Lymphoma

Different Types Of Lymphoma?

There are many different types of lymphoma. Researchers continue to seek better ways to group lymphomas so that doctors can predict the best treatment for a particular type of tumor.

In most cases the type of lymphoma is less important than the grade and stage of a particular lymphoma.

The different categories of lymphoma can seem very complicated, but they are based on:

• The appearance or histology of the cancer cells under a microscope.
• What kinds of genetic mutations they carry.
• Whether they form tight clusters (nodular) or are spread throughout a lymph node or other organ of the body (diffuse).
• What type of cell they arose from.
• What types of proteins the lymphoma cells have on their surface.
• Where they occur in the body.

Many types of lymphoma have traits that overlap with one another so it is often difficult to group them into definite categories. Also, many lymphomas that begin as one type gradually develop into another.

Some types of non-Hodgkin’s lymphoma are distinct, either because of the age group they most often affect or the form they take. These include:

• Lymphoblastic lymphoma (LBL) – This form occurs more often in children than adults, and accounts for about 30% of all lymphomas in children. It is an aggressive, fast-growing form of lymphoma. In the past, it has been fatal for many patients. Today, intensive chemotherapy has greatly improved the chance of surviving LBL.

• Burkitt’s lymphoma – This form of lymphoma has been found in Africa, where infection with Epstein-Barr virus may play a role in its cause. Burkitt’s lymphoma is also seen in other parts of the world, but in most of these cases a virus doesn’t seem to be involved. Burkitt’s usually causes a large tumor either in the bone of the jaw, or in the abdomen.

• Diffuse histiocytic lymphoma (DHL) – Also called reticulosarcoma, this type of lymphoma is made of a substance that is more like connective tissue than white blood cells. DHL is usually slow-growing, hard to treat, and often returns after treatment.

• Cutaneous T-cell lymphoma (CTLC) – Also called mycosis fungoides or Sezary syndrome, this kind of lymphoma affects the skin. In CTLC, white blood cells in the skin become cancerous and eventually cause tumors to form. This form tends to grow slowly over many years. In the early stages of CTLC, the skin may develop dry, scaly, red or dark patches and begin to itch. Eventually, raised tumors form on the skin. When the cancer becomes more advanced, it may spread to the blood, and from there to other organs.

  In addition to the therapies used for other types of lymphoma, two additional treatments are used for CTLC. One is phototherapy, in which a drug that makes cancer cells sensitive to light is given to the patient, and a special light is then shone on the cancer cells to kill them. The other treatment is total skin electron-beam radiation therapy or TSEB, in which the entire surface of the skin is exposed to radiation.

  Today, treating CTLC often causes the cancer to disappear, or go into remission, but it is a very difficult cancer to cure if not caught early. Treatment does help the symptoms, however, and can often increase a patient’s life. New combinations of therapies are being studied in the hopes that more cases can be kept in remission for a longer time.

• Lymphoplasmacytoid lymphoma (LPL) with Waldenstrom’s macroglobulinemia – LPL develops when special white blood cells called plasma cells begin to divide out of control, becoming cancerous. It is a slow-growing or indolent form of lymphoma.

  LPL cells also release too much of a kind of antibody called IgM into the blood. This condition is called Waldenstrom’s macroglobulinemia. In addition to the cancer, this is dangerous because it causes a thickening of the blood. This in turn can cause fatigue, headaches, weight loss, visual problems, confusion, dizziness, loss of coordination and excessive bleeding. If not treated, the thickened blood can tax the heart so much that it leads to heart failure.