Lymphoma is a cancer of the lymphatic system, the network of vessels, lymph nodes, and organs that helps fight infection and maintain fluid balance. At Cape Fear Valley Health, our oncology team offers comprehensive evaluation, lymphoma treatment, and support for all types of lymphoma, delivering evidence-based care tailored to your needs.
Overview of Lymphoma
Lymphoma develops when lymphocytes, a type of white blood cell, grow and divide uncontrollably. Abnormal cells can collect in lymph nodes, the spleen, bone marrow, and other organs. The lymphatic system includes lymph fluid and vessels, lymph nodes, the thymus, tonsils, and spleen—key components of the immune system. There are two main categories.
- Hodgkin lymphoma (HL) is characterized by Reed-Sternberg cells and often spreads in a predictable pattern
- Non-Hodgkin lymphoma (NHL) includes many subtypes with different behaviors, such as diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, marginal zone lymphoma, T-cell lymphomas, and Burkitt lymphoma.
Lymphomas are described as indolent (slow growing) or aggressive (fast growing). Indolent types like follicular lymphoma may be safely monitored, while aggressive types such as Burkitt lymphoma usually require prompt treatment. Staging, from stage I (single area) to stage IV (widespread involvement), helps guide therapy and predict outcomes for lymphoma.
Symptoms, Risk Factors & Causes of Lymphoma
- Painless swelling of lymph nodes in the neck, armpits, or groin
- Drenching night sweats, persistent fever, and unexplained weight loss
- Fatigue or itching
- Chest discomfort or cough if mediastinal lymph nodes are enlarged
- Abdominal fullness if the spleen is involved
Risk factors include older age for many NHL types, a weakened immune system (such as HIV or medicines after organ transplant), certain infections like Epstein-Barr virus or Helicobacter pylori, family history of lymphoma, and exposure to some chemicals or radiation. Most people with risk factors do not develop lymphoma, and many diagnosed have no identifiable cause.
See a doctor if swollen lymph nodes persist beyond two to four weeks, or if you have unexplained fevers, night sweats, weight loss, or ongoing fatigue. Your primary care provider can order initial tests and refer you to a hematology-oncology specialist. There is no routine screening for people without symptoms, so paying attention to warning signs of lymphoma matters.
Diagnosis of Lymphoma
Diagnosis starts with a medical history and physical exam. Blood tests evaluate blood counts and organ function. Imaging such as CT or PET-CT identifies involved lymph nodes and organs. A biopsy is essential: an excisional lymph node biopsy usually provides the most information, while a core needle biopsy may be used when surgery is not feasible. In some cases, a bone marrow biopsy checks for marrow involvement. A pathologist classifies the subtype using microscopy, immunohistochemistry, and molecular tests, distinguishing entities like follicular lymphoma or Burkitt lymphoma from other forms of lymphoma.
After diagnosis, treatment planning considers the lymphoma type and stage, overall health, and preferences. Some indolent lymphomas are monitored with watchful waiting and regular follow-up. Active lymphoma treatment options include chemotherapy, immunotherapy with monoclonal antibodies, targeted therapies that address specific cancer cell changes, radiation therapy for localized disease, and stem cell transplantation for select patients. Clinical trials may offer access to promising new options. Survivorship care focuses on late effects, surveillance, and wellness after treatment.
At Cape Fear Valley, your care is coordinated by a multidisciplinary team of hematologist-oncologists, radiation oncologists, pathologists, radiologists, nurses, and patient navigators. We offer education, nutrition counseling, social work support, symptom management, and connections to financial counseling and community resources for people with lymphoma.
Treatment of Lymphoma
Your plan is personalized to the subtype, stage, symptoms, and goals. Common approaches include combination chemotherapy, targeted drugs such as BTK or BCL2 inhibitors for specific B-cell lymphomas, and immunotherapies including anti-CD20 antibodies. CAR T-cell therapy may be considered at specialized centers. Radiation therapy can be used alone in early-stage Hodgkin lymphoma or to treat specific sites in non-Hodgkin lymphoma. For relapsed or high-risk disease, options may include high-dose chemotherapy followed by stem cell transplant, particularly for aggressive types like Burkitt lymphoma.
Supportive care is central to lymphoma treatment. Our team helps manage side effects such as nausea, infections, neuropathy, and fatigue, and supports nutrition and activity. We coordinate timely imaging and lab monitoring to assess response and adjust treatment as needed. Many patients receive care in our outpatient infusion centers with access to same-day support for urgent concerns related to lymphoma.
If you have questions about symptoms, diagnosis, or treatment—or would like a second opinion—contact Cape Fear Valley Health. Early evaluation and a clear plan for lymphoma can make a meaningful difference in outcomes and quality of life.
Lymphoma FAQ
What are the first symptoms of lymphoma?
Early symptoms often include painless swelling of one or more lymph nodes (neck, armpit, or groin). Some people notice persistent fatigue, low‑grade fevers, drenching night sweats, or unexplained weight loss. Itching, a persistent cough, chest pressure, or a feeling of abdominal fullness can also occur, depending on where lymph nodes are enlarged. Because these symptoms can be caused by many conditions, evaluation by a clinician is important if they persist beyond a few weeks.
How are the stages of lymphoma explained?
Staging reflects how far lymphoma has spread:
- Stage I: One lymph node region or a single lymphatic structure (such as the thymus) is involved.
- Stage II: Two or more lymph node regions are involved on the same side of the diaphragm (either above or below).
- Stage III: Lymph node regions on both sides of the diaphragm are involved; the spleen may also be affected.
- Stage IV: Involvement of one or more organs outside the lymphatic system (such as liver, bone marrow, or lungs).
Symptoms may be further categorized with “A” (no systemic symptoms) or “B” (fever, drenching night sweats, or weight loss). Stage helps guide treatment but prognosis also depends on subtype and other risk factors.
What are the differences between Hodgkin lymphoma (HL) and non‑Hodgkin lymphoma (NHL)?
HL and NHL differ in cell appearance, spread patterns, and typical treatments. HL is defined by Reed–Sternberg cells and often spreads in a contiguous pattern, frequently presenting with mediastinal (chest) nodes in younger adults. NHL comprises many subtypes (B‑cell and T‑cell) with variable behavior—some indolent, others aggressive—and spread is less predictable. Treatment regimens and expected outcomes differ by subtype; many HL cases are highly curable, while NHL outcomes vary widely based on the specific disease.
Is lymphoma hereditary?
Most lymphomas are not directly inherited. Having a close relative with lymphoma can slightly increase risk, but the overall likelihood remains low. Shared environmental exposures, immune system conditions, and certain infections play a larger role for most people. Rare familial syndromes and inherited immune disorders can raise risk, and genetic counseling may be considered if there is a strong family history or associated conditions.