Lymphoma is a cancer of the lymphatic system that occurs when lymphocytes grow abnormally and accumulate in lymph nodes or other organs of the lymphatic system. The two main types are Hodgkin lymphoma and non-Hodgkin lymphoma. Risk factors include age, family history, immune system disorders, and certain infections. Signs and symptoms vary depending on the type but may include swelling of lymph nodes, fever, night sweats, and weight loss. Diagnosis involves biopsy and imaging tests. Treatment options include chemotherapy, radiation therapy, immunotherapy, and stem cell transplants.

1. LYMPHOMA
PRESENTED BY
R.PRIYA

2. INTRODUCTION
Lymphoma is a cancer of the lymphatic
system. Lymphoma begins when healthy B cells, T cells, or NK
cells in the lymphatic system change and grow out of control,
which may form a tumor. Hodgkin lymphoma is a specific type
of lymphoma that is covered in another section of this website.
Non-Hodgkin lymphoma (NHL) is one of the most common
cancers in the United States, accounting for about 4% of all
cancers. The American Cancer Society's estimates for non-
Hodgkin's lymphoma in 2021 are: About 81,560 people (45,630
males and 35,930 females) will be diagnosed with NHL.12-Jan-
2021

3. DEFINITION
Lymphoma is cancer that begins in infection-fighting
cells of the immune system, called lymphocytes. These
cells are in the lymph nodes, spleen, thymus, bone
marrow, and other parts of the body. When you have
lymphoma, lymphocytes change and grow out of control.

4. REVIEW ABOUT LYMPH
The lymph includes the following:
•Bone marrow –The spongy interior of large bones where white blood cells, red blood cells
blood cells (which carry oxygen), and platelets (which help blood clot) are made.
•Lymph – Colorless, watery fluid that carries white blood cells (lymphocytes) through the
through the vessels of the lymph system all through the body. Lymphocytes can be either B-
cells orT-cells.Their job is to fight disease and the growth of tumors.
•Lymph vessels –Tubes that collect lymph from different parts of the body and send it back to
send it back to the bloodstream.
•Lymph nodes – Small oval or round structures that filter lymph and store white blood cells.
blood cells. Lymph nodes are located throughout the body but are concentrated in the
underarms, pelvis, neck, abdomen and groin.
•Thymus – An organ behind the breastbone in which lymphocytes grow and reproduce.
reproduce.
•Spleen – An organ on the left side of the body near the stomach.The spleen filters blood,
filters blood, stores blood cells, and removes old blood cells. It also makes lymphocytes.
•Tonsils – Lymph tissue in the back of the throat that makes lymphocytes.
Because the lymph system is present throughout the body, lymphoma can begin in almost any
area and spread to other tissues and organs such as the liver.

5. TYPES OF LYMPHOMA
Lymphomas are categorized into two broad
groups: non-Hodgkin lymphoma and Hodgkin
lymphoma. Both types can occur in either children or
adults.
There are four subtypes of classical Hodgkin
lymphoma, including:
•nodular sclerosis Hodgkin lymphoma
•mixed cellularity Hodgkin lymphoma
•lymphocyte-rich Hodgkin’s disease
•lymphocyte-depleted Hodgkin’s disease
.

6. TYPES
There are two types of Hodgkin lymphoma. About 95 percent of all cases are
classical (or classic) Hodgkin lymphoma. This form of the disease is divided into
four subtypes:
Nodular sclerosis: This is the most common sub-type of classical Hodgkin
classical Hodgkin lymphoma. It often occurs in children and young adults, especially
young women, and is most often found in the chest and/or neck. This sub-type may
cause fibrous scars in the lymph nodes.
Mixed cellularity: This accounts for about 25 percent of all classical Hodgkin
classical Hodgkin lymphoma cases and is more common among older adults. This
sub-type is often found in the abdomen.
Lymphocyte-rich: This form of Hodgkin lymphoma accounts for 5 percent of all
for 5 percent of all classical cases and is most often diagnosed in men.
Lymphocyte-depleted: This extremely rare disease represents less than 1 percent
less than 1 percent of all Hodgkin lymphomas and is most often diagnosed in older
adults or people with HIV.

