Overview

Non-Hodgkin's lymphoma is cancer that originates in your lymphatic system, the disease-fighting network spread throughout your body. In non-Hodgkin's lymphoma, tumors develop from lymphocytes — a type of white blood cell.

Non-Hodgkin's lymphoma is more common than the other general type of lymphoma — Hodgkin lymphoma. Many different subtypes of non-Hodgkin's lymphoma exist. Diffuse large B-cell lymphoma and follicular lymphoma are among the most common subtypes.

Advances in diagnosis and treatment of non-Hodgkin's lymphoma have helped improve the prognosis for people with this disease.

Non-Hodgkin's lymphoma care at Mayo Clinic

Source: http://www.mayoclinic.com

Symptoms

Signs and symptoms of non-Hodgkin's lymphoma may include:

• Painless, swollen lymph nodes in your neck, armpits or groin
• Abdominal pain or swelling
• Chest pain, coughing or trouble breathing
• Persistent fatigue
• Fever
• Night sweats
• Unexplained weight loss

When to see a doctor

Make an appointment with your doctor if you have any persistent signs and symptoms that worry you.

Source: http://www.mayoclinic.com

Causes

In most cases, doctors don't know what causes non-Hodgkin's lymphoma. In some cases, it's due to a weakened immune system. But it begins when your body produces too many abnormal lymphocytes — a type of white blood cell.

Normally, lymphocytes go through a predictable life cycle. Old lymphocytes die, and your body creates new ones to replace them. In non-Hodgkin's lymphoma, your lymphocytes don't die, but continue to grow and divide. This oversupply of lymphocytes crowds into your lymph nodes, causing them to swell.

B cells and T cells

Non-Hodgkin's lymphoma can begin in the:

• B cells. B cells fight infection by producing antibodies that neutralize foreign invaders. Most non-Hodgkin's lymphoma arises from B cells. Subtypes of non-Hodgkin's lymphoma that involve B cells include diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma and Burkitt lymphoma.
• T cells. T cells are involved in killing foreign invaders directly. Non-Hodgkin's lymphoma occurs less often in T cells. Subtypes of non-Hodgkin's lymphoma that involve T cells include peripheral T-cell lymphoma and cutaneous T-cell lymphoma.

Whether your non-Hodgkin's lymphoma arises from your B cells or T cells helps to determine your treatment options.

Where non-Hodgkin's lymphoma occurs

Non-Hodgkin's lymphoma generally involves the presence of cancerous lymphocytes in your lymph nodes. But the disease can also spread to other parts of your lymphatic system. These include the lymphatic vessels, tonsils, adenoids, spleen, thymus and bone marrow. Occasionally, non-Hodgkin's lymphoma involves organs outside of your lymphatic system.

Source: http://www.mayoclinic.com

Diagnosis

Your doctor will likely ask you about your personal and family medical history. He or she may then have you undergo tests and procedures used to diagnose non-Hodgkin's lymphoma, including:

• Physical exam. Your doctor checks for swollen lymph nodes, including in your neck, underarm and groin, as well as for a swollen spleen or liver.
• Blood and urine tests. Blood and urine tests may help rule out an infection or other disease.
• Imaging tests. Your doctor may recommend imaging tests to look for tumors in your body. Tests may include X-ray, CT, MRI and positron emission tomography (PET).
• Lymph node test. Your doctor may recommend a lymph node biopsy procedure to remove all or part of a lymph node for laboratory testing. Analyzing lymph node tissue in a lab may reveal whether you have non-Hodgkin's lymphoma and, if so, which type.
• Bone marrow test. A bone marrow biopsy and aspiration procedure involves inserting a needle into your hipbone to remove a sample of bone marrow. The sample is analyzed to look for non-Hodgkin's lymphoma cells.

Other tests and procedures may be used depending on your situation.

Staging non-Hodgkin's lymphoma

After your doctor has determined the extent of your non-Hodgkin's lymphoma, your cancer will be assigned a stage. Knowing your cancer's stage helps your doctor determine your prognosis and treatment options.

