Understanding Hodgkin And Non-Hodgkin Lymphoma

Health Topics Jul 14, 2021

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From time to time, you may have noticed the lymph nodes in your neck, armpits, or groin are swollen. That’s your lymphocytes (a type of white blood cell) doing their job fighting infection. Once the infection is gone, your lymph nodes return to their normal size.

But in some people these lymphocytes become abnormal and grow out of control, explains Joseph See, MD, a specialist in hematology-oncology. In these instances, swollen lymph nodes could be a sign of a cancer called lymphoma.

There are two main types of lymphoma, Hodgkin lymphoma (HL) and Non-Hodgkin lymphoma (NHL), explains Dr. See. Their symptoms are similar:

Swollen lymph nodes in your neck, armpit, or groin that may multiply or get bigger over time
Itchy skin
Excessive fatigue
Loss of appetite
Coughing or trouble breathing. “This can happen if a lymph node inside your chest is swollen and pressing on your windpipe,” says Dr. See.
NHL sometimes has these additional symptoms: chills, swollen belly, severe or frequent infections, easy bruising or bleeding

More serious symptoms of HL and NHL, called B symptoms, are fever that comes and goes, drenching night sweats, and weight loss without trying.

How Is Lymphoma Diagnosed?

To determine if you have HL or NHL, your doctor likely will want to look at results of:

Imaging tests like MRI or PET or CT scan
Blood tests
Biopsies of one or more of your lymph nodes

Results are used to confirm the presence of cancer and whether it has spread to other organs in your body. If an abnormal cell called Reed-Sternberg is present, the cancer is diagnosed as HL. If Reed-Sternberg cells are not present, the cancer is NHL.

The Basics Of Hodgkin Lymphoma

“Both children and adults can develop Hodgkin lymphoma,” says Dr. See, “but it is more common in early adulthood, especially during your 20s. The risk also rises in late adulthood, after age 55.”

Your risk of developing HL is higher if:

You’ve had infectious mononucleosis (mono) or Epstein-Barr virus
You have a weakened immune system
You have one or more autoimmune diseases

A family link is not common, but brothers and sisters of young people with NHL have a higher risk of getting it.

Compared to other cancers, HL is very curable. Treatment success is based on the extent of your disease. Chemotherapy and radiation are the most common treatments.

The Basics Of Non-Hodgkin Lymphoma

NHL is a more serious lymphoma.

The cancer can start almost anywhere in the body: in a single lymph node, a group of lymph nodes, or in an organ such as the spleen. You may also have cancerous cells in your tonsils, adenoids, thymus, and bone marrow (all parts of your lymphatic system). As the cells become out of control, they form tumors that can spread to almost any part of the body including the brain, skin, or chest.

There are many types of NHLs:

Some are slow-growing. The cancer spreads slowly and causes few symptoms.
Others are fast-growing. The cancer spreads quickly and causes severe symptoms. These may also be called aggressive lymphomas and may be classified as intermediate-grade or high-grade.

Your risk of developing NHL is higher if:

Someone else in your family has had it
You’ve been treated with chemotherapy in the past
You’ve been treated with radiation for another cancer like breast, lung, or thyroid cancer
You have a weakened immune system
You have one or more autoimmune diseases like rheumatoid arthritis, lupus, Sjogren’s Syndrome, or celiac disease

Your risk of developing NHL increases throughout life. More than half of patients are 65 or older at the time of diagnosis. “The aging American population will likely lead to an increase in non-Hodgkin cases,” says Dr. See.

Treatment depends on the type of NHL you have, and the stage of your disease (how far it has progressed). Chemotherapy and radiation are the main treatments. Immunotherapy or a stem cell transplant ( allogeneic or autologous) may be recommended for some patients. Surgery is rarely used to treat lymphoma. Treatment can cure some people and may allow others to live for years. But even following successful treatment, NHL can return.

“Much research is being done to find new and better ways to treat this cancer,” says Dr. See. “Some treatments have shown encouraging results in clinical trials, including a lymphoma vaccine.”

Are There Screening Tests For Lymphoma?

“Screening tests look for a disease in people who have no symptoms,” says Dr. See. “At this time there are no widely recommended screening tests for lymphoma. But cases still can be found early. The best way to find it early is to pay attention to possible signs. If you have symptoms, especially if they don’t go away or get worse, contact your doctor.”