Non-hodgkin's Lymphoma Support Group

Lymphomas may develop in any organ associated with the lymphatic system (e.g. spleen, and tonsils). Most cases start with infiltration of lymph nodes (nodal), but specific subtypes may be restricted to the lymphatic organs (e.g.spleen, thymus, and tonsils).

Diagnosis of lymphoma requires biopsy of involved tissue. Before treatment, a common method to decide on treatment is called "watch and wait". "Watch and wait" is when doctors judge the case of NHL and how it is affecting the patient before deciding on a treatment option. Treatment of indolent or low-grade lymphoma may be supportive, while aggressive high-grade non-Hodgkin lymphoma is typically treated with chemotherapy and often with radiation therapy.

Over the years, doctors have used a variety of terms to classify the many different types of non-Hodgkin's lymphoma. Most often, they are grouped by how the cancer cells look under a microscope and how quickly they are likely to grow and spread. Aggressive lymphomas, also known as intermediate and high-grade lymphomas, tend to grow and spread quickly and cause severe symptoms. Indolent lymphomas, also referred to as low-grade lymphomas, tend to grow quite slowly and cause fewer symptoms. One of the paradoxes of non-Hodgkin's lymphoma is that the indolent lymphomas generally cannot be cured by chemotherapy, while in a significant number of cases aggressive lymphomas can be. Current lymphoma classification is complex. Common types of lymphomas include follicular lymphoma and diffuse large B cell lymphoma.

If non-Hodgkin's lymphoma is diagnosed, the doctor needs to learn the stage, or extent, of the disease. Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. Treatment decisions depend on these findings. The doctor considers the following to determine the stage of non-Hodgkin's lymphoma:

1) The number and location of affected lymph nodes;
2) Whether the affected lymph nodes are above, below, or on both sides of the diaphragm (the thin muscle under the lungs and heart that separates the chest from the abdomen);
3) Whether the disease has spread to the bone marrow, spleen, or to organs outside the lymphatic system, such as the liver.