Non-Hodgkin Lymphoma

Non-Hodgkin lymphoma is a group of cancers that begin in lymphocytes, a type of white blood cell.

Lymphocytes travel through lymph nodes, the spleen, bone marrow and other tissues, so lymphoma can involve different parts of the body. The name covers many subtypes that can behave differently and need different care.

Swollen lymph nodes are a very common presentation of non-Hodgkin lymphoma. Night sweats are a common presentation. Lymph nodes may enlarge in the neck, armpit or groin, and swelling can be painless.

Some people notice tiredness, fever, itching, reduced appetite, weight change, cough or abdominal discomfort. A lump that persists or grows, drenching sweats, fever, or new breathing difficulty should be assessed by a clinician.

Non-Hodgkin lymphoma develops when lymphocytes acquire changes that allow them to grow or survive abnormally. Usually, no clear single cause is found. Certain infections, immune-system conditions and medicines that suppress immunity can be relevant in some situations.

Some lymphomas grow slowly and may be monitored before treatment is needed. Others grow more quickly and are usually treated soon after diagnosis. The subtype, where lymphoma is found, symptoms and test results shape the plan.

A weakened immune system, some autoimmune conditions and selected infections may be associated with particular lymphoma subtypes. Helicobacter pylori infection can be relevant to certain lymphomas of the stomach. These associations do not mean that a person with one of these factors will develop lymphoma.

A biopsy, in which a sample of a lymph node or other affected tissue is examined, is usually needed to identify the subtype. Blood tests and scans help map where the lymphoma is present. Further tests may examine the bone marrow or the lymphoma cells themselves to help select treatment.

The care team matches treatment to the lymphoma subtype, extent, symptoms and general health. Chemotherapy may be used to destroy lymphoma cells. Targeted therapy can act on features of lymphoma cells or immune pathways. Radiotherapy may treat a defined area. Some slow-growing lymphomas can be watched carefully until treatment is needed.

Keep a note of symptoms and treatment effects so the team can respond early. Before treatment begins, ask about infection prevention, fertility concerns, work and travel plans, and who to contact outside clinic hours. Emotional support can be as useful as practical help from family or a specialist nurse.

A haematologist or medical oncologist coordinates lymphoma care with radiologists, pathologists, nurses and other clinicians. Ask for the lymphoma subtype in writing and bring questions about the aims of treatment, likely monitoring and symptoms that need urgent advice.