In non-Hodgkin's lymphoma, cells in the lymphatic system become abnormal. They divide and grow without any order or control, or old cells do not die as cells normally do. Because lymphatic tissue is present in many parts of the body, non-Hodgkin's lymphoma can start almost anywhere in the body. Non-Hodgkin's lymphoma may occur in a single lymph node, a group of lymph nodes, or in another organ. This type of cancer can spread to almost any part of the body, including the liver, bone marrow, and spleen.

Types of Non-Hodgkin's Lymphoma

Over the years, doctors have used a variety of terms to classify the many different types of non-Hodgkin's lymphoma. Most often, they are grouped by how the cancer cells look under a microscope and how quickly they are likely to grow and spread.

Aggressive lymphomas, also known as intermediate and high-grade lymphomas, tend to grow and spread quickly and cause severe symptoms. Indolent lymphomas, also referred to as low-grade lymphomas, tend to grow quite slowly and cause fewer symptoms.

Surgical biopsy establishes the diagnosis.  Special tests of blood, LN, or bone marrow establish the exact type of lymphoma e.g. cell surface markers and genetic studies (if needed). Cell surface markers are proteins in the surface of lymphoma cells that identify the kind of lymphoma. In CLL, CD5, CD19, CD23 and CD20 are present. For leukemia the presence of CD38 helps determine prognosis.  These cell surface markers are important since, therapy is available that can act directly on lymphoma cells with such markers – e.g., rituximab, a monoclonal antibody against CD20(+) cells.

Signs and Symptoms

The most common symptom of non-Hodgkin's lymphoma is a painless swelling of the lymph nodes in the neck, underarm, or groin.

Other symptoms may include the following:
• Unexplained fever
• Night sweats
• Constant fatigue
• Unexplained weight loss
• Itchy skin
• Reddened patches on the skin

When symptoms like these occur, they are not sure signs of non-Hodgkin's lymphoma. They may also be caused by other, less serious conditions, such as the flu or other infections. Only a doctor can make a diagnosis. When symptoms are present, it is important to see a doctor so that any illness can be diagnosed and treated as early as possible. Do not wait to feel pain; early non-Hodgkin's lymphoma may not cause pain.

Risk Factors

The incidence of non-Hodgkin's lymphoma has increased dramatically over the last couple of decades. At this time, little is known about the reasons for this increase or about exactly what causes non-Hodgkin's lymphoma.

Doctors can seldom explain why one person gets non-Hodgkin's lymphoma and another does not. It is clear, however, that cancer is not caused by an injury, and it is not contagious.

By studying patterns of cancer in the population, researchers have found certain risk factors that are more common in people who get non-Hodgkin's lymphoma than in those who do not. However, most people with these risk factors do not get non-Hodgkin's lymphoma, and many who do get this disease have none of the known risk factors.

The following are some of the risk factors associated with this disease:

• Age/Sex -- The likelihood of getting non-Hodgkin's lymphoma increases with age and is more common in men than in women.

• Weakened Immune System -- Non-Hodgkin's lymphoma is more common among people with inherited immune deficiencies, autoimmune diseases, or HIV/AIDS, and among people taking immunosuppressant drugs following organ transplants.

• Viruses -- Human T-lymphotropic virus type I (HTLV-1) and Epstein-Barr virus are two infectious agents that increase the chance of developing non-Hodgkin's lymphoma.

• Environment -- People who work extensively with or are otherwise exposed to certain chemicals, such as pesticides, solvents, or fertilizers, have a greater chance of developing non-Hodgkin's lymphoma.

People who are concerned about non-Hodgkin's lymphoma should talk with their doctor about the disease, the symptoms to watch out for, and an appropriate schedule for checkups. The doctor's advice will be based on the person's age, medical history, and other factors. Currently, there are no known preventive measures against Non-Hodgkin’s Lymphoma.
 

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