Non-Hodgkin Lymphoma — Lymphatic System Cancer

Non-Hodgkin lymphoma encompasses a heterogeneous collection of lymphoproliferative malignancies that arise primarily from B cells, T cells, or natural killer (NK) cells. It is clinically distinguished from Hodgkin lymphoma by the absence of characteristic Reed-Sternberg cells upon microscopic examination.

Pathologically, NHL is classified into indolent (slow-growing) or aggressive subtypes based on cell morphology, immunophenotype, and clinical behaviour. Common indolent forms include follicular lymphoma and marginal zone lymphoma, whereas diffuse large B-cell lymphoma is the most frequent aggressive subtype. Disease staging utilises the Ann Arbor or Lugano systems to quantify nodal and extranodal involvement across the body.

Knowing the precise subtype of non-Hodgkin lymphoma is critical because treatment plans vary widely. A slow-growing lymphoma may only require active monitoring without immediate medication, sparing you side effects until intervention is necessary. Conversely, an aggressive subtype demands immediate systemic therapy but often carries a high potential for cure. Accurate diagnosis ensures you receive the correct treatment regimen matched to your specific tumour biology.

Definitive diagnosis requires an excisional or core needle lymph node biopsy evaluated by a haematopathologist. Diagnostic workups include immunohistochemistry, flow cytometry, and fluorescence in situ hybridisation (FISH) for translocations like MYC or BCL2. Staging involves PET-CT scans, routine blood tests, and occasionally bone marrow biopsies or lumbar punctures.

This term refers directly to non-Hodgkin lymphoma itself, which contains over 60 distinct subtypes. The most prevalent B-cell varieties are diffuse large B-cell lymphoma and follicular lymphoma, followed by mantle cell lymphoma and Burkitt lymphoma. T-cell and NK-cell lymphomas occur less frequently, and NHL can sometimes involve organs outside the lymphatic network, such as the stomach, brain, or skin.

Therapy depends heavily on subtype and stage. Treatment options include chemoimmunotherapy regimens, such as rituximab combined with chemotherapy, targeted therapies (such as BTK inhibitors), and radiation therapy. In relapsed or refractory aggressive cases, autologous stem cell transplantation, CAR T-cell therapy, or bispecific antibodies may be recommended.