Lymphoma
In 1832, Thomas Hodgkin published the first description of lymphoma, specifically of the form that now bears his name. This condition is a group of blood and lymph tumors that develop from lymphocytes, which are a type of white blood cell. The name typically refers to just the cancerous versions rather than all such tumors. Signs and symptoms may include enlarged lymph nodes, fever, drenching sweats, unintended weight loss, itching, and constantly feeling tired. The enlarged lymph nodes are usually painless. The sweats are most common at night.
Risk factors for Hodgkin lymphoma include infection with Epstein, Barr virus and a history of the disease in the family. Risk factors for common types of non-Hodgkin lymphomas include autoimmune diseases, HIV/AIDS, infection with human T-lymphotropic virus, immunosuppressant medications, and some pesticides. Eating large amounts of red meat and tobacco smoking may also increase the risk. Because the whole lymphatic system is part of the body's immune system, people with a weakened immune system such as from HIV infection or from certain drugs or medication also have a higher number of cases of lymphoma.
Lymphoma is definitively diagnosed by a lymph-node biopsy, meaning a partial or total excision of a lymph node examined under the microscope. This examination reveals histopathological features that may indicate lymphoma. After lymphoma is diagnosed, a variety of tests may be carried out to look for specific features characteristic of different types of lymphoma. These include immunophenotyping, flow cytometry, and fluorescence in situ hybridization testing. Medical imaging may then be done to determine if and where the cancer has spread. Lymphoma most often spreads to the lungs, liver, and brain.
According to the World Health Organization, lymphoma classification should reflect in which lymphocyte population the neoplasm arises. Most mature lymphoid neoplasms comprise the non-Hodgkin lymphomas. Historically, mature histiocytic and dendritic cell neoplasms have been considered mature lymphoid neoplasms, since these often involve lymphoid tissue. A division into Hodgkin and non-Hodgkin lymphomas is used in several of the older classification systems. A Hodgkin lymphoma is marked by the presence of a type of cell called the Reed, Sternberg cell. The WHO classification, published in 2001 and updated in 2008, 2017, and 2022, groups lymphomas by cell type and defining phenotypic, molecular, or cytogenetic characteristics.
Treatment may involve one or more of the following: chemotherapy, radiation therapy, proton therapy, targeted therapy, and surgery. In some non-Hodgkin lymphomas, an increased amount of protein produced by the lymphoma cells causes the blood to become so thick that plasmapheresis is performed to remove the protein. Watchful waiting may be appropriate for certain types. The outcome depends on the subtype, with some being curable and treatment prolonging survival in most. Four chimeric antigen receptor T cell therapies are FDA-approved for non-Hodgkin lymphoma, including lisocabtagene maraleucel, axicabtagene ciloleucel, tisagenlecleucel, and brexucabtagene autoleucel.
Worldwide, lymphomas developed in 566,000 people in 2012 and caused 305,000 deaths. They make up 3, 4% of all cancers, making them as a group the seventh-most-common form. In children, they are the third-most-common cancer. They occur more often in the developed world than in the developing world. Taken together, lymphomas represent 5.3% of all cancers in the United States and 55.6% of all blood cancers. According to the U.S. National Institutes of Health, lymphomas account for about 5%, and Hodgkin lymphoma in particular accounts for less than 1% of all cases of cancer in the United States.
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Common questions
When was lymphoma first described by Thomas Hodgkin?
Thomas Hodgkin published the first description of lymphoma in 1832. This publication specifically detailed the form that now bears his name.
What are the common signs and symptoms of lymphoma?
Signs and symptoms include enlarged painless lymph nodes, fever, drenching sweats at night, unintended weight loss, itching, and constant fatigue. The sweats associated with this condition occur most frequently during nighttime hours.
How is lymphoma definitively diagnosed through medical testing?
Lymphoma is definitively diagnosed by a lymph-node biopsy involving partial or total excision examined under a microscope. Additional tests may include immunophenotyping, flow cytometry, fluorescence in situ hybridization, and medical imaging to determine spread to organs like the lungs, liver, and brain.
Which cell type marks Hodgkin lymphoma according to WHO classification?
A Hodgkin lymphoma is marked by the presence of a specific cell called the Reed Sternberg cell. The World Health Organization classification groups lymphomas by cell type and defining phenotypic, molecular, or cytogenetic characteristics.
What percentage of all cancers do lymphomas represent worldwide in 2012?
Worldwide, lymphomas developed in 566,000 people in 2012 and caused 305,000 deaths. They make up 3.4% of all cancers, making them as a group the seventh-most-common form globally.