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Lymphoma is a tumor of the lymphatic system, caused by abnormal growth of the lymphatic system and abnormalities of white blood cells. Both systems are related to immunity.
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The cause of lymphoma is still unknown. Lymphoma can occur in various organs of the lymphatic system, including the spleen, bone marrow, tonsils, and thymus gland.
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<h4>Types of Lymphoma 
</h4>
Lymphoma is divided into two main types:
<ol>
<li aria-level="1">Hodgkin Lymphoma, characterized by the presence of Reed-Sternberg cells.</li>
<li aria-level="1">Non-Hodgkin Lymphoma, which can be further divided into two main types based on the growth rate of the cancer cells:
<ol>
<li aria-level="2">Indolent NHL: cancer cells grow slowly. Currently, there is no cure.</li>
<li aria-level="2">Aggressive NHL: cancer cells grow rapidly. If treated early, there is a chance of cure, but without treatment, patients may die within 6 months to 2 years.</li>
</ol>
</li>
</ol>
<h4>Symptoms of Lymphoma</h4>
<ol>
<li aria-level="1">Palpable lumps in various areas such as the neck, armpits, groin, or abdomen. Lymphoma lumps are painless, unlike lumps caused by infections which are usually painful.</li>
<li aria-level="1">Fever, chills, night sweats.</li>
<li aria-level="1">Loss of appetite, unexplained weight loss, and fatigue.</li>
<li aria-level="1">Enlarged tonsils.</li>
<li aria-level="1">Chronic cough, difficulty breathing.</li>
<li aria-level="1">Paleness and easy bleeding, with possible bruising or petechiae on the body.</li>
<li aria-level="1">In cases of abdominal lymphoma, symptoms may include abdominal fullness, indigestion, abdominal pain, or abdominal swelling due to fluid accumulation.</li>
</ol>
<h4>Risk Factors for Lymphoma</h4>
<ol>
<li aria-level="1">Age: risk increases with age.</li>
<li aria-level="1">Infections: some types of lymphoma are associated with infections, such as Helicobacter Pylori infection with MALT lymphoma, and EBV infection with Burkitt lymphoma.</li>
<li aria-level="1">Immunodeficiency: such as HIV patients, organ transplant recipients, or those on immunosuppressive drugs.</li>
<li aria-level="1">Autoimmune diseases: patients with SLE have a higher risk of lymphoma than the general population.</li>
</ol>
<h4>Diagnosis of Lymphoma 
</h4>
When a doctor suspects lymphoma, diagnosis is confirmed by tissue biopsy for pathological examination. Additional tests may be performed to assess the stage of the disease and plan appropriate treatment, including:
<ol>
<li aria-level="1">Bone marrow study.</li>
<li aria-level="1">Imaging tests: CT scan, PET/CT scan, MRI.</li>
<li aria-level="1">Blood tests.</li>
</ol>
<h4>Stages of Lymphoma 
</h4>
Lymphoma is divided into 4 stages:
Stage 1: Disease is found in one lymph node region or a single extralymphatic site.
Stage 2: Disease is found in two or more lymph node regions or extralymphatic sites on the same side of the diaphragm.
Stage 3: Disease is found in lymph node regions or extralymphatic sites on both sides of the diaphragm, and/or involves the spleen.
Stage 4: Disease has spread beyond the initial sites, commonly to the liver, bone marrow, or lungs.
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<h4>Current Treatment Approaches for Lymphoma 
</h4>
Treatment depends on the type and stage of lymphoma and may involve single or combined therapies as follows:
<ol>
<li aria-level="1">Watchful waiting: Used for indolent lymphoma at stage 1 without other symptoms. During this period, patients undergo regular physical exams, blood tests, or imaging as directed by the doctor.</li>
<li aria-level="1">Chemotherapy: Uses drugs to destroy cancer cells, usually combining several drugs or combined with monoclonal antibody therapy.</li>
<li aria-level="1">Monoclonal antibody therapy: Synthetic substances that bind to proteins on cancer cell surfaces, stimulating the immune system to destroy cancer cells. This method targets cancer cells broadly with minimal impact on normal tissues.</li>
<li aria-level="1">Radiation therapy: Uses high doses of radiation to destroy cancer cells.</li>
<li aria-level="1">Stem cell transplantation: Divided into two types: allogeneic stem cell transplantation (using donor cells) and autologous stem cell transplantation (using the patient’s own cells).</li>
<li aria-level="1">Immunotherapy with cell therapy (Chimeric Antigen Receptor T Cell, CAR T Cell): A highly effective treatment for leukemia or lymphoma patients.</li>
</ol>

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Dr. Patcharawadee Rongwararoj 
Hematology Specialist 
Meesuk Center (Cancer and Blood Diseases) 
Phyathai 3 Hospital

If a lump is found in various areas such as the neck, armpit, groin, or abdomen, and it is palpable but not painful, it should be suspected as lymphoma. This is because lumps caused by infections are usually painful when touched.

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