7. TYPES OF NON HODGKIN LYMPHOMA
There many types of NHL, all of which are divided into two major groups: B cell lymphoma and T cell lymphoma.
Types of B cell lymphoma
B cell lymphoma is much more common. It accounts for about 80 percent of all NHL cases. It includes:
•diffuse large B-cell lymphoma
•primary mediastinal B cell lymphoma
•follicular lymphoma
•small lymphocytic lymphoma and chronic lymphocytic leukaemia
•marginal zone lymphoma
•mantle cell lymphoma
•Wald Enstrom's macroglobulinemia
•Burkitt lymphoma
Types of T cell lymphoma
T cell lymphoma accounts for approximately 15 percent of all cases of NHL in the United States. The most common types
of T cell lymphoma include:
•peripheral T cell lymphoma not otherwise specified
•anaplastic large cell lymphoma
•angioimmunoblastic lymphoma
•cutaneous T cell lymphoma
There are also several types of relatively rare T cell non-Hodgkin lymphoma

8. TYPES OF B CELL LYMPHOMA
Diffuse B-cell lymphoma. About 1 of every 3 B-cell lymphomas is this type. It gets its name because
the cancer cells spread out (diffuse) all over the lymph node.
Diffuse B-cell lymphoma mainly affects people in their 60s. This cancer grows quickly, but treatments
work well against it and can often cure it.
Follicular lymphoma This other common B-cell lymphoma mainly affects people 60 and over. It tends
to grow slowly, but it can change into a more aggressive form. It's usually not curable, but treatment
can manage it to the point where it becomes a chronic disease.
Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). CLL and SLL are
basically the same disease. Both cancers grow slowly over many years, but sometimes they turn into
a faster-growing type. The only difference is where the cancer cells are found:
Mantal cell lymphoma This rather rare lymphoma affects mostly men ages 60 and older. The
cancer cells grow in the outer edge, or mantle, of B cells in the lymph node follicle. This type grows
slowly at first, but it can become aggressive.
Marginal zone lymphomas. These slow-growing lymphomas usually affect people older than 60.
Marginal zone lymphomas come in three subtypes:
•Extranodal marginal zone lymphoma starts outside the lymph nodes.
•Nodal marginal zone lymphoma starts inside the lymph nodes.
•Splenic marginal zone lymphoma starts in the spleen and blood.

9. TYPES OF B CELL LYMPHOMA
Burkitt lymphoma. This rare, fast-growing cancer is mainly found in
Africa. The kind that affects people in the United States usually starts in
your belly. It's different from other lymphomas because it affects more
children than adults.
Lymphoplasmacytic lymphoma. Only 1% to 2% of lymphomas are this
type. In about half of people with lymphoplasmacytic lymphoma, the
cancer cells make a protein that makes the blood very thick, a condition
called Waldenström macroglobulinemia. Cancer cells are mainly found in
bone marrow, but they also can be in your lymph nodes or spleen.
Central nervous(CNS) lymphoma. CNS lymphoma affects
your brain and spinal cord. It's more common in people who
have immune system damage from a disease like AIDS.

10. TYPES OF T CELL LYMPHOMA
T-cell Lymphomas
These less-common cancers affect T lymphocytes.
Peripheral T-cell lymphoma, not otherwise specified: Peripheral T-cell lymphomas are a
group of aggressive cancers that start in T cells. The most common one is called “not otherwise
specified” because it includes lymphomas that are hard for doctors to put into a single category.
This type can affect your lymph nodes, liver, bone marrow, intestines, and skin.
Anaplastic large cell lymphoma: This has different types. One can affect any part of your
body, while another only affects your skin. In some people, the cancer makes a protein called
anaplastic large cell kinase (ALK). Treatment seems to work better for people who have this
protein.
Angioimmunoblastic T-cell lymphoma. This fast-growing type of lymphoma spreads quickly,
and it often returns after treatment. Because it affects your immune system, infections are a
common problem.
Adult T-cell lymphoma/leukemia. This rare and aggressive type is caused by an infection of
the virus human T-cell lymphotropic virus 1. Cancer cells may be in your bones, skin, and blood.

