Lymphoma is cancer that starts in your immune system cells

Lymphoma is a type of cancer that develops in lymphocytes, which are white blood cells that fight infection. These cells live throughout your body in lymph nodes (small bean-shaped structures), your spleen, bone marrow, and other tissues. When lymphoma develops, lymphocytes begin to grow out of control and crowd out healthy cells, which stops your immune system from working properly.

There are two main categories: Hodgkin lymphoma and non-Hodgkin lymphoma. The difference lies in which type of lymphocyte becomes cancerous and how the cells look under a microscope. Non-Hodgkin lymphoma is more common and includes many subtypes. Both can occur in children and adults, though some types are more common at certain ages.

Lymphoma is not the same as leukemia, another blood cancer. Leukemia starts in bone marrow and affects blood cells circulating in your bloodstream. Lymphoma starts in lymph tissue itself and spreads through the lymphatic system.

Key Takeaways

  • Lymphoma is cancer of lymphocytes, a type of white blood cell, and develops in lymph nodes and other immune tissues throughout your body.
  • The two main types are Hodgkin lymphoma and non-Hodgkin lymphoma, which differ in the specific cells involved and how they appear under a microscope.
  • Common early signs include swollen lymph nodes, fever, night sweats, and unexplained weight loss, though many people have no symptoms when diagnosed.
  • Doctors identify lymphoma through blood tests, imaging scans, and a biopsy, which involves removing a small sample of tissue to examine under a microscope.
  • Treatment depends on the type and stage of lymphoma and may include chemotherapy, radiation, immunotherapy, or a combination of these approaches.

Signs and symptoms you might notice

Many people with early lymphoma have no symptoms at all and discover it during routine blood work or imaging for another reason. When symptoms do appear, they often develop slowly over weeks or months.

The most common sign is swollen lymph nodes — usually in the neck, armpit, or groin. These nodes feel like lumps under the skin and may be tender or painless. You might also experience fever that comes and goes, night sweats (sometimes heavy enough to soak clothing), unexplained weight loss, fatigue, or itching skin.

Some people report abdominal swelling or pain if lymph nodes inside the belly are enlarged. Others have chest discomfort or a cough if nodes in the chest are affected. These symptoms can also be caused by infections or other conditions, so having them does not mean you have lymphoma — but they are worth mentioning to your doctor.

How doctors diagnose lymphoma

Your doctor will start by asking about your symptoms and how long you have had them, then perform a physical exam to check for swollen lymph nodes. If lymphoma is suspected, the next step is usually blood tests to count your white blood cells and check for other abnormalities.

Imaging scans — typically a CT scan or PET scan — show whether lymph nodes are enlarged and where they are located in your body. These scans help doctors understand how widespread the cancer is.

The only way to confirm lymphoma is through a biopsy, a procedure in which a doctor removes a small sample of tissue from a swollen lymph node or affected area. A pathologist then examines the sample under a microscope to identify the type of cancer cells present. This step is essential because it determines which type of lymphoma you have, which directly affects your treatment plan.

Stages of lymphoma and what they mean

Once lymphoma is confirmed, doctors assign it a stage — a number from 1 to 4 that describes how far the cancer has spread. Stage 1 means cancer is in one lymph node region or one organ. Stage 2 means it is in two or more node regions on the same side of the diaphragm (the muscle that separates your chest from your abdomen). Stage 3 means it is on both sides of the diaphragm. Stage 4 means it has spread to organs outside the lymph system, such as the liver, lungs, or bone marrow.

Doctors also note whether you have B symptoms — fever, night sweats, or unexplained weight loss — which can affect treatment decisions. A patient might be described as having "Stage 2B lymphoma," for example, meaning stage 2 with B symptoms present.

Stage does not always predict outcome. Some early-stage lymphomas are aggressive and need immediate treatment, while some advanced-stage lymphomas respond very well to treatment. Your doctor will discuss what your specific stage means for your situation.