Stages of non-Hodgkin's lymphoma include:

• Stage I. The cancer is limited to one lymph node region or a group of nearby nodes.
• Stage II. In this stage, the cancer is in two lymph node regions, or the cancer has invaded one organ and the nearby lymph nodes. But the cancer is still limited to a section of the body either above or below the diaphragm.
• Stage III. When the cancer moves to lymph nodes both above and below the diaphragm, it's considered stage III. Cancer may also be found in the lymph nodes above the diaphragm and in the spleen.
• Stage IV. This is the most advanced stage of non-Hodgkin's lymphoma. Cancer cells are in several portions of one or more organs and tissues. Stage IV non-Hodgkin's lymphoma may also affect other parts of the body, such as the liver, lungs or bones.

Additionally, your doctor uses the letters A and B to indicate whether you're experiencing symptoms of non-Hodgkin's lymphoma:

• A means that you don't have any significant symptoms as a result of the cancer.
• B indicates that you may have significant signs and symptoms, such as a persistent fever, unintended weight loss or severe night sweats.

Many types of non-Hodgkin's lymphoma exist, including rare forms that are difficult for inexperienced pathologists to identify. Accurate diagnosis and staging are key to developing a treatment plan. Research shows that review of biopsy tests by pathologists who aren't experienced with lymphoma results in a significant proportion of misdiagnoses. Get a second opinion from a specialist if needed.

Source: http://www.mayoclinic.com

Alternative medicine

No alternative medicines have been found to treat non-Hodgkin's lymphoma. But alternative medicine may help you cope with the stress of a cancer diagnosis and the side effects of cancer treatment. Talk with your doctor about your options, such as:

• Art therapy
• Exercise
• Meditation
• Music therapy
• Relaxation exercises
• Spirituality

Source: http://www.mayoclinic.com

Coping and support

A non-Hodgkin's lymphoma diagnosis can be overwhelming. The following strategies and resources may help you deal with cancer:

• Learn about non-Hodgkin's lymphoma. Learn enough about your cancer to feel comfortable making decisions about your treatment and care. In addition to talking with your doctor, look for information in your local library and on the internet. Start your information search with the National Cancer Institute and the Leukemia & Lymphoma Society.

• Maintain a strong support system. Keeping your close relationships strong will help you deal with your non-Hodgkin's lymphoma. Friends and family can provide the practical support you'll need, such as helping take care of your house if you're in the hospital. And they can serve as emotional support when you feel overwhelmed by cancer.

  Although friends and family can be your best allies, they sometimes may have trouble dealing with your illness. If so, the concern and understanding of a formal support group or others coping with cancer can be especially helpful.

• Set reasonable goals. Having goals helps you feel in control and can give you a sense of purpose. But avoid setting goals you can't possibly reach. You may not be able to work a 40-hour week, for example, but you may be able to work at least part time. In fact, many people find that continuing to work can be helpful.
• Take time for yourself. Eating well, relaxing and getting enough rest can help combat the stress and fatigue of cancer. Also, plan for the downtimes when you may need to rest more or limit what you do.
• Stay active. Receiving a diagnosis of cancer doesn't mean you have to stop doing the things you enjoy or normally do. For the most part, if you feel well enough to do something, go ahead and do it. It's important to stay active and involved as much as you can.

Source: http://www.mayoclinic.com

Risk factors

In most cases, people diagnosed with non-Hodgkin's lymphoma don't have any obvious risk factors. And many people who have risk factors for the disease never develop it.

Some factors that may increase the risk of non-Hodgkin's lymphoma include:

• Medications that suppress your immune system. If you've had an organ transplant, you're more susceptible because immunosuppressive therapy has reduced your body's ability to fight new illnesses.
• Infection with certain viruses and bacteria. Certain viral and bacterial infections appear to increase the risk of non-Hodgkin's lymphoma. Viruses linked to increased non-Hodgkin's lymphoma risk include HIV and Epstein-Barr infection. Bacteria linked to an increased risk of non-Hodgkin's lymphoma include the ulcer-causing Helicobacter pylori.
• Chemicals. Certain chemicals, such as those used to kill insects and weeds, may increase your risk of developing non-Hodgkin's lymphoma. More research is needed to understand the possible link between pesticides and the development of non-Hodgkin's lymphoma.
• Older age. Non-Hodgkin's lymphoma can occur at any age, but the risk increases with age. It's most common in people 60 or over.