Non-Hodgkin Lymphomas: What They Are, Types, and How They Are Detected

The diagnosis of "non-Hodgkin lymphoma" encompasses dozens of different diseases, not just one. This name refers to all lymphomas except Hodgkin lymphoma, and both the prognosis and how the disease behaves depend on the specific subtype.

What non-Hodgkin lymphomas are

Lymphomas are malignant tumors that arise from lymphocytes. Non-Hodgkin lymphomas begin when a T or B lymphocyte becomes abnormal and divides again and again, and these cells can spread to almost any part of the body. The term is historically a collective one: in the WHO 2008 classification, the "Hodgkin lymphoma — non-Hodgkin lymphomas" dichotomy was largely abandoned, combining more than 80 forms into four main groups. For statistical comparability, the outdated 1982 classification with 16 subtypes is sometimes still used. The average five-year survival for all types in the United States is 69%, but it varies greatly by individual form and stage.

Main types: B-cell and T-cell lymphomas

Based on the cell of origin, B-cell and T-cell lymphomas are distinguished; among the described forms are anaplastic large cell lymphoma and adult T-cell lymphoma. The causes differ for different forms. Burkitt lymphoma and extranodal NK-T-cell lymphoma are linked to the Epstein-Barr virus, adult T-cell lymphoma to the human T-cell leukemia virus, gastric MALT lymphoma to Helicobacter pylori, and splenic marginal zone lymphoma and diffuse large B-cell lymphoma to the hepatitis C virus. Immunosuppression, certain infections, and weakened immunity increase the risk.

Indolent and aggressive lymphomas: what the difference is

Forms differ in their growth rate — from slowly growing indolent to highly aggressive. With less aggressive variants, long-term survival without treatment is possible, with active surveillance alone, whereas with aggressive forms the absence of active treatment can quickly lead to deterioration. That is precisely why "non-Hodgkin lymphoma" without specifying the subtype says little.

Large cell, follicular, marginal zone, and Burkitt lymphoma

Among the forms encountered are diffuse large B-cell lymphoma, follicular lymphoma, marginal zone lymphoma, and Burkitt lymphoma. They differ in biology, course, and prognosis, which is why the approach to monitoring by a physician also differs. The prognosis within a single form depends on the stage, immunophenotype, cytogenetic abnormalities, and the tumor's proliferation index.

Symptoms of non-Hodgkin lymphomas

Manifestations can vary:

• enlarged, painless lymph nodes in the neck, armpits, or groin;
• unexplained weight loss, fever, drenching night sweats;
• cough, difficulty breathing, or chest pain;
• weakness and fatigue that do not go away;
• pain, swelling, or a feeling of fullness in the abdomen.

How lymphoma is diagnosed and when to see a doctor

The diagnosis is established through examination, blood tests, chest X-ray, and biopsy; bone marrow studies and imaging are also used, and staging is performed to assess the extent of disease. If there are no symptoms, active treatment may not be needed right away — this is called a watch-and-wait approach. With persistent lymph node enlargement or the listed symptoms, one should see a doctor; the doctor decides which examinations are needed.

Enlarged lymph nodes alone are not a reason to call an ambulance; 103/112 — if breathing suddenly becomes difficult or severe chest pain appears.

This material is for reference: it does not replace consultation with a doctor, who assesses the specific situation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer