Non Hodgkin’s Lymphoma

Non Hodgkin’s Lymphoma

In this information there are sections on
What is lymphoma?
Definite risk factor for NHL
Possible risk factor for NHL
Symptoms of NHL
Screening for NHL
Types of NHL
Should i see a specialist?
Questions for your doctor

What is lymphoma

Lymphoma means cancer of the lymphatic system. There are two main types of lymphoma, called Hodgkin’s lymphoma and Non Hodgkin’s lymphoma (NHL).

Where in the body do you get non Hodgkin’s lymphoma (NHL)?

Because the lymphatic system runs all through the body, you can get non Hodgkin’s lymphoma just about anywhere. The most common place for it to be noticed first is in the lymph nodes in the neck. It is quite common to find it in the liver or spleen. But it can occur in other body organs as well.

What happens to your body when you get lymphoma?

If you have lymphoma, some of your white blood cells (lymphocytes) are ‘out of control’. They start to divide abnormally. And they do not naturally die off as they usually do. These cells start to divide before they are fully mature. This makes them unable to fight infection as normal white blood cells do. These abnormal , useless lymphocytes start to collect in the lymph nodes. They can then grow into tumours and begin to cause problems in the organs.

Definite risk factors for non Hodgkin’s lymphoma

Non Hodgkin’s lymphoma is the 5th most common type of cancer in adults. The majority of people who get non Hodgkin’s lymphoma do not have any of the known risk factors. Doctors just don’t know why most people get this disease.

Having a weakened immune system

Any ones whose immune system is not working as well as it should may be more likely to develop a lymphoma. This includes people taking drug to stop organ rejection after a transplant, and people who have AIDS or autoimmune disease.

Past cancer treatment

Some chemotherapy drugs can increase your risk of developing NHL. 10 to 15 years after treatment. Having had radiotherapy in the past also increases your risk.


Infection with some viruses and bacteria can increase the risk of developing NHL.

Other risks

People with celiac disease have an increases risk of some type of NHL. If you have a parent, brother or sister diagnosed with NHL, you have a slightly increased risk of getting it yourself. It’s about 2 to 3 times the average risk.

But remember that the general risk of NHL is small. If you’ve had a melanoma, you have an increases risk of NHL and vice versa. We don’t know why this is.

Possible risk factors for non Hodgkin’s lymphoma

These are possible risk factors for NHL. We have included information on these because we are sometimes asked about them. But we must stress that there is not enough evidence for these to be thought of as definite risk factors. They include.

  • Weed killers and pesticides
  • Hair dye
  • Simian virus 40 (SV40)
  • Recreational drugs
  • Diet
  • Levels of chemicals in drinking water
  • Sunlight
  • Smoking or chewing tobacco
  • Obesity
  • Medicines
  • Alcohol

CancerHelp UK has information about the research into these possible risk factors.

Symptoms of non Hodgkin’s lymphoma

The most common symptom of non Hodgkin’s lymphoma is one or more painless swellings in the neck, armpit or groin. Each swelling is an enlarged lymph node. If you have a swollen lymph node that does not go away after 6 weeks, you should see your GP.

B symptoms

You may have other general symptoms such as heavy sweating at night, temperatures that come and go with no obvious cause, losing a lot of weight, or unexplained Itching .  Doctors call these ‘B symptoms’. Some people with NHL have them but most don’t, it’s important to tell your doctor about any symptoms like this. It helps them decide which type of NHL you have and what treatment you need.

Other symptoms

Some people have NHL in their bone marrow. This can cause anaemia, increased risk of infection or bleeding problems NHL can also cause enlarged tonsils, liver or spleen. Or you may feel breathless if the lymph nodes that start in the brain are very rare. They can cause headaches, difficulty moving parts of the body, and seizures (fits).

Screening for non Hodgkin’s lymphoma

Screening means testing people for the early stages of a disease before they have any symptoms. It is important part of the health care for some cancers. But before screening for any type of cancer can be carried out, doctors must have a test that will reliably detect  early disease. The screening test must be accurate and reliable in picking up cancers that are there. And it must not give false positive results in people who do not have cancer. At the moment there is no reliable screening test for NHL.

Should I see a specialist in non Hodgkin’s lymphoma

It can be very difficult for GPs to decide who may have a suspected cancer and who may have something much more minor. The National Institute for Health and Clinical Excellence (NICE) has produced guidelines for GPs to help them decide which patients need to be seen urgently by a specialist.


Guidelines for urgent referral

You should ideally get an appointment within 2 weeks for an urgent referral. You should have an urgent referral to a specialist (usually haematologist) if you have and enlarged spleen that isn’t getting better and your doctor can’t explain the cause. You might also need further investigations or a referral if you have a swollen lymph node that is.

  • Larger than 2cm wide
  • Has been there for more than 6 weeks
  • Is getting bigger
  • Accompanied by night sweats, weight loss and an enlarged spleen
  • One of several swollen lymph nodes.

The guidelines also say that a GP should do tests and possible refer anyone with a combination of symptoms that includes fatigue, weight loss, fever, night sweats, itching, breathlessness, bruising easily or bleeding, infections that keep coming back or pain.

There are separate guidelines for children.

Questions for your doctor about non Hodgkin’s lymphoma

  • The glands in my neck swell up and go down again. Does this mean I have non Hodgkin’s lymphoma?
  • How can you tell if I have non Hodgkin’s lymphoma?
  • Am I more likely to get non Hodgkin’s lymphoma than anyone else?
  • How common is non Hodgkin’s lymphoma?
  • What are the different types of non Hodgkin’s lymphoma?
  • What does low grade and high grade lymphoma mean?
  • Can I catch non Hodgkin’s lymphoma from someone?

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