Non-Hodgkin lymphoma is a diverse set of cancers arising from lymphocytes. Common signs include painless swollen lymph nodes and B symptoms (fever, night sweats, weight loss). Definitive diagnosis requires a biopsy; CT and PET-CT help stage disease. Treatment is subtype- and stage-specific and ranges from watchful waiting to chemotherapy with targeted agents, radiation, or transplant. Prognosis depends on subtype, stage, and patient factors.
What is Non-Hodgkin Lymphoma?
Non-Hodgkin lymphoma (NHL) is a group of cancers that begin in the lymphatic system, which includes lymph nodes, spleen, bone marrow, and other tissues. Lymphocytes - immune cells that fight infection - stop functioning normally when they become cancerous. NHL contains many distinct subtypes; most are B-cell lymphomas, while a smaller portion arise from T-cells.
How it can present
People often notice a painless swollen lymph node in the neck, armpit, or groin. Other common signs include fever, night sweats, unexplained weight loss and persistent fatigue - these are sometimes called "B symptoms." Some patients have itching (pruritus) or symptoms related to a mass pressing on nearby organs. In early stages some individuals have no symptoms at all.
How doctors diagnose NHL
Diagnosis relies on a combination of history, physical exam and tests. The definitive test is a tissue biopsy, usually an excisional lymph node biopsy or core needle biopsy, examined by a pathologist. Blood tests provide supportive information. Imaging - commonly CT and PET-CT scans - helps define the extent of disease and guide staging. Bone marrow biopsy may be done in certain subtypes.
Staging and prognosis
Physicians commonly use the Ann Arbor staging system to describe how far lymphoma has spread (stages I-IV). Prognosis depends heavily on the lymphoma subtype, stage, patient age and overall health. For aggressive lymphomas clinicians often use scoring tools such as the International Prognostic Index (IPI) to estimate risk and guide treatment.
Treatment options
Treatment varies by subtype and stage. Options include:
- Observation ("watchful waiting") for some slow-growing lymphomas
- Radiation therapy for localized disease
- Chemotherapy regimens, often combined with immunotherapy
- Monoclonal antibodies and targeted agents (for example, anti-CD20 therapies for many B-cell lymphomas)
- Stem cell transplant in relapsed or high-risk cases
Living with and after treatment
Follow-up includes periodic physical exams, blood work and imaging to monitor for recurrence and treatment effects. Supportive care (infection prevention, managing side effects, and addressing emotional needs) is an important part of care. Many people live long, productive lives after successful treatment; outcomes vary by subtype and stage.
When to see a doctor
See your primary care doctor if you have a persistent, painless swollen lymph node, unexplained fever, night sweats, or weight loss. Early evaluation helps identify treatable causes and, if needed, get you to a specialist quickly.