What Is Lymphoma? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Lymphoma is a form of cancer that usually starts in your body’s lymphatic system.

The lymphatic system is made up of the lymph nodes, spleen, and thymus gland. It’s part of your immune system, which helps fight disease and infection.

Because you have lymph tissue throughout your whole body, lymphoma can begin almost anywhere.

This type of cancer can affect both adults and children. (1,2)

There are two main categories of lymphoma: Hodgkin lymphoma and Non-Hodgkin lymphoma (NHL), which is much more common.

Symptoms of Hodgkin lymphoma and non-Hodgkin lymphoma can vary depending on what area of the body is affected and how fast the cancer is growing. To further complicate the issue, some of the symptoms are not specific to lymphoma — they can be similar to those of many other illnesses, according to the Lymphoma Research Foundation. (3) Patients with Hodgkin and non-Hodgkin lymphoma often turn up in the doctor’s office thinking they have a cold, flu, or some other persistent respiratory infection.

Hodgkin lymphoma and non-Hodgkin lymphoma in adults can share similar symptoms. These can include:

• Swelling, or feeling a lump in the lymph nodes of the neck, armpit, or groin area.
• Fever or chills
• Drenching night sweats
• Unexplained weight loss
• Fatigue
• Pain in the chest, abdomen, or bones
• Coughing or shortness of breath

Learn More About Signs and Symptoms of Lymphoma

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Different Forms of Lymphoma

Within the two main categories of NHL and Hodgkin lymphoma, there are a number of different types of lymphoma.

Non-Hodgkin Lymphoma (NHL)

NHL isn’t just one type of lymphoma. It’s the name given to describe a group of cancers that share similar characteristics. In fact, there are more than 90 types of NHL. (3)

This form of lymphoma can begin in the:

• B Lymphocytes (B cells) These cells make antibodies to fight infections. Most NHL is caused by B cells.
• T Lymphocytes (T cells) T cells have several jobs, including helping B cells make antibodies and fighting viruses.

They typically develop in the lymph nodes and lymphatic tissue. But sometimes they can affect bone marrow and blood. (3)

Some NHLs are slow-growing, while others can be aggressive. Your treatment options will depend on the type of NHL you have and how advanced it is.

Types of NHL

Some of the more common types of NHL include:

• Diffuse Large B-Cell Lymphoma (DLBCL) This form of NHL accounts for about 1 in every 3 lymphomas, making it the most common type. It’s often aggressive but responds well to treatment. DLBCL mostly impacts older people, though there are several subtypes, including primary mediastinal B-cell lymphoma, which primarily affects young women, notes the American Cancer Society. (4)
• Follicular Lymphoma Follicular lymphoma accounts for about 1 in 5 lymphomas in the United States. These NHLs are typically slow-growing, although some can be aggressive. This type of lymphoma is rare in younger people and is difficult to cure, though patients often live for many years with this, oftentimes with long periods of not needing treatment. Some follicular lymphomas can turn into fast-growing DLBCL. (4)
• Chronic Lymphocytic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL) These are closely-related diseases. They're usually slow-growing and though they're not typically cured with standard treatments, many people with CLL and SLL live long lives. Both diseases are treated the same way, and there are many new therapies available. (4) The main difference between the two conditions is that when the cancer cells are found primarily in the lymph nodes, it is referred to as SLL. If the cancer cells are found mostly in the bloodstream and bone marrow, it is diagnosed as CLL. It is most common in older adults and is so slow growing that doctors sometimes opt to watch the disease, or monitor it with tests, for a time, before treating.
• Mantle Cell Lymphoma (MCL) MCLs are much more prevalent in men than in women. They’re also more likely to affect older people and are challenging to treat. This type accounts for about 5 percent of lymphomas. (4)

Some rarer types of NHL include:

• Cutaneous T-Cell Lymphomas Sezary syndrome and mycosis fungoides are considered cutaneous T-cell lymphomas, which are lymphomas that start in the skin. (4)
• Cutaneous B-Cell Lymphomas These lymphomas also attack the skin, notes the Mayo Clinic. (5)
• Primary Central Nervous System Lymphoma This type of lymphoma affects the brain or spinal cord. It’s more common in older people and those who have weakened or compromised immune systems. (4)
• Waldenstrom Macroglobulinemia In some cases, Waldenstrom macroglobulinemia doesn’t cause signs or symptoms for years. This type of NHL is rare and slow-growing, according to the Mayo Clinic. (6)
• Burkitt Lymphoma This fast-growing lymphoma is more common in children, and more common in the developing world. The disease can grow quickly and requires prompt treatment. (4)

Hodgkin Lymphoma 

Hodgkin lymphoma, which used to be called “Hodgkin’s disease,” is thought to start in the B cells of the body. It can begin anywhere but most often affects lymph nodes in the upper body, such as those located near the chest, neck, or underarms, according to the American Cancer Society. (7)

This form of lymphoma can spread from lymph node to lymph node.

