What is adult non-Hodgkin’s lymphoma (NHL)?

Adult non-Hodgkin’s lymphoma (NHL) is a malignant cancer that begins in the lymph system. The lymph system is part of the body’s immune system. “Malignant” means a disease spreads from where it starts and invades other areas of the body. Adult non-Hodgkin’s lymphoma differs from lymphoma in children and has a different course of treatment. “Non-Hodgkin’s” means the absence of a certain type of cell, called Reed-Sternberg cells, in the cancerous tissue.

The lymph includes the following:

  • Bone marrow – The spongy interior of large bones where white blood cells, red blood cells (which carry oxygen), and platelets (which help blood clot) are made.
  • Lymph – Colorless, watery fluid that carries white blood cells (lymphocytes) through the vessels of the lymph system all through the body. Lymphocytes can be either B-cells or T-cells. Their job is to fight disease and the growth of tumors.
  • Lymph vessels – Tubes that collect lymph from different parts of the body and send it back to the bloodstream.
  • Lymph nodes – Small oval or round structures that filter lymph and store white blood cells. Lymph nodes are located throughout the body but are concentrated in the underarms, pelvis, neck, abdomen and groin.
  • Thymus – An organ behind the breastbone in which lymphocytes grow and reproduce.
  • Spleen – An organ on the left side of the body near the stomach. The spleen filters blood, stores blood cells, and removes old blood cells. It also makes lymphocytes.
  • Tonsils – Lymph tissue in the back of the throat that makes lymphocytes.

Because the lymph system is present throughout the body, lymphoma can begin in almost any area and spread to other tissues and organs such as the liver.

What are the types of non-Hodgkin’s lymphoma (NHL)?

NHL comes in many types, but is often divided into indolent (slow-moving, usually with few symptoms) or aggressive (growing quickly, often causing symptoms). These two forms of NHL behave quite differently and are treated differently. Some types of indolent NHL (i.e., follicular lymphoma, chronic lymphocytic leukemia/small lymphocytic leukemia, and marginal zone lymphomas) can occasionally change or “transform” into more aggressive lymphomas.

NHL is also grouped by types based on whether the cancer has started in the B cells (B lymphocytes) or the T cells (T lymphocytes). The majority of cases begin in the B cells, which are responsible for creating antibodies that are able to stop foreign substances from causing problems in the body. T cells, on the other hand, attack foreign substances directly.

What are types of aggressive B-cell non-Hodgkin’s lymphoma (NHL)?

Types include:

  • Diffuse large B-cell lymphoma (DLBCL)
  • Primary mediastinal B-cell lymphoma (PMBL)
  • Burkitt lymphoma

What are types of indolent B-cell non-Hodgkin’s lymphoma (NHL)?

  • Follicular lymphoma
  • Marginal zone lymphoma
  • Chronic lymphocytic leukemia (CLL) and small lymphomcytic lymphoma (SLL) are interchangeable terms for an indolent B-cell cancer that is found mostly in the blood or tissues of the body, respectively
  • Cutaneous B-cell lymphoma

What are types of T-cell non-Hodgkin’s lymphoma (NHL)?

These types of T-cell NHL are relatively rare and include:

  • Cutaneous T-cell lymphoma
  • Peripheral T-cell lymphoma
  • Anaplastic large cell lymphoma. There is a version of this cancer that is associated with breast implants called breast-implant associated anaplastic large cell lymphoma.
  • Angioimmunoblastic T-cell lymphoma
  • Adult T-cell leukemia/lymphoma
  • Lymphoblastic lymphoma, which more often develops in T-cells but can develop in B-cells

What is the difference between non-Hodgkin’s lymphoma (NHL) and Hodgkin’s lymphoma (HL)?

Both types of lymphomas are diseases that start in lymphocytes, a type of white blood cells. Hodgkin’s lymphoma, which is also known as Hodgkin’s disease, involves a certain type of mature and very large cells called Reed-Sternberg cells. HL is less common than NHL.

What is the difference between leukemia and lymphoma?

Both diseases involve the blood, but start in different places. Leukemia begins in the bone marrow and is found in the blood. Non-Hodgkin’s lymphoma develops in the tissue of the body such as lymph nodes or other organs

What are the risk factors for non-Hodgkin’s lymphoma (NHL)?

  • Being older, male, or Caucasian
  • Having any of the following conditions:
  • Use of immunosuppressant drugs following an organ transplant
  • High levels of exposure to certain pesticides has been found in some observational studies to slightly increase the risk of NHL in in agricultural workers. The risk from low level and/or periodic exposure to these substances is not certain.
  • Exposure to radiation
  • A diet containing high amounts of meat and fat
  • Previous treatment for Hodgkin’s lymphoma

How common is adult non-Hodgkin’s lymphoma (NHL)?

An estimated 74,200 new cases of NHL are expected to be diagnosed in 2019. About 1,000 people will die from the disease in 2019. NHL is the seventh most common cancer in US adults.

What are the symptoms of adult non-Hodgkin’s lymphoma (NHL)?

  • Painless swelling in the lymph nodes of the neck, underarm, groin, or stomach
  • Unexplained fever
  • Heavy night sweats
  • Feeling much more tired than usual for at least several weeks for no apparent reason
  • Unexplained weight loss
  • Skin rash or itchy skin
  • Unexplained pain in the chest, abdomen, or bones
  • A feeling of fullness even though you did not eat a lot

These symptoms and signs are common to many conditions. You shouldn’t assume that you have NHL. However, you should contact your healthcare provider when you have symptoms that worry you.

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