Lymphomas are malignant diseases of the human body Lymphatic system together, which are mostly spread throughout the body via the Lymph fluid can spread and the intermediary Lymph nodes change viciously.

Causes and forms

In principle, lymphomas / lymphomas are divided into two different groups: Hodgkin lymphoma (also called Hodgkin's disease) and non-Hodgkin lymphoma (NHL). With Hodgkin's lymphoma, that too Lymphogranulomatosis is called, it is a lymph node change that initially only occurs locally and only affects one or two lymph nodes, but can then affect other organs in the body (bone marrow and liver) in the further course.

Read more on the topic: Hodgkin lymphoma

The cause of the lymph node changes are B lymphocytes from the germinal centers of the lymph nodes, which begin to divide in the nodes in an uncontrolled manner. In non-Hodgkin lymphoma, the causative cells are both B lymphocytes and T lymphocytes. Non-Hodgkin's lymphomas are classified according to both their malignancy and morphological criteria. Non-Hodgkin lymphomas that arise from B cells would be small cell lymphocytic lymphoma (B-CLL), mantle cell lymphoma, follicular lymphoma, marginal zone B cell lymphoma of the MALT type, plasmacytoma, the large B-cell lymphoma and Burkitt lymphoma. Non-Hodgkin lymphomas caused by T cells are: T cell CLL, mycosis fungoides (Sézary syndrome), Angioimmunoplastic T-cell lymphoma, extranodal T-cell lymphoma, and anaplastic large cell lymphoma.

Read more on the topic: Non-Hodgkin lymphoma

The chronic lymphocytic leukemia represents a subgroup of non-Hodgkin lymphomas. In contrast to the other non-Hodgkin lymphomas, the malignant cells always migrate into the blood and are distributed both via the lymphatic system and the blood system in the body and in the organs. While the cause of non-Hodgkin's lymphomas is primarily being sought in damage to the human chromosomes, which is mainly found in old age, in chronic lymphocytic leukemia it is mainly assumed that genetic factors are inherited. In Hodgkin's lymphoma one is very uncertain about the cause and suspects a connection with Wood preservatives such as Hair dyes. Also HIV and EBV A history of infection in the patient appears to be a contributing factor in the development of Hodgkin lymphoma.


A lymphoma is one Cancer of the lymphatic system. These can arise in lymph nodes or in other lymphatic structures and in the blood system. Depending on the localization of the lymphoma and the affected structure arise different symptoms.
Most of the time, however, lymphomas only show very late symptoms, in some cases they even pose as symptom-free Therefore, lymphomas are often discovered in the context of others - mostly routine examinations. The following section looks at the general symptoms that can occur with lymphoma. Often times, lymphomas go through swollen lymph nodes noticeable.
This lymph node swelling can affect one or more lymph nodes. Common locations are the neck, the strip or the Axillary wrinkles.
Malignant swelling of the lymph nodes in the context of a lymphoma often present as painless, firmly baked and hardly or not at all movable. Affected lymph nodes can remain the same in size or continue to grow over time. The lymph node swelling is usually asymmetrical. This means that usually only the lymph nodes of one half of the body in a certain region are affected.
Symmetrical painful swelling of the lymph nodes in the neck e.g. speak more for one Infectious disease than for cancer. In this context, it is also important to emphasize that lymph node swellings in the vast majority of cases have a benign cause such as an infection.

More symptomsthat can occur with lymphoma are under the term B symptoms summarized. This includes fever, Night sweats and a general tiredness such as Exhaustion.
The fever is over 38 ° C high and has no apparent reason like the flu. Night sweats are understood as a very profuse night sweats. Patients often report several times at night her nightgown to have to change.
Another symptom of the B symptom is the unwanted weight loss. This complex of symptoms also occurs in the context of other diseases, but is actually very common in lymphoma.
Furthermore, it can lead to a so-called Splenomegaly, a swelling of the spleen, come. This is explained by the fact that the spleen is a important lymphatic organ and is therefore mostly affected in the context of a lymphoma disease. Splenomegaly can spread in patients Pain in the left upper abdomen to make noticable.
Some lymphoma diseases, such as some non-Hodgkin lymphomas, lead to one Displacement of the bone marrow.
This creates a anemiawhich manifests itself in a tiredness. Also be fewer platelets so-called platelets are formed, causing an increased Bleeding tendency arises. Ultimately, due to the lack of intact white blood cells, one develops increased susceptibility to infection.
Other special symptoms are, for example Itchy skin at Hodgkin lymphoma or that Vomiting blood if you have malt lymphoma.

