About

Non-Hodgkin Lymphoma (NHL)


About Non-Hodgkin Lymphoma

Non-Hodgkin Lymphoma (NHL), also called non-Hodgkin’s lymphoma or lymphoma, is a type of cancer that originates in the lymphocytes, or white blood cells. There are many subtypes of NHL, thus, many different treatment approaches based on each individual case.

The following information is about NHL in adults. Find out about NHL in children here.


Cancer is when cells grow out of control. This can happen in any part of the body, and in advanced stages it can spread to other parts of the body as well.

In NHL, the cancerous cells originate from lymphocytes, a type of white blood cell that is part of the immune system. It is more common in adults than in children, although it can affect children as well.

Non-Hodgkin lymphoma includes many different types of lymphomas with the same characteristics. Hodgkin lymphoma is another type of lymphoma that is treated differently from NHL.

Lymphoma originates in the lymphatic system, which transports lymph, a fluid that contains disease-fighting white blood cells and circulates through the body, much like blood does.

The lymphatic system spans the whole body, and lymphomas can start anywhere lymph tissue is found. Major sites of lymph tissue include:

  • Lymph nodes: Small, bean-shaped organs that are present throughout the body and contain collections of B and T lymphocytes and other immune system cells. They help to filter out lymph fluid. Lymph nodes are connected by lymphatic vessels.
  • Spleen: An organ located under the lower ribs on the left side of the body. The spleen is responsible for making lymphocytes and other immune system cells.
  • Bone Marrow: Spongy tissue located inside certain bones. Bone marrow is where new blood cells, including some lymphocytes, are made.
  • Thymus: A small lymphoid organ located beneath the sternum at heart-level. The thymus is where T lymphocytes mature.
  • Adenoids and tonsils: Patches of lymphatic tissue located at the back of the throat. They help to make antibodies and trap pathogens that enter the body through the nose and mouth.
  • Digestive tract: The stomach and intestines contain lymph tissue.

There are about 60 known types of NHL, making diagnosis a complicated process. A treatment plan cannot be created until the type of lymphoma is identified. Specialists will make a diagnosis based on several factors:

  • The type of lymphocyte affected (B-cells or T-cells)
  • The appearance of the lymphocyte under a microscope
  • Chromosomal features of the lymphoma cells
  • Presence of certain proteins on the surface of the cancer cells
  • Maturity of the cells when they become cancerous
  • Aggressiveness of the lymphoma

Just like with any other type of cancer, all types of NHL can spread to other parts of the body when not treated quickly enough.

B-cells are responsible for fighting infection by producing antibodies to neutralize pathogens. About 85% of NHL cases are B-cell lymphomas. A few of the most common classifications include:

  • Diffuse Large B-Cell Lymphoma (DLBCL). This type of NHL accounts for 1 out of every 3 lymphomas. It generally affects older people, with an average age of 65 at the time of diagnosis. DLBCL tends to be aggressive, but often responds well to treatment. Subtypes include primary mediastinal B-cell lymphoma and intravascular large B-cell lymphoma.
  • Chronic Lymphocytic Leukemia (CLL) / Small Lymphocytic Lymphoma (SLL). Both CLL and SLL are slow-growing diseases. They are grouped together because the lymphocytes found in both diseases are the same, and treatment is usually the same as well. In CLL, cancer cells are found in the blood and bone marrow. In SLL, cancer cells are found in the lymph nodes and spleen.
  • Follicular Lymphoma. This type of lymphoma is usually slow-growing. It occurs in many lymph node sites throughout the body as well as in the bone marrow.
  • Mantle Cell Lymphoma (MCL). Mantle cell lymphoma accounts for 5% of lymphomas. It is usually widespread throughout the body and difficult to treat.
  • Marginal Zone Lymphomas. There are three subtypes of marginal zone lymphomas, and they tend to be slow-growing and responsive to treatment.

Rarer types of B-cell lymphomas include Burkitt lymphoma; lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia); hairy cell leukemia; and primary central nervous system (CNS) lymphoma.

T-cell lymphomas account for up to only 15% of NHL cases. Still, they come in many forms, including:

  • Cutaneous T-cell lymphoma (CTCL). There are two main types of CTCL: mycosis fungoides that affects the skin and causes lesions; and Sezary syndrome that affects the blood, lymph nodes, and other organs.
  • Precursor T-lymphoblastic lymphoma/leukemia. This lymphoma usually starts in the thymus and grows in the area between the lungs.
  • Angioimmunoblastic T-cell lymphoma. This is a rare type of T-cell lymphoma that tends to be quite aggressive.
  • Anaplastic large cell lymphoma (ALCL). ALCL includes three subtypes and can affect the skin, lymph nodes, and other organs.

