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Lymphoma

Lymphoma is a type of blood cancer that affects the lymphatic system, a key part of the immune system. It is one of the main hematologic cancers, along with leukemia and myeloma, and is classified into two main types:

  • Hodgkin lymphoma (HL)
  • Non-Hodgkin lymphoma (NHL)

In Italy, over 15,000 cases of lymphoma were estimated in 2024: 2,218 HL and 13,271 NHL (source: The Numbers of Cancer in Italy 2024, AIOM-AIRTUM).

Lymphoma develops from B and T lymphocytes, and more rarely from NK cells—immune system cells that protect the body from infections.

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What Is Lymphoma?

Lymphoma is a heterogeneous group of cancers that originate in the cells of the lymphatic system, which is responsible for defending the body against infections and diseases. These malignancies arise from the abnormal multiplication of lymphocytes, a type of white blood cell.

Since lymphatic tissue is present throughout the body, lymphoma can develop in various locations.

Types of lymphoma

The lymphoma type and subtype depend on the type of cell in which the lymphoma began and how quickly cancer cells grow.

The two most common lymphoma types are:

  • Hodgkin lymphoma (HL). HL, or Hodgkin's disease, typically forms in lymph nodes in the neck, armpits, or near the lungs. HL can begin at any age, but it's most common in young adults (20s) and those older than 55.
  • Non-Hodgkin lymphoma (NHL). People can get NHL at any age, but risk increases as you age. Half of people newly diagnosed with NHL are 65 or older. NHL is more common than HL and may affect lymph nodes in the stomach or groin.

Lymphoma risk factors

Certain factors may increase the risk of developing lymphoma:

  • Age: 15–35 or over 60 for HL; over 65 for NHL
  • Environmental factors: Exposure to radiation or chemicals (e.g., herbicides, pesticides)
  • Infections: Epstein-Barr virus, HIV, hepatitis C, Helicobacter pylori
  • Male sex
  • Weakened immune system: Autoimmune diseases, organ transplants, or immunosuppressive therapies

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What Are the Symptoms of Lymphoma?

Symptoms of lymphoma vary from person to person. They may also differ based on the type and stage of cancer.

Symptoms may include:

  • Swollen lymph nodes in the neck, armpits, or groin.
  • Fatigue.
  • Coughing, trouble breathing, or chest pain.
  • Itchy skin.
  • Fever and chills.
  • Soaking night sweats.
  • Extreme, unexplained weight loss.

Talk to your doctor if you have any ongoing symptoms, especially if you have a family history of blood cancers.

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How Do You Diagnose Lymphoma?

The diagnosis of lymphoma is based on a specialist medical examination and targeted tests to confirm the disease and determine its type and stage.

The most commonly used tests include:

  • Blood and urine tests: To assess white blood cells, red blood cells, platelets, and LDH (lactate dehydrogenase) levels.
  • Lymph node biopsy: Analysis of a sample of lymph node tissue, essential for identifying the specific lymphoma subtype. In some cases, a spinal tap (lumbar puncture) is also performed.
  • Bone marrow biopsy: Sampling of bone tissue from the pelvis to evaluate the bone marrow.
  • Imaging tests (X-ray, CT scan, MRI, PET scan, ultrasound): Used to examine the extent of the disease, monitor its progression, and assess the effectiveness of treatment.

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How Do You Treat Lymphoma?

Lymphoma treatment is personalized and may involve a combination of therapies, depending on the type, stage of the disease, and the patient’s overall condition.

The main treatment options include:

  • Chemotherapy: Drugs that destroy cancer cells.
  • Targeted therapy: Treatments that block specific genetic mutations or molecular targets involved in the growth of lymphoma cells.
  • Immunotherapy: Includes monoclonal antibodies, CAR-T cell therapy (genetically modified T cells), and other innovative therapies that stimulate the immune system to recognize and destroy cancer cells.
  • Radiation therapy: High-energy radiation used to target and destroy cancer cells in specific areas.
  • Radioimmunotherapy: A combination of immunotherapy and radiation that delivers targeted radiation directly to cancer cells.
  • Stem cell transplant: Either autologous (using the patient’s own cells) or allogeneic (using donor cells), typically used in cases of refractory or relapsed lymphoma.

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Reviewed August 2025.