What causes it?

There are many types of non-hodgkin's lymphoma (NHL), and the cause of most of them is still unknown, but there are a few key trends:

• People who are taking medicines after an organ transplant; or people who have HIV are slightly more likely to develop non-Hodgkins than other people. This is because their overall immunity is weakened.
• It’s also slightly more common in people who’ve been treated for cancer before. Some chemotherapy drugs and radiotherapy treatments can increase a person’s risk of developing NHL many years later (the risk is very small though, compared to the benefit of having the treatment in the first place).
• Infection with the Epstein Barr virus (commonly known as glandular fever or the ‘kissing disease’) may contribute to the development of lymphomas. This doesn’t mean that lymphomas themselves are infectious though!
• People who have coeliac disease (an allergy to gluten) have a slightly increased risk of developing B-cell NHL or a rare type of T-cell lymphoma called enteropathy type T-cell lymphoma (ETTL).

What are some of the symptoms?

They vary, but might include:

• Swollen lymph nodes in the neck, armpit or groin (these are usually painless)
• Unexplained high temperatures or sweating (usually at night)
• Weight loss or loss of appetite
• Tiredness
• A cough or breathlessness
• A pesky itch all over the body
• Pain in various parts of the body. E.g. If the lymphoma is in the abdomen you might have abdominal pain or indigestion.

How is it diagnosed?

Usually, you’ll start by seeing your GP. They’ll examine you and organise any tests you might need.
These could include:

• Blood tests
• x-rays
• CT Scan

If any of your tests look a bit suspicious, they’ll refer you to a specialist.

For a definite diagnosis, you’ll need to have a biopsy. This is a small operation, usually done under general anaesthetic, where an enlarged lymph node (or just part of it) is removed and examined under a microscope.

If the biopsy shows that lymphoma cells are present, your doctor will want you to have some further tests to find out the exact stage of the lymphoma. This is very important because the type of treatment you have depends on the stage of the disease. Tests to find the stage of your lymphoma may include any of the following:

• Blood tests
• Chest x-ray
• CT scan
• MRI scan
• Bone Marrow aspirate
• Lumbar puncture
• PET scan

Grading and staging

Grading refers to how quickly the NHL is predicted to grow and develop. Staging describes where it is in the body, how many lymph glands are affected and whether it has spread to other lymph glands or other organs.