Causes of Lymphoma and Its Action in the Body

Lymphoma refers to a group of difficult cancers that affect the lymphocytes, allowing cancer cells to spread through the lymph system and collect in nodes throughout the body.

Lymphoma is a cancer of the lymphocytes, cells that are part of the body's immune system. In lymphoma, lymphocytes become abnormal and grow out of control. The abnormal cells can travel all over the body and often collect in the lymph nodes, causing them to swell. 

There are different types of lymphoma.

• Hodgkin lymphoma (Hodgkin disease) 
• Non-Hodgkin lymphoma (sometimes called NHL, or just lymphoma) 
• Childhood Non-Hodgkin lymphoma
• Skin lymphomas (cutaneous lymphomas)
• Waldenstrom macroglobulinemia

Signs and symptoms of lymphoma include:

• One or more large, swollen lymph nodes
  • Felt under the skin
  • Usually are not painful
  • Often found in the neck, groin, armpit, or stomach
• Cough or trouble breathing (from swollen lymph nodes around the lungs)
• Fever
• Chills
• Weight loss without trying
• Night sweats that soak your clothes
• Itching skin
• Tiredness (fatigue)
• Loss of appetite
• Chest pain
• Swollen abdomen
• Feeling full after only a small amount of food
• Chest pain or pressure
• Severe or frequent infections
• Easy bruising or bleeding

5 Causes of Hodgkin lymphoma and non-Hodgkin lymphoma include:

1. Genetic mutations
2. Changes in the immune system
3. Immune deficiencies (due to inherited conditions, certain drugs treatments, organ transplants, or HIV infection) 
4. Autoimmune diseases 
5. Chronic infections 

Risk factors for developing Hodgkin lymphoma include:

• Epstein-Barr virus (EBV) 
• Age: The most common in early adulthood (especially in a person’s 20s) and late adulthood (after age 55)
• Gender: Lymphoma occurs slightly more often in males than in females
• Family history
• The weakened immune system, such as in people with HIV, those who take medicines to suppress the immune system after an organ transplant, and people with autoimmune diseases 

Risk factors for developing non-Hodgkin lymphoma include:

• Age over 60
• Gender: usually more common in men than in women, but some types of NHL are more common in women
• Race, ethnicity, and geography: More common in Caucasians than African Americans and Asian Americans, and more common in developed countries, with the U.S. and Europe having some of the highest rates
• Family history
• Exposure to certain chemicals and drugs such as benzene, certain herbicides and insecticides, some chemotherapy drugs used to treat other cancers, and certain drugs used to treat rheumatoid arthritis, such as methotrexate and the tumor necrosis factor (TNF) inhibitors
• Radiation exposure: patients treated with radiation therapy for other cancers and survivors of atomic bombs and nuclear reactor accidents
• Having a weakened immune system
• People who receive organ transplants and are treated with immunosuppressants
• Human immunodeficiency virus (HIV)
• Some genetic (inherited) syndromes, such as ataxia-telangiectasia (AT) and Wiskott-Aldrich syndrome
• Autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus (SLE or lupus), Sjogren (Sjögren) disease, and celiac disease
• Certain infections
• Being overweight or obese
• Breast implants (rare)

Lymphoma is diagnosed with a physical exam and tests such as:

• Lymph node biopsy
• Bone marrow aspiration and biopsy 
• Imaging tests
  • X-rays
  • Computerized tomography (CT) scan
  • Positron emission tomography (PET) scans
  • Magnetic resonance imaging (MRI)
  • Ultrasound
• Blood tests
  • Complete blood count (CBC) 
  • Erythrocyte sedimentation rate (ESR) 
  • Tests to check liver and kidney function 
  • HIV test
  • Hepatitis B and C virus test
• Lumbar puncture (spinal tap)
• Echocardiogram (an ultrasound of the heart) or a MUGA scan 
• Lung (pulmonary) function tests (PFTs) 

Treatments for lymphoma may include one or more of the following:

• Chemotherapy 
• Immunotherapy 
• Radiation therapy 
• Bone marrow transplant (also called "stem cell transplant") 

Life expectancy is often expressed in 5-year survival rates, which is the percent of patients still alive five years following diagnosis. 

The five-year survival rate for Hodgkin lymphoma: 

• Localized: Cancer is limited to one lymph node area, one lymphoid organ, or one organ outside the lymph system - is 92%
• Regional: Cancer reaches from one lymph node area to a nearby organ, is found in two or more lymph node areas on the same side of the diaphragm, or is considered bulky disease – is 94%
• Distant: Cancer has spread to distant parts of the body such as the lungs, liver, or bone marrow, or to lymph node areas above and below the diaphragm – is 78%

The five-year survival rate for non-Hodgkin lymphoma, diffuse large B-cell lymphoma: 

• Localized is 73%
• Regional is 72%
• Distant is 55%

The 5-year survival rate for non-Hodgkin lymphoma, follicular lymphoma:

• Localized is 96%
• Regional is 89%
• Distant is 85%