Lymphoma

Dr Dan J Bell and A.Prof Frank Gaillard et al.

Lymphoma is a malignancy arising from lymphocytes or lymphoblasts. Lymphoma can be restricted to the lymphatic system or can arise as extranodal disease. This, along with variable aggressiveness results in a diverse imaging appearance.

Lymphoma accounts for ~4% of all cancers 4. They are more common in developed countries.

In children, lymphoma accounts for 10-15% of all cancers, being the third most common form of malignancy 5.

Lymphoma can present as nodal or extra-nodal disease. Hodgkins lymphoma and low-grade NHL classically present as nodal disease, whereas high-grade NHL can present with complications from mass effect such as superior vena cava obstruction, cauda equina syndrome, etc. Extra-nodal disease can affect any organ. 

Lymphoma can often present with B symptoms (fever, night sweats and weight loss). 

Lymphomas are a malignancy that arises from mature lymphocyte. The aetiology is unknown but potential lymphomatogenic risk factors include 4:

  • viral infection, e.g. EBV, HTVL-1, HIV, HCV, HSV
  • bacterial infection, e.g. Helicobacter pylori
  • chronic immunosuppression, e.g. post-transplantation
  • prior chemotherapy (especially alkalising agents) and drug therapy, e.g. digoxin

Lymphomas are currently classified according to the 2008 WHO classification of tumours of haematopoietic and lymphoid tissues. The main division is into:

The majority (85%) of lymphomas are B-cell with the remainder (15%) being T-cell 4.

Additionally it is worth, especially for radiologists, dividing extranodal lymphomas according to the location:

Imaging characteristics will depend on the location and subtype of lymphoma. CT is the workhorse of imaging in lymphoma and plays a crucial role in staging (see main article: lymphoma staging). US and MRI are also used, for example assessing cervical lymph nodes (US) or CNS lymphoma (MRI). 

Lymphoma cure rates are comparatively high (up to 90%) compared to many other malignancies. Prognosis depends not only on histological subtype and grade but also on stage, hence why imaging plays a pivotal role in treatment. Aggressive lymphomas (e.g. Burkitt lymphoma) typically have a prognosis of weeks without treatment.

Lymphoma
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Article information

rID: 9229
Sections: Pathology, Gamuts
Synonyms or Alternate Spellings:
  • Lymphoma - general
  • Lymphomas
  • Lymphoma - overview
  • Overview of lymphoma
  • Lymphosarcoma
  • Lymphosarcomas

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Cases and figures

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    Case 1: vertebral body B cell lymphoma
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    Case 2: primary CNS lymphoma
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    Case 3: cervical lymphoma
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    Case 4: gastric lymphoma
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    Case 5: orbital lymphoma
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    Case 6: lymphoma involving neck nodes
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    Case 7: mutlifocal visceral lymphoma
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    Case 8: small lymphocytic lymphoma
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    Case 9: Non-hodgkin lymphoma, thigh
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    Case 10
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    Case 11
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    Case 12
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    Case 13: primary pleural
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    Case 14: retroperitoneal lymphoma
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    After a month the...
    Case 15: primary hepatic lymphoma
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