11. CAUSES
•Are in your 60s or older for non-Hodgkin lymphoma
•Are between 15 and 40 or older than 55 for Hodgkin
lymphoma
•Are male, although certain subtypes may be more
common in females
•Have a weak immune system from HIV/AIDS,
an organ transplant, or because you were born with an
immune disease
•Have an immune system disease such as rheumatoid
arthritis, Sjögren's syndrome, lupus, or celiac disease
•Have been infected with a virus such as Epstein-
Barr, hepatitis C, or human T-cell leukemia/lymphoma

12. CAUSES
•Have a close relative who had lymphoma
•Were exposed to benzene or chemicals that kill
bugs and weeds
•Were treated for Hodgkin or non-Hodgkin
lymphoma in the past
•Were treated for cancer with radiation

13. RISK FACTOR
Hodgkin’s lymphoma risk factors
Risk factors for Hodgkin’s lymphoma include:
•Age. More cases are diagnosed in people between the ages of 20 and
30, and in people over 55.
•Sex. Men are more likely than women to develop this type of
lymphoma.
•Family history. If asibling is diagnosed with this type of cancer, your
risk for also developing it is higher.
•Infectious mononucleosis. An EBV infection can cause
mononucleosis. This infection can increase the risk for lymphoma.
•Affluence. Individuals that come from a background with a higher
socioeconomic status have a greater risk for this type of cancer.
•Immunodeficiency. Individuals with HIV have a greater risk for
developing lymphoma.

14. HODGKIN
Risk factors for non-Hodgkin’s lymphoma (NHL) include:
•Immunodeficiency. This could be due to a weak immune system from human
immunodeficiency virus (HIV) or AIDs, or taking an immune system-suppressing drug after
an organ transplant.
•Autoimmune disease. People with certain autoimmune disease, such as rheumatoid
arthritis and celiac disease, have an increased risk for lymphoma.
•Age. Lymphoma is most common in people over 60. However, some types are more
common in children and infants.
•Sex. Women are more likely to develop some particular types of lymphoma, and men are
more likely to develop other types.
•Ethnicity. White Americans in the United States are more likely to develop some types of
lymphoma than African-Americans or Asian-Americans.
•Infection. People who have had infections such as the human T-cell
leukemia/lymphotropic virus (HTLV-1), Heliobacter pylori, hepatitis C, or the Epstein-Barr
virus (EBV) are associated with an increased risk.
•Chemical and radiation exposure. Those exposed to chemicals in pesticides, fertilizers,
and herbicides are also at increased risk. Nuclear radiation can also increase risks for
developing NHL.
•Body size. Obesity has been connected to lymphoma as a possible risk factor, but more
research is needed to understand this possible risk factor.

15. PATHOPHYSIOLOGY

16. SIGNS AND SYMPTOMS HL
•Painless swelling of lymph nodes in your neck, armpits or groin.
•Persistent fatigue.
•Fever.
•Night sweats.
•Unexplained weight loss.
•Severe itching.
•Increased sensitivity to the effects of alcohol or pain in your lymph nodes after
drinking alcohol
Warning signs of lymphoma include:
•Swollen glands (lymph nodes), often in the neck, armpit, or groin that are
painless
•Cough
•Shortness of breath
•Fever
•Night sweats
•Fatigue
•Weight loss
•Itching

