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Non-Hodgkin's Lymphoma

In non-Hodgkin's lymphoma, tumors develop from white blood cells called lymphocytes, often at different locations in your body. Normally, lymphocytes go through a predictable life cycle. Old lymphocytes die and your body creates new ones to replace them. But in non-Hodgkin's lymphoma, your body produces abnormal lymphocytes that continue to divide and grow without control. This excess of lymphocytes crowds into your lymph nodes, causing them to swell.

Non-Hodgkin's lymphoma accounts for about 4 percent of all new cancers in the United States. The disease is about eight times more common than Hodgkin's lymphoma. About 55,000 cases of non-Hodgkin's lymphoma are diagnosed each year in the U.S.

The most common symptom of non-Hodgkin's lymphoma is a painless swelling of the lymph nodes in the neck, underarm or groin. Other symptoms may include the following:

  • Unexplained fever
  • Night sweats
  • Constant fatigue
  • Unexplained weight loss
  • Itchy skin
  • Reddened patches on the skin

However, these symptoms are not sure signs of non-Hodgkin's lymphoma. They also may be caused by other, less serious conditions, such as the flu or other infections — only a doctor can make a diagnosis. Therefore, when symptoms like these are present, it is important to see a doctor so that any illness can be diagnosed and treated as early as possible.

If non-Hodgkin's lymphoma is suspected, the doctor will ask about your medical history and perform a physical exam, which will include feeling the lymph nodes in the neck, underarm or groin and feeling to see if the liver or spleen is enlarged. In addition to checking general signs of health, the doctor may order blood tests.

The doctor also may recommend tests that produce pictures of the inside of the body, including:

  • X-Rays — High-energy radiation is used to take pictures of areas inside the body, such as the chest, bones, liver and spleen.
  • Computed Tomography (CT) Scan — A CT scan uses a thin X-Ray beam that rotates around the area being examined. A computer processes data to construct a three-dimensional, cross-sectional image.
  • Magnetic Resonance Imaging (MRI) — An MRI provides detailed pictures of areas inside the body, using a powerful magnet linked to a computer.
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The treatment of non-Hodgkin's lymphoma will vary according to the specific sub-type of lymphoma.

Patients with non-Hodgkin's lymphoma undergo an extensive evaluation that may include:

Some slow growing lymphomas, called indolent or low-grade lymphomas, may not require any initial therapy, and the doctor may decide to wait until the disease causes symptoms before starting treatment. Often, this approach is called "watchful waiting."

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Reviewed by health care specialists at UCSF Medical Center.