Lymphocytic lymphoma

Alternative names
Lymphoma - non-Hodgkin’s; Non-Hodgkin’s lymphoma; Histiocytic lymphoma; Lymphoblastic lymphoma; Cancer - non-Hodgkin’s lymphoma

Definition
Non-Hodgkin’s lymphomas are cancers of lymphoid tissue (lymph nodes, spleen, and other organs of the immune system).

Causes, incidence, and risk factors

Non-Hodgkin’s lymphomas can be slow-growing (low-grade) or rapidly growing (high-grade) cancer. For most patients, the cause is unknown, but lymphomas may develop in people with suppressed immune systems as a result of organ transplantation, for instance.

The tumors are graded according to their level of malignancy (aggressiveness)- low-grade, intermediate-grade or high-grade. Burkitt’s tumor is an example of a high-grade lymphoma. Non-Hodgkin’s tumors occur more frequently than Hodgkin’s lymphoma.

Usually, non-Hodgkin’s lymphomas affect people older than 50. High-risk groups include organ transplant recipients and immunosuppressed people. The incidence is 3 in 10,000 people.

Symptoms

     
  • Enlarged lymph nodes (such as an armpit lump), isolated or widespread  
  • Fever  
  • Excessive sweating, with night sweats  
  • Unintentional weight loss

Additional symptoms that may be associated with this disease include flank pain.

Signs and tests

Tests that may indicate non-Hodgkin’s lymphoma include:

     
  • A peripheral blood smear showing abnormal white blood cells  
  • A CBC with differential  
  • A lymph node biopsy  
  • A bone marrow biopsy

A staging evaluation (tumor staging) to determine the extent of the disease includes:

     
  • A physical examination  
  • CT scans of the chest, abdomen and pelvis  
  • A lymphangiogram  
  • An exploratory laparotomy or liver biopsy  
  • Blood chemistry tests  
  • MRI or other x-ray study may also be performed  
  • A PET scan, (positron emission test)

This disease may also alter the results of the following tests:

     
  • A gallium (Ga.) scan  
  • An immunoelectrophoresis - serum test  
  • A quantitative immunoglobulins (nephelometry) test  
  • A mononucleosis spot test

Treatment
Treatment depends upon the stage of the disease. Low-grade disease may just need to be observed with no treatment until it causes problems (early treatment is not more effective). When treatment becomes necessary, chemotherapy or radiation therapy may be used. Patients with more aggressive or resistant disease may require more intensive treatment. High-dose chemotherapy with bone marrow transplantation may be a treatment option in selected cases.

Support Groups
The stress of illness may be eased by joining a support group whose members share common experiences and problems. See cancer - support group.

Expectations (prognosis)
The average survival is 6 to 8 years for patients with low-grade lymphoma. The outcome for patients with high-grade lymphoma depends upon the response to chemotherapy or other treatment, and the type of high-grade lymphoma. About 30% of adults with high-grade lymphoma are permanently cured.

Complications

     
  • Infections resulting from immune suppression from chemotherapy or radiation therapy, or low gamma globulin secondary to disease  
  • Autoimmune hemolytic anemia

Calling your health care provider
Call your health care provider if symptoms of this disorder develop.

If you have non-Hodgkin’s lymphoma, call your health care provider if you experience persistent fever or other signs of infection.

Johns Hopkins patient information

Last revised: December 4, 2012
by Harutyun Medina, M.D.

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