What is Non-Hodgkin’s Lymphoma?

Cancer is when cells grow out of control. This can happen in any part of the body, and in advanced stages it can spread to other parts of the body as well.

In NHL, the cancerous cells originate from lymphocytes, a type of white blood cell that is part of the immune system. It is more common in adults than in children, although it can affect children as well.

Non-Hodgkin lymphoma includes many different types of lymphomas with the same characteristics. Hodgkin lymphoma is another type of lymphoma that is treated differently from NHL.

 

Where Lymphoma Starts

Lymphoma originates in the lymphatic system, which transports lymph, a fluid that contains disease-fighting white blood cells and circulates through the body, much like blood does.

The lymphatic system spans the whole body, and lymphomas can start anywhere lymph tissue is found. Major sites of lymph tissue include:

  • Lymph nodes: Small, bean-shaped organs that are present throughout the body and contain collections of B and T lymphocytes and other immune system cells. They help to filter out lymph fluid. Lymph nodes are connected by lymphatic vessels.
  • Spleen: An organ located under the lower ribs on the left side of the body. The spleen is responsible for making lymphocytes and other immune system cells.
  • Bone Marrow: Spongy tissue located inside certain bones. Bone marrow is where new blood cells, including some lymphocytes, are made.
  • Thymus: A small lymphoid organ located beneath the sternum at heart-level. The thymus is where T lymphocytes mature.
  • Adenoids and tonsils: Patches of lymphatic tissue located at the back of the throat. They help to make antibodies and trap pathogens that enter the body through the nose and mouth.
  • Digestive tract: The stomach and intestines contain lymph tissue.

 

Types of Non-Hodgkin Lymphoma

There are about 60 known types of NHL, making diagnosis a complicated process. A treatment plan cannot be created until the type of lymphoma is identified. Specialists will make a diagnosis based on several factors:

  • The type of lymphocyte affected (B-cells or T-cells)
  • The appearance of the lymphocyte under a microscope
  • Chromosomal features of the lymphoma cells
  • Presence of certain proteins on the surface of the cancer cells
  • Maturity of the cells when they become cancerous
  • Aggressiveness of the lymphoma

Just like with any other type of cancer, all types of NHL can spread to other parts of the body when not treated quickly enough.

 

B-Cell Lymphomas

B-cells are responsible for fighting infection by producing antibodies to neutralize pathogens. About 85% of NHL cases are B-cell lymphomas. A few of the most common classifications include:

  • Diffuse Large B-Cell Lymphoma (DLBCL). This type of NHL accounts for 1 out of every 3 lymphomas. It generally affects older people, with an average age of 65 at the time of diagnosis. DLBCL tends to be aggressive, but often responds well to treatment. Subtypes include primary mediastinal B-cell lymphoma and intravascular large B-cell lymphoma.
  • Chronic Lymphocytic Leukemia (CLL) / Small Lymphocytic Lymphoma (SLL). Both CLL and SLL are slow-growing diseases. They are grouped together because the lymphocytes found in both diseases are the same, and treatment is usually the same as well. In CLL, cancer cells are found in the blood and bone marrow. In SLL, cancer cells are found in the lymph nodes and spleen.
  • Follicular Lymphoma. This type of lymphoma is usually slow-growing. It occurs in many lymph node sites throughout the body as well as in the bone marrow.
  • Mantle Cell Lymphoma (MCL). Mantle cell lymphoma accounts for 5% of lymphomas. It is usually widespread throughout the body and difficult to treat.
  • Marginal Zone Lymphomas. There are three subtypes of marginal zone lymphomas, and they tend to be slow-growing and responsive to treatment.

Rarer types of B-cell lymphomas include Burkitt lymphoma; lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia); hairy cell leukemia; and primary central nervous system (CNS) lymphoma.

 

T-Cell Lymphomas

T-cell lymphomas account for up to only 15% of NHL cases. Still, they come in many forms, including:

  • Cutaneous T-cell lymphoma (CTCL). There are two main types of CTCL: mycosis fungoides that affects the skin and causes lesions; and Sezary syndrome that affects the blood, lymph nodes, and other organs.
  • Precursor T-lymphoblastic lymphoma/leukemia. This lymphoma usually starts in the thymus and grows in the area between the lungs.
  • Angioimmunoblastic T-cell lymphoma. This is a rare type of T-cell lymphoma that tends to be quite aggressive.
  • Anaplastic large cell lymphoma (ALCL). ALCL includes three subtypes and can affect the skin, lymph nodes, and other organs.

 

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