Overview & Definition
Lymphoma is a blood cancer that originates in the lymphatic system—the disease-fighting network comprising lymph nodes, spleen, thymus, and bone marrow. Lymphocytes undergo malignant transformation, multiply uncontrollably, and accumulate as painless masses in lymph nodes and organs.
The Two Main Categories of Lymphoma
- Hodgkin Lymphoma (HL) – characterized by the diagnostic presence of multinucleated Reed-Sternberg cells under microscopy. Highly curable with modern multi-agent chemotherapy and immunotherapy.
- Non-Hodgkin Lymphoma (NHL) – a diverse group of B-cell and T-cell neoplasms, categorized into aggressive subtypes (e.g., Diffuse Large B-Cell Lymphoma - DLBCL, Burkitt Lymphoma) and indolent subtypes (e.g., Follicular Lymphoma, Marginal Zone Lymphoma).
Common Symptoms & "B Symptoms"
Diagnostic Evaluation
Accurate diagnosis requires tissue biopsy and whole-body PET-CT staging:
- 🔍 Excisional Lymph Node Biopsy – gold-standard surgical removal of an intact enlarged lymph node for histopathological examination.
- 🔍 Immunohistochemistry (IHC) Panel – classifying lineage markers (CD20, CD30, CD15, BCL2, MYC).
- 🔍 Whole-Body 18F-FDG PET-CT Scan – establishing Ann Arbor baseline stage (I–IV) and Deauville score for treatment response.
- 🔍 Bone Marrow Trephine Biopsy – evaluating marrow involvement in aggressive Non-Hodgkin Lymphoma.
Treatment Options & Clinical Management
- 💊 ABVD / AVD-Brentuximab Protocol – standard multi-agent chemotherapy for Hodgkin Lymphoma.
- 💊 R-CHOP Chemoimmunotherapy – Rituximab + Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone for Diffuse Large B-Cell Lymphoma (DLBCL).
- 💊 Targeted BTK Inhibitors & PI3K Inhibitors – oral Acalabrutinib or Zanubrutinib for Mantle Cell Lymphoma and indolent NHL.
- 💊 Autologous Hematopoietic Stem Cell Transplant – standard consolidation therapy for relapsed chemo-sensitive Hodgkin and Non-Hodgkin Lymphoma.
- 💊 CAR-T Cell Therapy – FDA-approved cellular therapy for relapsed/refractory DLBCL and Follicular Lymphoma.
Frequently Asked Questions
"B symptoms" consist of unexplained fevers, drenching night sweats, and significant unexplained weight loss (>10%). Their presence indicates higher biological tumor activity and plays a critical role in Ann Arbor clinical staging and treatment intensity selection.
Hodgkin Lymphoma is one of the most curable forms of adult cancer, with cure rates exceeding 85–90% in early stages. Diffuse Large B-Cell Lymphoma (DLBCL) can also be cured in over 60–70% of cases with frontline R-CHOP chemoimmunotherapy. Treatment outcomes depend on early diagnosis, subtype, and PET-CT response.