Definition and Overview
The lymphatic system is one of the body’s protectors against infection and diseases. It is composed of lymph vessels, lymph, and lymph nodes. Lymph vessels connect the lymph nodes throughout the body. They are also the passageway through which lymph (a clear liquid) carries white blood cells to the lymph nodes when necessary. The lymph nodes, where the white blood cells are stored, are usually located in the neck, underarms, abdomen, chest, and groin. When lymph nodes become activated at the onset of infection, they become swollen making it easy for them to be palpated by the patient or the doctor.
At the center of the lymphatic system are the lymphocytes called B and T cells. These are types of white blood cells that work to protect the body against germs like bacteria and viruses by destroying the infected cells. When there’s an infection, these lymphocytes rush to the lymph node nearest the infection. For example, if a patient has a cold, his lymph nodes on the neck will be swollen as the lymphocytes try to combat the cold virus. Since lymphoid tissues are located in many parts of the body, lymphomas can turn up anywhere.
There are two common types of cancer that invade the lymphatic system of the body – Hodgkin’s lymphoma (formerly Hodgkin’s Disease) and Non-Hodgkin’s lymphoma (or simply NHL). They both start from lymphocytes that mutate and infect other cells. These infected cells then travel to other lymph nodes, spreading cancer to other parts of the body. They both present with similar symptoms but it is only through further examination of the infected cells that a determination is made as to which type of lymphoma is at work. Hodgkin’s lymphoma is determined when the Reed-Sternberg cell is present in the cancer cell, otherwise, it is diagnosed as Non-Hodgkin’s. Hodgkin’s lymphoma is considered rare compared to NHL, which is the 6th most common cancer in the United States.
Cause of Condition
As of yet, doctors have no idea what causes Hodgkin’s and Non-Hodgkin’s lymphomas. What is apparent, however, is that lymphomas usually begin in the lymph nodes in the upper body like in the neck, underarms, or chest. The most common lymphocytes that turn into lymphomas are the B cells, which produce antibodies to fight infections. These antibodies mark the infected cells enabling the white cells to identify and destroy them. However, when there are more infected cells than antibodies and normal cells, they have the potential to overwhelm the said antibodies and normal cells and effectively annihilate them. T Cells, another type of lymphocyte, can kill infected cells directly but their potential to turn into lymphomas is much lower than their B cells counterpart.
Considering the nature of the lymphatic system, there are certain risk factors that increase a person risk of developing either Hodgkin’s lymphoma or NHL and these include:
Having a compromised immune system. This condition weakens the lymphatic system, making it more susceptible to being overwhelmed by infected cells.
Taking immunosuppressive medication. Patients under immunosuppressive medications, like those who have undergone organ transplants, are at a higher risk of developing the condition. This is because their body is unable to fight infection, making it easier for abnormal cells to proliferate and spread.
Exposure to certain viruses. People who have been exposed to specific viruses like HIV, Hepatitis C and Epstein-Barr, are also at risk of developing lymphoma because of their compromised immune systems.
Family history of the condition
Both lymphomas usually affect young adults (15 to 35 years old) and older people (55 years old and up).
Both Hodgkin’s lymphoma and NHL share the same key symptoms because they are caused by the same factors. The most common of symptoms is the painless swelling of the lymph nodes in the neck, underarms or groin. The swelling indicates that there is an increased amount of lymphocytes in the affected lymph nodes and that there is an ongoing war between infected cells and lymphocytes. However, swollen lymph nodes are not always indicative of lymphoma because they do normally swell up when they’re fighting an infection. Aside from swollen lymph nodes, other symptoms that may be experienced by patients with lymphoma include:
- Unexplained weight loss
- Night sweats
- Weakness and general fatigue
- Persistent itching
Who to See and Types of Treatments Available
When the symptoms mentioned above are experienced, it is best to consult your general physician. Various tests may be recommended to determine the exact cause and to positively diagnose the type of lymphoma. Blood tests are required to ascertain if there is an elevated level of lymphocytes and to rule out normal infection. Imaging diagnostics are also necessary to see if there are tumors or to detect any and all enlarged lymph nodes. A biopsy is also necessary to determine the type of lymphoma.
A medical oncologist may be consulted to recommend the best treatment program to be undertaken should lymphoma has been confirmed. Chemotherapy is usually part of the treatment program because it targets cancer cells in the whole body, which is important since lymphoma can affect the whole body. A radiation oncologist may also be called in if radiation therapy is part of the treatment program.
National Cancer Institute: PDQ Adult Non-Hodgkin Lymphoma Treatment. Bethesda, MD: National Cancer Institute. Date last modified February 13, 2015. Available at: www.cancer.gov/cancertopics/pdq/treatment/adult-non-hodgkins/HealthProfessional.
Roschewiski MJ, Wilson WH. Non-Hodgkin lymphoma. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 106.