Hodgkin lymphoma is most common in people in their early twenties and those over age 55, but it can affect adults and children of any age.

Types of Hodgkin Lymphoma

There are two main types of Hodgkin lymphoma:

• Classical Hodgkin Lymphoma Classical Hodgkin lymphoma is the more common form, accounting for about 95 percent of Hodgkin lymphomas in developed countries, notes the American Cancer Society. (8) People with this form of lymphoma have large, abnormal cells, known as Reed-Stern cells, in their lymph nodes. There are four subtypes of classical Hodgkin lymphoma, per the Mayo Clinic: nodular sclerosis Hodgkin lymphoma, mixed cellularity Hodgkin lymphoma, lymphocyte-rich Hodgkin lymphoma, and lymphocyte-depleted Hodgkin lymphoma. (9)
• Nodular Lymphocyte Predominant Hodgkin Lymphoma This rare type of Hodgkin lymphoma is characterized by abnormal, large cells that look like popcorn. It usually starts in the lymph nodes of the neck and underarms. (7)

The exact cause of lymphoma isn’t known, but it begins when special white blood cells, called lymphocytes, develop a genetic change that instructs them to multiply. This mutation triggers many lymphocytes to grow out of control. (2)

According to the Rosewell Park Comprehensive Cancer Center, you might be at a greater risk for developing lymphoma if you:

• Are male
• Have a family history of lymphoma
• Are over 55
• Develop certain types of infection, such as Epstein-Barr virus, hepatitis C, or Helicobacter pylori
• Have a compromised or weak immune system
• Have received chemotherapy or radiation in the past (10)

While treatment for lymphoma is often successful and leads to complete remission, for some patients, lymphoma may be a chronic illness. The cancer doesn't go away, but with ongoing treatment and close monitoring, it can be controlled and might not grow or spread for months or years, notes the American Cancer Society. (16)

While many of the risk factors for lymphoma can't be controlled, there are some that you can manage.

Because HIV and hepatitis C weaken the immune system, and are known to increase lymphoma risk, it's important to avoid behavior that increases your risk for these infections — such as intravenous drug use and unprotected sex with multiple partners, notes the American Cancer Society. (20)

Avoiding unnecessary exposure to radiation is another precaution you can take to lower your risk. As is maintaining a healthy weight and diet.

In rare instances, women have developed lymphoma in the scar tissue around breast implants, per the Cleveland Clinic. (21)

Treatments for Hodgkin and non-Hodgkin lymphoma are now so varied and effective that many patients will be cured and live long, productive lives after diagnosis and treatment. But there can be complications as a result of treatment. Depending upon the type of treatment and the health of the patient, doctors will watch for heart disease, secondary cancers (elsewhere in the body), lung and bone health, and cognitive and memory problems. Regular follow-up care is essential.

Learn More About the Complications of Surviving Lymphoma: How It Affects Your Body in the Short and Long Term

While white Americans are more likely to develop and be diagnosed with lymphoma, studies have shown that prognosis and treatment outcomes are often worse in Black and Hispanic Americans.

Black Americans and Lymphoma

A review of research published in November 2017 in the journal Annals of Lymphoma noted that studies suggest that while the incidence of lymphoma is lower among Black Americans than white Americans, Black patients are generally younger and the lymphoma is at more advanced, aggressive stages when diagnosed. (23) Additionally, Black patients have a decreased rate of event-free survival and overall survival.

A study published in November 2015 in the journal Pediatric Blood & Cancer examined the association between race and survival in pediatric Hodgkin lymphoma. (24) Study authors concluded that Black Americans had a worse survival rate than white or Hispanic Americans.

Another study, published in November 2019 in the Journal of Clinical Oncology, examined data for over 1600 patients with pediatric and adolescent Hodgkin lymphoma. (25) The researchers found that five-year post-relapse survival probabilities were 66 percent for non-Hispanic Black Americans compared with 90 percent for white Americans. Authors of both studies suggest that the reasons for these disparities are complex and warrant more investigation.

Hispanic Americans and Lymphoma

The same study published in the Journal of Clinical Oncology also found that Hispanic children and adolescents diagnosed with Hodgkin lymphoma had an 80 percent survival probability, compared with the 90 percent probably for white children and teens. (25)

Need a ride to treatment? Someone to talk to who has been there? There are many resources available to people who have been diagnosed with lymphoma and their families.

Learn More About Additional Resources and Support for Lymphoma