On neck

Lymphomas are particularly common in the Neck region. For example, 60-70% are the Lymph node swelling as part of a Hodgkin lymphoma localized to the cervical lymph nodes. A particularly large number of lymphatic pathways run in the neck region. There are also a lot of lymph nodes there.
Most of the time, those affected notice one fixed, hard swelling on the neckwhich can be of different sizes. Often they are swollen lymph nodes on the neck painless and not reddened. They cannot be moved at all or only very little and are caked with their surroundings.
It can separate or multiple lymph nodes on the neck are affected. The infestation is mostly asymmetrical, one side of the neck is usually more affected than the other. A symmetrical infestation is, however, also possible in principle, just much less often.


There are Lymphomathat also take part in our Make skin noticeable can. One of these symptoms is generalized, i.e. affecting the whole body, Itchy skin as part of the so-called Hodgkin lymphoma. This is a specific type of lymphoma.
However, there are also lymphomas that start directly from the skin and thus affect it. They are known as cutaneous lymphoma.
The best known and most common cutaneous lymphoma is Mycosis fungoides. This lymphoma goes through three stages, each with characteristic Changes in the skin accompanied.
In the eczema stage, which can often persist for years, show up itchy and flaky rashesthat present themselves as resistant to therapy. In the infiltrate stage see the rashes plaque-like and brownish out. There is still healthy skin between the affected skin areas. In the tumor stage, nodular, red-brownish tumors form within the plaques. These are prone to infection and can become flaky and ulcerate.
In the course of the disease, lymph nodes, internal organs and the bone marrow are also affected, so that other symptoms such as fever, weight loss, fatigue, night sweats and swelling of the lymph nodes.


First of all, the doctor should try to use the patient survey (anamnesis) to obtain information about the course of the disease (lymphoma), the symptoms and the first occurrence of the patient. He will also ask about the presence of the B symptoms, which could already give the first indications of a malignant disease. In addition, the case history of malignant diseases and previous illnesses of the patient should be asked about in the anamnesis interview.

During the physical examination, great emphasis should be placed on looking for enlarged lymph nodes. In addition, a complete physical examination with listening to the lungs, examination of the gastrointestinal system and blood pressure measurement should be carried out. Liver and spleen enlargements are examined by palpation on the patient lying down. This should be followed by a blood test (complete blood count), which could show changes in blood cells.

If an enlarged lymph node is found, it should be removed for a tissue examination and examined in the laboratory. Local anesthesia is usually sufficient here.
If lymph nodes in the chest are affected, general anesthesia and surgery are usually necessary.
In order to be able to determine the extent of the disease, if a malignant disease is suspected, a computed tomography will be carried out, in which swelling of the lymph nodes and involvement of organs such as the liver or spleen can be diagnosed.

In order to find out whether the liver or spleen is involved, an ultrasound examination should first be carried out. In order to determine whether the skeletal system is affected, a skeletal scintigraphy is also carried out in the course of the examination series, in which the patient is injected with a radioactive agent, which can then be made visible on a film and thus areas that show increased activity ( Metastases) can be represented. A similar procedure is used for non-Hodgkin lymphoma.

In chronic lymphocytic leukemia, blood tests are the most important after general medical examinations. It is absolutely necessary to take a blood smear from the patient's blood in order to carry out a so-called immunophenotyping.
The diagnosis of chronic lymphocytic leukemia is considered confirmed if the blood smear shows more than 5000 lymphocytes per microliter and the lymphocytes are showing signs of maturity and very specific surface features.
Both an examination of the bone marrow and a sampling of a lymph node are only necessary if a differentiation from Hodgkin's lymphoma is to be made or a precise assessment of the extent of the clinical picture is to be carried out.

