Doctor's Notes on Lymphoma (Hodgkin's Disease and
Lymphoma is a type of cancer of the cells of the immune system. Lymphomas are broadly divided into two groups: Hodgkin lymphomas (Hodgkin’s disease) and non-Hodgkin lymphoma, or NHL. Within these categories there are many different subtypes of lymphomas that differ in their behavior and response to treatment. The cause of lymphoma is not completely understood. It is likely that both genetic and environmental factors play a role in its development.
Symptoms and signs of lymphoma can include enlargement of the lymph nodes anywhere in the body. This enlargement (often referred to as “swollen glands”) is usually painless. In some cases, other associated symptoms can occur, including fevers, night sweats, fatigue, weight loss, chest pain or pressure, abdominal swelling, shortness of breath, and weakness.
Lymphoma (Hodgkin's Disease and
Non-Hodgkin's Lymphoma) Symptoms
Often, the first sign of lymphoma is a painless swelling of lymph nodes in the neck, under an arm, or in the groin.
- Lymph nodes and/or tissues elsewhere in the body may also swell. The spleen, for example, may become enlarged in lymphoma.
- The enlarged lymph node sometimes causes other symptoms by pressing against a vein or lymphatic vessel (swelling of an arm or leg), a nerve (pain, numbness, or tingling), or the stomach (early feeling of fullness).
- Enlargement of the spleen (splenomegaly) may cause abdominal pain or discomfort.
- Many people have no other symptoms.
Symptoms of lymphoma may vary from patient to patient and may include one or more the following:
- Unexplained weight loss
- Night sweats
- Lack of energy
- Itching (up to 25% of patients develop this itch [pruritus], most commonly in the lower extremity but it can occur anywhere, be local, or spreading over the whole body)
- Loss of appetite
- Shortness of breath
- Back or bone pain
- Blood in the stool or vomit
- Blockage of urine flow
These symptoms are nonspecific, and not every patient will have all of these potential symptoms. This means that a patient's symptoms could be caused by any number of conditions unrelated to cancer. For instance, they could be signs of the flu or other viral infection, but in those cases, they would not last very long. In lymphoma, the symptoms persist over time and cannot be explained by an infection or another disease.
Lymphoma (Hodgkin's Disease and
Non-Hodgkin's Lymphoma) Causes
The exact causes of lymphoma are not known. Several factors have been linked to an increased risk of developing lymphoma, but it is unclear what role they play in the actual development of lymphoma. These risk factors include the following:
- Age: Generally, the risk of NHL increases with advancing age. HL in the elderly is associated with a poorer prognosis than that observed in younger patients. In the 20-24-year age group, the incidence of lymphoma is 2.4 cases per 100,000 while it increases to 46 cases per 100,000 among individuals 60-64 years of age.
- Infection with HIV
- Infection with Epstein-Barr virus (EBV), one of the causative factors in mononucleosis, is associated with Burkitt lymphoma, a NHL that most often occurs in children and young people (ages 12 to 30).
- Infection with Helicobacter pylori, a bacterium that lives in the digestive tract
- Infection with hepatitis B or hepatitis C virus
- Medical conditions that compromise the immune system
- Exposure to toxic chemicals
- Farm work or an occupation with exposure to certain toxic chemicals such as pesticides, herbicides, or benzene and/or other solvents
- Hair dye use has been linked to higher rates of lymphoma, especially in patients who started to use the dyes before 1980.
- Genetics: Family history of lymphoma
The presence of these risk factors does not mean a person will actually develop lymphoma. In fact, most people with one or several of these risk factors do not develop lymphoma.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.