Types of lymphoma and how they differ

Hodgkin lymphoma accounts for about 10 percent of all lymphomas. It involves a specific type of abnormal cell called a Reed-Sternberg cell, which doctors can identify under a microscope. Hodgkin lymphoma tends to spread in an orderly way from one lymph node group to the next, which makes it somewhat easier to predict and treat.

Non-Hodgkin lymphoma is more common and includes dozens of subtypes. It can develop from B cells or T cells (two different types of lymphocytes) and may spread randomly throughout the body rather than in an orderly pattern. Some non-Hodgkin lymphomas grow slowly (indolent), while others grow quickly (aggressive). The specific subtype matters greatly for treatment decisions.

Within each category, lymphomas are further classified by how fast they grow and which genes or proteins are present in the cancer cells. Your pathology report will specify your exact type, which your doctor will use to recommend the best treatment approach.

Treatment options and what to expect

Treatment depends on the type of lymphoma, its stage, your age, and your overall health. Common approaches include chemotherapy (drugs that kill cancer cells throughout the body), radiation therapy (high-energy beams aimed at specific areas), and immunotherapy (drugs that help your immune system recognize and attack cancer cells).

Many people receive a combination of these treatments. For example, a common regimen for Hodgkin lymphoma is called ABVD, which combines four chemotherapy drugs given over several months. Some non-Hodgkin lymphomas are treated with targeted drugs designed to attack specific proteins on cancer cells.

Newer treatments like CAR-T cell therapy — in which your own immune cells are removed, modified in a lab to recognize lymphoma cells, and returned to your body — are now available for certain types of non-Hodgkin lymphoma. Your doctor will discuss which options are appropriate for your specific diagnosis.

Treatment can take several months, and side effects vary depending on which drugs or therapies you receive. Your medical team will monitor you closely with blood tests and scans to track how well treatment is working.

Life after lymphoma treatment

After treatment ends, you will have follow-up appointments with your oncologist (cancer doctor) to watch for signs of recurrence. These visits typically happen every few months at first, then less frequently over time. Your doctor will perform physical exams and may order blood tests or imaging scans.

Many people with lymphoma go into remission, meaning tests show no evidence of cancer. Remission can last for years or a lifetime, depending on the type of lymphoma and how it responded to treatment. Some people experience a recurrence, in which the cancer returns; if this happens, treatment options are still available.

Fatigue, difficulty concentrating, and emotional effects like anxiety or depression can persist after treatment ends. These are common and worth discussing with your doctor or a counselor. Support groups — both in-person and online — connect you with others who have had similar experiences.

Frequently Asked Questions

Is lymphoma hereditary or contagious?

Lymphoma is not contagious and cannot spread from person to person. It is not typically hereditary, though having a family member with lymphoma may slightly increase your risk. Most lymphomas develop due to random genetic changes in cells, not inherited mutations.

Can lymphoma be prevented?

There is no proven way to prevent lymphoma. Some risk factors — such as a weakened immune system, certain infections, or exposure to specific chemicals — are known, but most people with these risk factors never develop lymphoma. Living a healthy lifestyle may lower your overall cancer risk, but it cannot may provide prevention.

What is the difference between remission and cure?

Remission means tests show no evidence of cancer in your body. Cure is a term doctors use cautiously; it typically means the cancer has not returned after a long period (often five years or more). Your doctor will discuss what remission means for your specific type of lymphoma and what follow-up care you will need.

Will I lose my hair during treatment?

Hair loss depends on which treatment you receive. Some chemotherapy drugs cause hair loss, while others do not. Radiation therapy only affects hair in the area being treated. Your doctor can tell you what to expect based on your specific treatment plan and can discuss options like cold caps or wigs if hair loss occurs.

Can I work during lymphoma treatment?

Many people continue working during treatment, though some need to reduce hours or take time off for appointments and recovery. This depends on the type of treatment, your job, and how you feel. Talk with your employer about what accommodations might help, and discuss your work plans with your medical team.