Read more on the topic: Bone marrow puncture

Especially for the diagnosis of non-Hodgkin lymphoma is the Blood test Very important, but blood tests are always carried out for other lymphomas as well.
This allows the general condition of the patient, but also the function of important internal organs such as the liver or kidneys, to be assessed. The blood test includes counting the blood smear under the microscope, measuring the rate of sedimentation (ESR), which is often increased, and determining blood proteins (immunoglobulins).
It can still be seen whether a Viral infection which could be responsible for the enlarged lymph nodes. An over- or underproduction of the various white blood cells and lymphocytes can be shown in the blood count. A lymphocytopenia, that is, a decrease in the Lymphocytes, shows up in around a quarter of patients with Hodgkin lymphoma. In the Immunohistochemistry can he Type of lymphoma can be determined more precisely. This procedure determines Surface markers on cellsthat provide information about the type of lymphoma.


Hodgkin lymphoma (Lymphoma) occur in 100,000 people in Germany 2-3 times a year. So the Hodgkin's disease (lymphoma) a rather rare disease.
Men get sick slightly more often than women (ratio 3: 2). There are two peaks in disease that can be identified. On the one hand between the ages of 20 and 30, on the other hand after the age of 65.
In principle, however, illness can occur at any age.
The Non-Hodgkin lymphoma occur much more frequently with 10-15 cases per 100,000 people in Germany. Here, too, men are affected somewhat more often than women.
Non-Hodgkin lymphomas can also occur at any age. The older the patients get, the higher the risk of a new disease. On average, most patients develop non-Hodgkin lymphoma by the age of 60.
The risk also increases with age in chronic lymphocytic leukemia, which is most common in 65-70 year olds. Men are slightly more likely to be affected than women. In the course of regular blood tests and routine tests, the average age at diagnosis has decreased somewhat. About 1/5 of the patients are 55 years old.


The therapy for a lymphoma disease depends on the Type of lymphoma from. Since lymphomas can originate from different cells and structures, the Therapy options are very different and are directed precisely against the affected structure.
The most important branches of therapy are presented in this section. Generally come chemotherapy, Stem cell transplants, radiotherapy such as surgical procedures for use.
In the so-called low-grade non-Hodgkin lymphomas, i.e. the less aggressive forms, radiation is used in stages I and II. In the case of low-grade non-Hodgkin lymphomas, radiation has a very good chance of a cure.
In the higher stages, however, the disease cannot be cured. Become palliative here wait and see procedures and Polychemotherapies used. Since the cells grow very slowly here, chemotherapeutic agents, which are supposed to kill the tumor cells, are not very effective. Therefore the higher stages cannot be treated curatively.
With the highly malignant, so aggressive forms the non-Hodgkin lymphoma is in all stages healing therapy approach possible. It will also be a chemotherapy used.
Classic chemotherapy is often used with a Immunotherapy combined, in which specific antibodies directed against the tumor cells are administered.
However, there are exceptions such as the chronic lymphocytic leukemiawhich has its own therapeutic approaches.

Both Hodgkin lymphoma trying the tumor at each stage to treat curatively. This means that therapy is always a Healing to the goal has, even if this unfortunately does not always succeed. The therapy of Hodgkin lymphoma is based on two important pillars, namely the radiotherapy and the chemotherapy. In the case of a less widespread disease, radiation may be sufficient. In the case of more extensive findings, however, chemotherapy is combined with radiation. In severe cases, a Stem cell transplant to be necessary.


The duration of therapy depends on the one hand Type of lymphoma and on the other hand on the chosen therapy option. A Chemotherapy usually lasts several months.
Also Irradiations can several times at an interval of some weeks be performed.
The exact therapy regimen is determined individually, so you can do not make a blanket statementhow long the therapy will ultimately last.
Another factor that plays a major role in the duration of the therapy is the relapse of the disease, also known as relapse. If the illness relapses, further therapeutic measures are also necessary.

