Non-Hodgkin's lymphoma

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at February 18, 2016
StartNon-Hodgkin's lymphoma

Non-Hodgkin’s lymphoma (NHL) is a type of lymphoma or cancer that affects the white blood cells in the body and the lymphatic system.


Definition & Facts

Non-Hodgkin’s lymphoma is one of the most common types of cancer in the United States. It is a category of cancer that includes many sub-types of cancer including diffuse large B-cell lymphoma, follicular lymphoma, hairy cell leukemia, and mantle cell leukemia.

There are a variety of differences between non-Hodgkin’s lymphoma and Hodgkin's lymphoma including the fact that NHL is more aggressive, more common, and usually occurs in patients above the age of 50 whereas the average age of onset for Hodgkin's lymphoma is 28.

Symptoms & Complaints

Symptoms depend on the specific type of NHL. Nevertheless, some of the symptoms include the swelling of the lymph nodes, an enlarged belly area, night sweats, extreme weight loss, mild cough, and difficulty breathing.

Many of the areas of the body where the lymphoma is present will be tender to the touch and begin to swell. Some patients also experience headaches if the lymphoma has traveled to the brain. Many patients also experience blotches on the skin when the lymphoma travels to the epidermis.

Many people with non-Hodgkin’s lymphoma bruise extremely easily. They can also feel easily fatigued and tired without exerting a lot of energy. Many patients also have extremely high white blood cell counts.


Non-Hodgkin's lymphoma typically involves the abnormal, uncontrolled growth of B cells which are a type of lymphocyte and white blood cell that the immune system produces to fight infection. Uncontrolled growth of these lymphocytes forms clusters that become malignant tumors.

Lymphoma usually spreads throughout the lymphatic system, including the lymph nodes, blood vessels, spleen and bone marrow. The disease can sometimes metastasize to other areas of the body too.

Most people with this disease are over the age of 50, so age is a factor. People with autoimmune diseases like HIV and rheumatoid arthritis are more prone to lymphoma. Exposure to environmental toxicants like radiation and insecticides may also play a role in causing NHL. Some non-Hodgkin's lymphomas may be caused in part by infection with the Epstein-Barr virus.

Diagnosis & Tests

Most people discover they have non-Hodgkin’s lymphoma as the result of swollen lymph nodes or a swollen spleen. Many doctors check for these symptoms during an annual checkup. If swelling is detected, the doctor will conduct blood tests and urinalysis.

If the blood and urinalysis is inconclusive the doctor could also order X-rays, CT scans, MRIs, or PET scans to determine the cause of the swelling. The doctor might even remove part of a lymph node to run a biopsy. After looking at the piece of the lymph node under a microscope, the doctor can determine if the issue is non-Hodgkin’s lymphoma or something else.

Bone marrow testing is also often used in the diagnosis of non-Hodgkin’s lymphoma. This will also give the doctor information to determine the rate at which the disease might have spread.

Treatment & Therapy

Depending on the state of lymphoma, the disease can be treated in a number of ways. The most common forms of treatment include radiation, chemotherapy, immunotherapy, target therapy and stem cell transplant.

In some cases, surgery may also be used to remove the cells, but these cases are very rare. Since lymphoma affects the lymphatic system, it’s difficult to remove the cancerous cells through surgery since the cells spread rapidly throughout the body.

Prevention & Prophylaxis

Prevention of non-Hodgkin’s lymphoma involves reducing the risk of contracting immune diseases like HIV as well as avoiding dangerous chemicals and radiation. Many patients are advised against activities that could spread HIV including partaking in unprotected sex and sharing needles.