human immunodeficiency virus (HIV) or drugs given because you had an organ transplant.
- You have been infected with human T-lymphotropic virus type I (HTLV-1), Epstein-Barr virus (which causes mononucleosis), or Helicobacter pylori (a bacteria that causes ulcers).
- You were exposed to certain chemicals, such as ingredients in pesticides, herbicides, solvents or fertilizers.
- For Hodgkin's lymphoma, the following are links have been noted, but none of these causes of the disease:
- The disease is more common between ages 15 and 34 and after age 55.
- The disease is more common in men than in women.
- Risk is higher in brothers and sisters of those who have the disease.
- Risk is linked with exposure to the Epstein Barr virus, which causes mononucleosis.
The symptoms of lymphoma can be caused by other non-cancer conditions. So it’s important to see a doctor if you have symptoms that concern you.
These are possible symptoms of lymphoma:
- Painless swollen lymph nodes in the neck, underarm, groin, chest or abdomen
- Unexplained fever, weight loss or night sweats—sometimes called “B symptoms”
- Ongoing fatigue
- Itchy skin
- Red bumps on the skin, in the case of non-Hodgkin lymphoma
- Swelling in the face, neck or upper chest, caused by lymphoma pressing on the major vein that drains blood from these areas
- Feeling of fullness in the abdomen from an enlarged liver, spleen or lymph nodes
- Abdominal problems, such as nausea, vomiting and indigestion
Diagnosis
Your doctor will do a physical exam first to look for signs of lymphoma. The doctor will also ask about your health history.
If the doctor thinks that you may have lymphoma, the doctor will probably perform a biopsy next to confirm the diagnosis. To perform a biopsy, a doctor removes a small sample of tissue to examine under a microscope. This may mean removing part or all of a lymph node or some tissue by surgery.
Another method is to take a sample of fluid or tissue using a needle, called needle biopsy or fine needle aspiration. This type of biopsy may be done to check the bone marrow or the fluid around the lungs (pleural fluid) or in the membrane around the abdominal organs (peritoneal fluid).
Your doctor may also want you to have imaging studies, such as a chest X-ray, computed tomography (CT) scan or PET scan, to see pictures of the inside of your body. This allows the doctor to look for enlarged lymph nodes, tumors or areas of cancer activity.
Doctors may do further tests to detect whether the cancer has spread around the lymph system or to other areas. This helps your doctor determine the stage of your cancer, which will be important when it’s time to make decisions about your treatment. You may need these or other tests:
- Complete blood count, or CBC: to determine how many cells of each type are circulating in the blood stream
- Blood chemistry analysis: to look for chemicals in the blood that indicate disease in certain organs or tissues
- Lumbar puncture, or spinal tap: to remove cerebrospinal fluid (CFS) from the spinal column and check it for cancer cells; used in non-Hodgkin lymphoma only
- Bone marrow test: to see if the lymphoma has spread to the bone marrow
- Staging refers to the way doctors classify lymphoma based on where it is in the body. People who have lymphoma are considered to be at one of these stages:
- Stage I: This stage applies to those who have lymphoma in only one lymph node area or one organ.
- Stage II: This stage applies to those who have lymphoma in two or three lymph node areas near each other, such as all in the neck and chest.
- Stage III: This stage applies to those who have lymphoma in several lymph node areas in the neck, chest and abdomen.
- Stage IV: This stage applies to those who have widespread lymphoma in their lymph nodes and other organs, such as lungs and liver.
- E (such as “stage IIIE”) means your cancer is extranodal (goes beyond your lymph nodes).
- S (such as “stage IIIS”) means the cancer is in your spleen.