learn more about lymphomas
Lymphoma is characterised by the malignant proliferation of lymphocytes that constitute the immune system’s defence cells.
The lymphoid tissue is located mainly in the lymph nodes. Lymphomas are therefore generally characterised by the presence of lymph nodes of increased size.
However, there are also lymphoid cells in many other organs. Lymphomas can therefore affect the gastrointestinal tract, spleen, liver, lungs, bone marrow, etc.
The incidence of this disease is high, given that 5,000 new cases are diagnosed each year in Spain in adults over 40.
Multidisciplinary coordination enables us to study and diagnose the disease quickly. Additionally, the Clínica Universidad de Navarra has the most advanced techniques for diagnosing this disease.
In general, lymphomas present as lymph nodes of increased size, which, when they appear in accessible areas such as the neck, armpits or groin, can be palpated to determine their size.
However, not all increases in lymph node size originate from a lymphoma. There are various infections and other diseases that can cause an increase in lymph node size. It is therefore important to see a specialist and, in case of uncertainty, take a biopsy.
Occasionally, the affected lymph nodes are located deep in the body (abdomen, mediastinum, etc.) and can go unnoticed. The diagnosis is therefore more difficult and can only be reached when other symptoms appear (fever, night sweats, fatigue, significant weight loss, pruritus, etc.), which require more exhaustive tests.
Traditionally, lymphomas have been classified into two major groups, based on the nature of the proliferative lymphoid cells:
Represents 15%-20% of cases.
Non-Hodgkin’s lymphoma (NHL)
They are a highly heterogeneous group that is currently divided into almost 30 variants, which depend on the type of lymphoid cell involved in the malignant proliferation.
They include B and T cell lymphomas and are subdivided into two major groups:
- Lymphoblastic lymphomas, which originate in immature lymphoid cells from the central compartments (bone marrow or thymus).
- Peripheral cell lymphomas, in which proliferate effector lymphoid cells typically located in the peripheral compartments.
The complexity is such that the best way to classify the lymphomas has been debated for years. Although we currently have a high degree of precision and consensus in the diagnosis of its different varieties, it is possible that we do not yet have a definitive classification.
The cause of lymphomas is still unknown. They represent 84% of all haematologic neoplastic diseases.
However, Hodgkin's lymphoma has been shown to be the most common among individuals 15 to 35 years of age and 50 to 70 years of age. One of the reasons why this lymphoma appears could be associated with a past Epstein-Barr virus (EBV) infection.
Moreover, patients with HIV infection have a greater risk of contracting the disease than the general population.
Although they can appear at any age, non-Hodgkin’s lymphomas have an incidence of less than 5% in children. The majority of the subtypes increase in frequency with age, with the average onset at 65 years of age. It is somewhat more common in men and the causes are unknown.
An accurate diagnosis is very important, as well as a proper study of the extent of the disease, which provides us with the necessary information to choose the most appropriate treatment.
Traditionally, lymphomas has been divided into the following categories:
- Aggressive or high-grade malignant lymphomas, when the malignant cells grow faster. They are more severe and require stronger treatments but are potentially curable.
- Indolent or low-grade malignant lymphomas, when the cells grow more slowly. They allow for a better quality of life for years, but are very difficult to completely cure.
At present, a differentiated prognosis is usually established in each case, taking into account the variety of lymphoma, its extent and the therapeutic possibilities in each specific patient.
Lymphomas are one of the tumours whose incidence is on the increase, especially non-Hodgkin's lymphoma, although the causes for this increase are not known.
However, they are also among the tumours with the most therapeutic options, taking into account its diversity, and among those with the greatest possibility for a cure at the present time.
The increased incidence of follicular lymphoma occurs mainly in the elderly. This is one of the main reasons for investigating a treatment that boosts the effectiveness of conventional therapies but does not increase its toxicity.”