Lymphoma is a group of blood cancers that originates from cells of the lymph system. As the broad distribution range of lymph system, lymphoma can start almost anywhere through the body. The two main categories of lymphomas are Hodgkin lymphoma (accounts for 10% ) and non-Hodgkin lymphoma (NHL accounts for about 90% ). Although both of these two types can occur at any age, lymphoma is most commonly diagnosed in young people. Hodgkin lymphoma can be classified into many subtypes, however, most cases are usually classic type of abnormal B lymphocyte, called Reed-Sternberg cells. Hodgkin lymphoma are usually treatable. NHL also has different types depending on the white blood cells types they arise from, such as B-cells, T-cells and NK cells. Scientists have identified certain risk factors which may be related to the development of lymphoma, such as age, sex, location, infection Immune deficiency etc. Although there’re some common ones, the signs and symptoms of lymphoma vary between different types. Thus the treatment and the out come may depend on the grade and the type of this disease.

In 2008, WHO classified lymphoma into 5 subtypes (NHL are classifed into 4 subtypes):

Hodgkin lymphomas TOP

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Overview

Hodgkin lymphoma is a type of lymphoma cancer that arises in the lymphatic system and causes affected lymph nodes to get larger, which results from the abnormally reproduction of cells in the lymphatic system. Hodgkin lymphoma forms tumors in the lymph nodes or can also spread to other organs, like spleen, liver, bone marrow or lungs. Each year. about 6000 new cases of Hodgkin lymphoma are diagnosed in America, with around 10% to 15% of which are diagnosed in children and adolescent teenagers, more commonly in boys than in girls. Both Epstein-Barr virus infecton and HIV infection are linked to the cause of this disease. A person who has a weakened immune system, or a close relative (especially a brother or sister) who is a Hodgkin lymphoma patient, is thought to have a higher risk of developing this disease.

Signs, symptoms and treatments

Symptoms of Hodgkin lymphoma vary from one case to another, which may include: painless swollen lymph nodes in the neck or armpit, extreme fatigue, loss of appetite, weight loss, fever, heavy night sweats, itchy skin and enlargement of the liver or spleen. In order to kill as many cancer cells as possible, chemotherapy may be used alone or combined with radiation therapy depending on the stage and subtype of Hodgkin lymphoma. The stem cell transplant therapy may be also an option if the disease reemerges.

Mature B cell neoplasms TOP

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Overview

Mature B-cell lymphoma is the most common type of NHL in children and adolescents, which accounts for more than 50% of all non-Hodgkin lymphoma in this group of population worldwide. Within this type, Burkitt lymphoma/leukemia and (diffuse large B-cell lymphoma) DLBCL make up the the major part. The incidence of a specific B-cell neoplasms subtype varies a lot in different regions globally. Some subtypes are more common in developed countries, while some ones are more common in underdeveloped areas, such as Burkitt's lymphoma is more endemic in African continent. Scientific reports show abundant evidence that the origination of some subtypes of B-cell lymphoma are caused by the infection of specific kinds of virus or bacteria, e.g. Epstein–Barr virus (EBV) infection plays a vital role in the pathogenesis of Burkitt’s Lymphoma.

Signs, symptoms and treatments

Depending on the grade of the lymphoma, symptoms may be different. High fever, tachycardia and respiratory distress are usually shown on patients with advanced high-grade lymphoma. Shortness of breath and bone pain are organ specific symptoms. However, lymphadenopathy is the most common symptom of lymphoma, which has been reported to resolve spontaneously in some patients with low-grade lymphomas. Because of the diversity of this disease, specific therapy need to be carried out according to the subtype, such as surgery, radiation therapy, combination chemotherapy with different alkylating agents, antibiotics and antibodies.

Mature T cell and natural killer (NK) cell neoplasms TOP

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Overview

Mature T cell and natural killer (NK) cell neoplasms are rare tumors that result from clonal proliferation of mature post-thymic lymphocytes, which make up about 10 to 12% of all lymphoid cancers. The diseases are usually diagnosed in adults with a age ranging from 17 to 90, and in the total population of this group, men, more than women are manifest to develop these neoplasms. The World Health Organization classifies this group of disorders into NK/T cell lymphoma, nasal type (NKTCL), aggressive NK-cell leukemia (ANKCL) and chronic lymphoproliferative disorders of NK-cells. As a group of biologically and clinically heterogeneous disorders, most NKTCL is exclusively extranodal with the nose and nasopharynx as its common initial sites, whereas ANKCL manifests to be a systemic disease with multiorgan involvement and rapidly evolutes to death.

Signs, symptoms and treatments

Nasal NKTCL patients present symptoms like mass, obstruction swelling, or bleeding, while the ANKCL population shows fever and other extreme systemic symptoms, such as hepatosplenomegaly, pancytopenia and abnormal liver function. Systemic chemotherapy is still the major treatment for unspreaded NK/T-cell lymphomas, but the hematopoietic stem cell transplantation hasn’t been prospectively evaluated. Meanwhile, combined chemotherapy-radiotherapy and combination of chemotherapy are also the current treatment strategies depending on the grade and symptoms of the disease.

Precursor lymphoid neoplasms TOP

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Overview

Precursor lymphoid neoplasms, also called neoplasms of precursor T cells and B cells, or lymphoblastic lymphomas which is used to describe the predominantly lymph node-based disease. This group of diseases represents a family of cancerous lymphoid neoplasms which recapitulate the characteristics of early lymphoid precursors of B- or T-lineage in morphology and immunophenotype, respectively. More than 70% of patients are diagnosed as stage IV, which is due to the aggressive nature of the disease. Lymphoblastic lymphoma comprises only 2% of all non-Hodgkin lymphomas (NHLs) in America, among which, 80 - 90% is T-Cell origin and the remainder part is B-cell phenotype. Congenital or acquired immunosuppression, and exposure to insecticide or high level of radiation are the most possible causes of the disease.

Signs, symptoms and treatments

The patients suffering from gross lymphadenopathy usually have impaired immunity, which leads to opportunistic infections and adjacent tissues getting compressed. In some cases, the lymphoblasts spread into central nervous system (CNS) or bone marrow, and in the later situation, it causes hematopoiesis dysfunction. However, combination chemotherapy can make a beautiful outcome with the help from supportive medications to control side effect and infection.