Lymphoma is (together with leukemias) a cancer disease, which comes from the blood cells. Lymphomas develop from group of white blood cells known as lymphocytes. The lymphocytes are very important in immune defense reactions; they control the immune response, directly attack any foreign particles including tumor cells and produce antibodies. Lymphomas may occur at any age, but they are typical for young adults under the age of 40.


Generally speaking, lymphoma is caused by mutation in a lymphocyte cell in one of its   developmental stages. The mutation causes a change in the behavior of the affected cell, which no longer responds to the regulatory mechanism of the body ands starts to multiply uncontrollably. Depending of the subtype of tumor cell, the lymphomas are further classified but this classification system is extremely extensive and difficult.


Lymphomas are relatively close to leukemias, which arise from lymphocytes (ALL, CLL). Unlike leukemia, tumor cells in lymphomas affect organs and tissues and they are less commonly present in blood or in bone marrow. The boundary between lymphoblastic leukemias and lymphomas is not very sharp and some lymphomas may even turn into leukemia. We often find painless enlarged lymph nodes, enlarged liver and enlarged spleen. These symptoms can be accompanied with warning signs such as fatigue, elevated body temperature, weight loss and night sweats. There is also a form of skin lymphoma that causes an eczema-like rash that turns into ulcers.


There are some specific types of lymphomas with quite special attributes such as Hodgkin's lymphoma (representing about a third of all lymphomas) and MALT lymphomas.


The symptoms may be suspicious, but it is not easy to state the right diagnosis. Blood tests may be normal or only with unspecific changes; they are usually pathologic in leukemias. The physical examination should focus on finding any enlarged lymph node, enlarged liver and spleen. Deep lymph nodes may be examined by chest X-ray, ultrasound and computed tomography. If there is any accessible enlarged lymph node, it is necessary to remove it surgically and sent the node for histological examination to determine the exact subtype of lymphoma. The result influences both the prognosis and treatment.


The treatment in individual and depends on the type of lymphoma, its extent and the overall health condition of the patient. Common therapeutic approach includes chemotherapy and certain lymphomas respond well to the biological therapy. In this case, the biological therapy means application of a special substance known as rituximab, which is antibody directed against surface receptors of the tumor cells. Some lymphomas may be also treated by bone marrow transplantation.


The prognosis depends on the actual type of lymphoma. Generally, the Hodgkin's lymphoma and MALT lymphoma have usually a relatively good prognosis. Other non-Hodgkin's lymphomas are may be more or less aggressive and the prognosis is uncertain.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources