Reviewed By : Dr. Anjali D.
Following are some common questions about Lymphoma:
- What is lymphoma?
- What are the two different types of lymphoma?
- What is lymphatic system and how is it related to lymphoma?
- What increases the risk of developing lymphoma?
- What are the symptoms of lymphoma?
- What tests are suggested for lymphoma?
- What are the lab values for tests required for lymphoma?
- What are the test rates for lymphoma diagnosis in India?
- What are the different treatment methods for lymphoma?
What is lymphoma?
- Lymphoma is a type of cancer that attacks the immune system and the lymphocytes
- The cause of lymphoma has not been correctly determined by doctors
- Screening tests do not exist, yet for this type of cancer
What is lymphatic system and how is it related to lymphoma?
- There are two different types of lymphomas.
- The difference is in the type of lymphocytes involved. This can be observed by looking at the cancer cells through a microscope.
- They are:
- Hodgkin's disease or Hodgkin's lymphoma:
- The cancer starts in the lymphatic tissue
- First described by Thomas Hodgkin in 1832
- The abnormality occurs in the B-lymphocytes
- More common in children over 5 years of age
- In childhood, this disease is more prevalent among boys
- Among young adults, the probability is equal for both young boys and girls
- Non Hodgkin lymphoma(NHL):
- This type of cancer occurs more often among children
- It starts in the lymphoid tissue but it can develop outside the lymph nodes, e.g. stomach
- The two types of NHL are:
- B-Cell lymphoma- located in the head,neck, throat and abdomen
- T-Cell lymphoma- located in the chest
What is lymphatic system and how is it related to lymphoma?
To have a better understanding of lymphoma, a basic understanding of the workings of the lymphatic system is vital.
The main function of the lymphatic system is:
The lymphatic system consists of
- Fighting infection and other diseases
- Movement of fluids in the body
Major sites of Lymphoid tissue:
The lymphoid tissues are present throughout the body and therefore, lymphoma can start anywhere.
- Lymphoid tissue: Includes lymph nodes and other organs that form a part of the immune and blood forming system
- Lymph: A clear fluid that is circulated by the lymphatic system. It carries waste products and excess fluid from tissues,lymphocytes and other immune system cells.
- Lymphatic vessels: Thin-walled small tubes with valves, very similar to blood vessels. They help in distributing the lymph to various parts of the body.
- Lymph Nodes:
- They are kidney shaped structures that act as filters for harmful substances
- They are made up of lymphocytes and other immune system cells
- Lymph nodes occur in the chest,abdomen and pelvis and sometimes can be felt under the skin in the neck,under arms and in the groin
- They get bigger when they fight an infection. Such kinds of lymph nodes are called as reactive or hyperplastic nodes.
- It is an organ situated to the left of the stomach,in the upper far left corner of the abdomen
- Acts as a filter for the blood-borne
- Old red blood cells are recycled
- Platelets and WBCs(White Blood Cells) are stored
- Helps fight certain types of Pneumonia-causing bacteria
- Bone Marrow:
- Bone Marrow is a spongy, gelatinous tissue found in the hollow spaces in the interior of bones
- Help in producing blood and connective tissue cells
- It is a triangular shaped organ located behind the breast bone, but in front of the heart
- Helps in the training and development of T-lymphocytes, an extremely important type of White
Blood Cells. They defend the body from deadly pathogens like bacteria, virus and fungi.
- Adenoids and Tonsils:
- Tonsils are situated at the back of the throat and the adenoids, higher up, behind the nose
- Protects the body against infection by producing antibodies against germs that are breathed in or swallowed
- Digestive tract: The intestines, stomach and other organs also have lymphatic tissues
Lymphocyte: Lymphatic tissue is mainly made up of lymphocytes, a form of White Blood Cell(WBC). They are of two kinds
- B-Lymphocytes: B cells produce antibodies. These antibodies fasten themselves to germs so that they can be destroyed by the immune system. Hodgkin's disease start in B-lymphocytes
- T-Lymphocytes: T cells destroy some types of bacteria and also fight infection. Other types of T- cells, stimulate or slow down, immune cell activity
What increases the risk of developing lymphoma?
