Non-Hodgkin Lymphoma

Non-Hodgkin lymphoma (abbreviated NHL) is a type of cancer that affects lymphatic tissue, and specifically the tissue’s B and T white blood cells. These cells play an important role in enabling the lymphatic system to protect the body against infections and rid the body of germs. When NHL develops in these cells it interferes with these processes. Non-Hodgkin Lymphoma accounts for 4% of all cancers in the United States1.


What different types of Non-Hodgkin Lymphomas exist?

Classifying non-Hodgkin lymphoma is a complicated process. The most recent system is maintained by the World Health Organization (WHO). The WHO classification groups lymphomas based on the appearance of the lymphoma cells under a microscope, the chromosome features of these cells, and the presence of certain proteins on the surface of the cells. Follicular lymphoma and diffuse large B-cell lymphoma are the two most common types of NHL. To learn more about the different types of Non- Hodgkin Lymphomas, visit:

What are some symptoms of Non-Hodgkin Lymphoma?

Most of the early symptoms of NHL are painless swelling of one or more lymph nodes in the neck, armpits or groin areas.

Other symptoms may include:

  • Fever
  • Sweating, especially at night
  • Tiredness or no energy
  • Loss of appetite
  • Weight loss
  • Enlarged lymph nodes
  • Rash*
  • Bone pain*
  • Cough*
  • Chest pain*
  • Abdominal pain*
  • Lumps under the skin*

*symptom of NHL if it has spread to distant sites such as bone, lungs, digestive tract or skin

How is Non-Hodgkin Lymphoma diagnosed?

Physical examinations will particularly focus on the lymph nodes and other areas involved with NHL, including the spleen and liver. These areas will be checked for swelling.

Biopsy is the removal of a portion of or the entire suspicious lymph node. The cells of the removed sample are studied under a microscope to determine the type of lymphoma.

Lab tests for Non-Hodgkin’s Lymphoma examine the cells obtained from tissue biopsy to help determine the presence of NHL and the type of NHL. Lab tests include immunohistochemistry, flow cytometry, cytogenetics, and molecular genetic tests.

Blood tests for non-Hodgkin’s lymphoma measure the cellular and chemical composition of the blood. While not used to diagnose lymphoma, blood tests may assist in determining the stage of the NHL. Blood tests for NHL include Complete Blood Counts (CBCs).

Imaging tests use x-rays, magnets, sound waves, or radioactive substances to create pictures of the inside of your body. For NHL, they may include chest X-rays, computed tomography (CT) scans, positron emission tomography (PET) scans and magnetic resonance imaging (MRI) scans, ultrasounds, gallium scans, and bone scans. These imaging tests help doctors determine the location and distribution of enlarged lymph nodes and/or tumor masses and whether organs other than the lymph nodes are involved.

What are the stages of Non-Hodgkin Lymphoma?

In order to stage Non-Hodgkin lymphoma the Ann Arbor system is commonly used.

What are the treatments for Non-Hodgkin Lymphoma?

Chemotherapy is the use of drugs to kill cancer cells. Depending on the type and stage of the NHL, chemotherapy may be given alone or combined with radiation therapy or immunotherapy.

Radiation therapy uses high-energy rays or particles to kill cancer cells. Radiation could be used as the main treatment for some types of NHL if found early, during stage I or II.

Stem cell transplants rebuild the supply of normal blood cells and the immune system via injection of stem cells. Stem cell transplants for NHL are used in conjunction with chemotherapy to counteract the chemotherapy’s tendency to destroy bone marrow and limit production of healthy white blood cells.

Immunotherapy is the injection of drugs directly into the blood that stimulate the immune system to attack and destroy cancer cells. Immunotherapy treatments may kill NHL cancer cells or slow their growth.

What are the major risk factors of Non-Hodgkin Lymphoma?

  • Age: NHL is most common in people over 60.
  • Gender: Males are slightly more likely to develop non-Hodgkin’s lymphoma than females.
  • Race: Those with Caucasian ancestry are more likely to develop the non-Hodgkin’s lymphoma than are those persons with African or Asian ancestry.
  • Geography: Non-Hodgkin lymphoma is more prevalent in developed regions, like the United States and Europe.
  • Genetics: Inherited immune disorders such as hypogammaglobulinemia and Wiskott-Aldrich syndrome can predispose individuals to later development of NHL.
  • HIV/AIDS: A person is at higher risk if they are infected with the HIV/AIDS virus.
  • Virus Exposure: Being exposed to the Epstein-Barr virus (EBV), sometimes called mono, raises risk for developing Hodgkin lymphoma and other lymphomas. The risk is very small.

How do I prevent Non-Hodgkin Lymphoma?

  • Avoiding exposure to immune deficiency causing viruses 
Mikayla D. Williams , BS student, Nursing , The University of Arizona
Michael Principe, MA, Information Resources and Library Science , The University of Arizona
Works Cited: 
American Cancer Society (2014). Non-Hodgkin Lymphoma.
Works Consulted: 
American Society of Clinical Oncology (2014). Lymphoma-Non-Hodgkin.
MD Anderson Cancer Center (2014). Non-Hodgkin's Lymphoma.
Leukemia and Lymphoma Society (2014). Non-Hodgkin Lymphoma.
Cancer Treatment Centers of America (2014). Non-Hodgkin Lymphoma.