The different types of T-cell NHLs according to the World Health Organization are listed below and explained in detail immediately following.
Non-Hodgkin’s Lymphoma (NHL) is not a single disease, but rather a group of many closely related cancers that affect the lymphatic system. Although the different types of NHL have some things in common, they differ in what the cancer cell looks like under a microscope, how the cell grows, and how the tumour affects the body.
What causes NHL is still unknown. The incidence of NHL has continued to increase over the years. Since the 1970s, the number of people diagnosed annually in Canada has almost doubled. NHL represents the fifth most common malignancy diagnosed in men and the sixth most common in women, with the incidence being approximately 39% higher in men. NHL is not contagious and the patient does not pose a risk to others in any way.
It is important to note that if you have one or more of these risk factors, it does not mean that you will get NHL. In fact, most people with risk factors never develop cancer. Many who are diagnosed have no identifiable risk factors.
The exact causes are unknown. Doctors often cannot explain why one person gets NHL and another does not. We do know that lymphomas are not caused by an injury and that you cannot get NHL by being in contact with someone who has the disease.
There has been recent progress in understanding how DNA may play a part in causing normal lymphocytes to become cancerous. Cancers can be caused by DNA defects (mutations), which cause genes that direct cell growth (oncogenes) to overproduce or genes that slow growth or promote cell death (tumour suppressor genes) to fail. Some DNA mutations can be inherited, increasing a risk for certain types of cancer, but NHL is NOT one of the cancers caused by these inherited gene mutations.
Unfortunately, the bottom line is that most patients with NHL have no known risk factors, therefore the true cause of NHL is still unknown. However, it is important to note that NHL is NOT contagious so patients pose no health risk to others at any time and possessing a risk factor does not mean a person will develop NHL.
NHL is medically diagnosed by taking a tissue sample (biopsy). A needle biopsy is sometimes used but a surgical biopsy, removal of a whole node, is preferred in getting enough tissue for a definite diagnosis. The pathologist (a person trained in the biology of cells) searches for cancerous cells, and will confirm a diagnosis of NHL.
Click here to review pathology slides of NHL biopsy samples
Certain medical centres may perform additional tests, including exploratory surgery to determine the extent of the disease, or a lymphangiogram, a procedure during which a radio-opaque liquid is injected into the lymph system through the feet; the fluid travels throughout the lymph system and remains visible for up to six months on x-rays.
Once the surgeon has performed the biopsy and the pathologist has examined the tissue and recorded the information about the tumour cells, they must then use this information to determine the exact type of NHL. The classification process is a complicated one. Many organizations have attempted to simplify the classification process and develop a standardized international classification system for NHL. The most commonly used system is the World Health Organization (WHO) lymphoma classification system, which allows different NHL types to be classified in a standardized way among doctors around the world. Once the NHL type, or classification, has been determined, it is then important to determine the stage and grade of the NHL.
The most common method for staging NHL is called the Ann Arbor Staging System, which can be summarized as follows:
Staging lymphoma
The doctor must also determine the grade of the tumour. The grade of the tumour provides information on how aggressive the tumour is and helps predict how the tumour will behave. This information helps determine the aggressiveness of the treatment approach. The grade is determined by the appearance of the cancer cells, what unique characteristics they have, how they function and how quickly they grow and divide. The grade is referred to as low-grade, intermediate-grade or high-grade NHL. Low-grade NHLs are often called indolent, or slow-growing NHLs. Intermediate and high-grade NHLs are often called aggressive, or fast-growing NHLs. Review the Treatment section for detailed information on how indolent and aggressive lymphomas are treated.
The following table summarizes the specialized process of classifying, staging and grading NHL:
As mentioned earlier, the most commonly used method for classifying NHL is the WHO Classification of Lymphoid Malignancies.
The major goals of NHL treatment include:
NHL often responds very well to modern treatments. This does not mean that NHL is always curable but it does mean that treatment can often provide long cancer-free periods, reduced symptoms and improved quality of life for many patients. Each patient responds differently to treatment, as does each NHL type. The International Prognostic Index (IPI) does give statistically valid estimates of which patients are most likely to relapse, and which patients are less likely to relapse.
This section is now in the process of being developed.
For supportive information please go to either of the following websites: Young Adult Cancer Canada Livestrong Young Adult Alliance
Once NHL is found, more tests will be done to find out the exact type or classification, whether the cancer has spread from where it started to other parts of the body (i.e., the staging of NHL), and the aggressiveness of the tumour (i.e., the grading of NHL).
Once childhood NHL is found, more tests will be conducted to find out if the cancer has spread from where it started to other parts of the body. This is called staging. Your child’s doctor needs to know the stage of the disease to plan treatment.
The following stages are used for childhood NHL:
Note: The LFC is not responsible for verifying the accuracy of all information that is contained on these sites.
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