There are some things that are known to increase the risk of lymphoma. Some of these factors are more in common with lymphoma patients. They have not been found to be causes of the disease as such.
- Problems in the Immune System: When the immune system has been weakened by some other medical condition. Such as,
- Being on Immunosuppressive drugs: These drugs are taken so that the body does not reject organ or bone marrow transplant
- HIV infection
- Genetic disorder of Immune System: This is usually rare and often show up in young children
- Over-active Immune System: People with autoimmune disorders suffer from this. Autoimmune disorder occurs when the immune system mistakenly attacks its own body's healthy cells.
- Some viruses are the cause of lymphoma, directly or indirectly
- Some of them live in the lymphocyte cells and make them grow and divide. Some cause infections which affect the immune system, over a period of time.
- Some infections are common, and people suffering from them don't necessarily develop lymphoma
- Family History:
- It is not a genetic disease. People suffering from lymphoma don't normally have a family history of the disease
- However, having a relative with lymphoma does double the risk of developing it
- Previous Cancer Treatment: Chemotherapy and Radiotherapy sometimes cause damage to the genes of the lymphocytes. This again increases the chance of lymphoma
- Old Age:Older people are susceptible to this disease as genes change when a body grows old, but the body is unable to repair them.
- Chemicals:Industrial chemicals, hair dyes and pesticides have come up as possible risk factors
- Smokers have a higher possibility of developing a low-grade non Hodgkin lymphoma or EBV-linked Hodgkin lymphoma
- A diet consisting of a larger portion of fruits and vegetables, rather than red meat, animal fats and dairy, have shown to lessen the risk of cancer
- Regular physical exercise also brings down the risk of lymphoma
What are the symptoms of lymphoma?
- Swollen painless lymph nodes, in the area of the neck,armpit or groin
- Coughing, with breathing trouble and chest pain
- Night sweats
- Pain or a feeling of fullness in the abdomen region
- Weakness or Exhaustion
- Unexplained weight loss
What tests are suggested for lymphoma?
- The doctor first performs a physical examination for swollen lymph nodes. If nodes are swollen, it does not mean that it is cancer. It can mean that there is an infection in the node, unrelated to cancer.
- A lymph node biopsy may be performed, to check for cancer cells. By this procedure, a part or whole of the lymph node is removed to be tested, or a needle is used to remove some tissues from the affected organ.
- Blood test: A Complete blood count (CBC) is conducted to rule out other conditions like leukemia or anemia. A CBC confirms if platelet or WBC count is low which indicates that lymphoma is present in the bone marrow and/or blood.
- Bone Marrow Biopsy: It is done to determine the presence of abnormal lymphoid cells
- Molecular Genetic Typing: It looks for changes in the genes, proteins,etc. in the cancer cells. This helps the doctor to find out the type of lymphoma the patient is suffering from.
- Chest X-Ray: Used to take images inside the chest
- MRI: It uses large magnets and radio waves to look at the image of internal organs and structures
- PET Scan: It uses a radioactive substance known as the tracer to look for disease in the body
What are the lab values for tests required for lymphoma?
- CBC Tests : WBC(leukocyte count and white blood cell count): 4.3-10.8×10³/mm
What are the test rates for lymphoma diagnosis in India?
The test rates for lymphoma diagnosis may be different, determined by the city of residence, type of hospital or diagnostic centre.
What are the different treatment methods for lymphoma?
The treatment of lymphoma depends on its type and how far it has spread.
The main treatment for both Hodgkin and non-Hodgkin lymphoma are:
- Chemotherapy: Powerful drugs are used to kill the cancer cells. They are specially effective in killing off rapidly-dividing and growing cells.
- Radiation Therapy: Ionizing radiation is used to kill the malignant cells
Non-Hodgkin lymphoma uses another procedure called as
- Immunotherapy: It uses the patient's own immunity system to attack the cancer
If these treatments does not work then the next option is:
- Stem cell transplant: The tissues in the bone marrow are completely destroyed using chemotherapy. Then a stem cell transplant is given to the patient.
The two types of transplants are:
- Autologous transplant: Stem cells of the patient are used
- Allogeneic transplant: Stem cells are taken from a donor