Side effects of therapy

Like almost any therapy, lymphoma therapy usually has Side effects for the patient. Many of the substances found in chemotherapy protocols for treating lymphoma are cytostatic. These are different substances that generally have the goal of To inhibit the growth and reproduction of tumor cellsso that cancer is defeated. These substances are often very aggressive and cause, among other things nausea, Vomit, Hair loss, Inflammation of the stomach and intestinal mucous membranes or infertility.
The modern chemotherapeutic agents are, however, much better tolerated with appropriate accompanying medication, so that side effects are minimized.
Depending on the substance used, there are also specific side effects such as damage to the lungs, kidneys, bladder or heart. A rare long-term complication of chemotherapy is the occurrence of a secondary tumor. This rarely happens, but should be mentioned as a complication.

Also the radiotherapy can cause side effects and complications. In the case of lymphoma, radiation therapy is very precise so that only the affected areas are irradiated. The radiation dose is also precisely calculated (Radiation therapy planning) so that the side effects and complications are minimized. This means that radiation therapy is well tolerated.
However, it can be acute too nausea, Vomit, Reddening of the skin and Inflammation of the mucous membranes come. Radiation pneumonitis, as one, can occur several weeks after radiation Inflammation in the lungs occur through cough, Shortness of breath and Coughing up blood can make noticeable.
In the area of ​​the irradiated tissue it can lead to chronic damage and an accompanying one Functional restrictions, the surrounding organs come.
A second malignancy, i.e. a new tumor disease, rarely occurs as a long-term consequence.

Life expectancy

The Life expectancy in patients with lymphoma can be very different, so no uniform statements made can be. There are many different types of lymphoma that can be found in theirs Differentiate between aggressiveness and its chances of recovery.
Many lymphomas can be treated well, so that some of them can still be treated curatively up to a late stage of the disease.
However, other lymphomas have a worse one forecastbecause they are particularly aggressive or the therapeutic options are particularly poor.
It is generally however quite possible, despite a lymphoma disease to reach old age.

Read more about: Lymphoma prognosis

Lymphoma in the brain

There are lymphomas that occur in the brain. They are known as cerebral lymphoma. Compared to other brain tumors, they are very rare and only make up about 2 to 3% of the total number of brain tumors.
You can outside of the brain or also arise within the brain and cause different symptomsthat of the Localization of the tumor in the brain depends.
These include, for example nausea, Vomit, Memory problems, a headache and Personality changes.
Other disorders of consciousness can also occur. In rare cases it can too epileptic seizures come. Signs of paralysis, Visual disturbances or Balance disorders and dizziness are also possible Signs of a tumor in the brain. Most often it is cerebral lymphoma Non-Hodgkin lymphoma.
In the Diagnosis are primarily imaging techniques like that CT and MRI priority. For reliable detection of the tumor, a biopsy, i.e. a tissue sample can be taken.
The therapy of a cerebral lymphoma can either consist of a single chemotherapy or a combined one Chemotherapy and radiation therapy consist. Surgery is not possible because lymphomas in the brain cannot be completely removed.

Lymphoma in the lungs

Lymphomas can spread and affect organs. This is called “extranodal” infestation. For example, the lung have Hodgkin's lymphoma. The involvement of the lungs can be manifested by symptoms such as Shortness of breath, to cough or Coughing up blood to make noticable. However, these symptoms do not have to occur.
More often, lymphomas are discovered during routine examinations or fall through the so-called B symptoms characterized by fatigue, fever, unwanted weight loss and night sweats.

Lymphoma in the stomach

A common lymphoma of the stomach is the so-called MALT lymphoma. In this type of lymphoma, the lining of the stomach is affected.
In most cases this one goes Type B gastritis and infection with the bacterium Helicobacter pylori ahead. In up to 90% of cases there is an infection with Helicobacter pylori verifiable.
The MALT lymphoma is mostly symptomatically normal. Except for non-specific symptoms such as abdominal pain and exhaustion, the patients usually do not notice much. It can rarely be Vomiting blood come. In the blood test one drops anemia on. Besides, it can too Weight loss come.
The diagnosis is through a Tissue extraction from the gastric mucosa by means of an esophagogastroduodenoscopy, i.e. one reflection the esophagus, of the stomach and the duodenum, secured.
In the early stages of the disease, a cure can be achieved by a antibiotic therapy of the bacterium Helicobater pylori (Eradication therapy) respectively. Come if the disease is advanced Chemotherapy, Irradiations as well as surgical procedures appropriate to the stage.