17. SIGNS AND SYMPTOMS OF NHL
Symptoms of non-Hodgkin lymphoma may include:
•Painless swelling of one or more lymph nodes, with no recent infection. Swelling may be intermittent.
•Swelling, fluid accumulation, or pain in the abdomen.
•Shortness of breath, wheezing, or coughing.
•Bloody stool or vomit.
•Swelling of the face, neck, and arms.
•Blockage of urine flow.
•Bone pain.
•Unexplained weight loss amounting to 10% of body weight over six months.
•Fever lasting for at least 14 consecutive days, usually in the late afternoon and early evening, and rarely above 102 degrees.
•Headache.
•Seizures.
•Visual problems.
•Mental status changes.
•Numbness on areas of the face.
•Balance problems.
•Night sweats and chills lasting at least 14 consecutive days.
•Severe itching of the skin.
•Fatigue.
•Weakness.
The symptoms of fever, heavy night sweats, and weight loss are known as "B" symptoms. They are most often associated with more

18. DIAGNOSTIC EVALUATION
Examine a tissue sample (called a biopsy) to make a lymphoma
diagnosis. The biopsy tissue is removed for examination in one of two
ways:
• Surgery (Surgical biopsy)
During a surgical biopsy, a doctor makes a small cut in the skin and
removes part or all of a lymph node or a piece of diseased tissue.
• Core Needle Biopsy
During a core needle biopsy, a doctor inserts a hollow needle into a
lymph node or tumor to remove a small amount of tissue or fluid.
Our interventional radiologists have extensive expertise in this approach.
• PET
• MRI
• CT
Characteristic of different types of lymphoma. These include:
•Immunophenotyping
•Flow cytometry
•Fluorescence in situ hybridization

19. MEDICAL MANAGEMENT
CHEMOTHERAPY DRUGS FOR LYMPHOMA
Alkylating agents
•Cyclophosphamide
•Chlorambucil
Corticosteroids
•Prednisone
Platinum drugs
•Cisplatin
•Carboplatin
•Often drugs from different groups are combined. One of the most
combinations is called CHOP. This includes the drugs cyclophosphamide,
(also known as hydroxydaunorubicin), vincristine (Oncovin)
common combination leaves out doxorubicin and is called CVP.
However, this intensive chemotherapy destroys your bone marrow, leading to the
problems mentioned above. You'll need a stem cell or bone marrow transplant to
replace the damaged bone marrow

20. RADIATIONTHERAPY
Radiotherapy
Radiotherapy is most often used to treat early-stage Hodgkin
lymphoma, where the cancer is only in 1 part of the body.
Treatment is normally given in short daily sessions, Monday to
Friday, over several weeks. You shouldn't have to stay in hospital
between appointments.
Radiotherapy itself is painless, but it can have some significant
side effects. These can vary and will be directly related to
the part of your body being treated. For example, treatment to
your throat can lead to a sore throat, while treatment to the head
can lead to hair loss.

21. MANAGEMENT
•Bone marrow transplant. A bone marrow transplant, also
known as a stem cell transplant, involves using high doses of
chemotherapy and radiation to suppress your bone marrow. Then
healthy bone marrow stem cells from your body or from a donor
are infused into your blood where they travel to your bones and
rebuild your bone marrow.
•Other treatments. Other drugs used to treat lymphoma include
targeted drugs that focus on specific abnormalities in your cancer
cells. Immunotherapy drugs use your immune system to kill
cancer cells. A specialized treatment called chimeric antigen
receptor (CAR)-T cell therapy takes your body's germ-fighting T
cells, engineers them to fight cancer and infuses them back into
your body.

22. COMPLICATION
• INFECTION
• LEUKEMIA
• BRAEAST CANCER
• CARDIO VASCUAR DISEASE
• LUNG DISEASE

23. PREVENTION
•Avoiding behaviors that increase the chance of getting
AIDS and hepatitis C infections, both of which weaken the
immune system.
•Avoiding unnecessary exposure to radiation.
•Maintaining a normal weight and eating a healthy diet.
•Rarely, some women develop lymphoma in the scar tissue
around breast implants.The decision to get breast implants
should be well thought-out.