Hematology focuses on diseases of the blood, bone marrow, and lymphatic system. Learn about the diagnosis and treatment of anemia, leukemia, and lymphoma.
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Lymphoma is a heterogeneous group of blood cancers that originate in the lymphatic system, which is a vital part of the body’s germ fighting immune network. Unlike leukemia, which starts in the blood forming cells of the bone marrow, lymphoma begins in the lymphocytes—specific white blood cells designed to protect the body against infection and disease. When a genetic mutation occurs within these cells, they begin to divide uncontrollably and fail to die naturally, accumulating to form tumors. These tumors can develop in the lymph nodes, spleen, thymus, bone marrow, and other parts of the body. Understanding lymphoma requires a deep dive into the complexity of the immune system, as the specific type of cell affected determines the behavior of the disease, the treatment approach, and the overall prognosis. At Liv Hospital, we emphasize that lymphoma is not a single disease but a collection of related malignancies, each requiring a precise biological definition for effective management.
To understand lymphoma, one must understand the terrain in which it develops. The lymphatic system is a network of tissues and organs that help rid the body of toxins, waste, and other unwanted materials.
These are small, bean shaped structures located throughout the body, including the neck, armpits, chest, abdomen, and groin. They act as filters, trapping viruses and bacteria. In lymphoma, these nodes become the primary site of tumor growth, often swelling to visible sizes without pain.
There are two main types of lymphocytes: B cells (B lymphocytes) and T cells (T lymphocytes). B cells produce antibodies that attack invading bacteria and toxins. T cells destroy the body’s own cells that have been taken over by viruses or have become cancerous. Lymphomas can start in either cell type, but B cell lymphomas are significantly more common.
Classifying lymphoma is the most critical step in the diagnostic process. The disease is broadly divided into two main categories based on the presence of a specific abnormal cell.
This type is characterized by the presence of Reed Sternberg cells, which are large, abnormal lymphocytes that can be seen under a microscope. Hodgkin Lymphoma typically follows a predictable pattern of spread, moving from one group of lymph nodes to the next. It is one of the most curable forms of cancer.
This is a much larger and more diverse group of cancers. It involves any lymphoma that does not have Reed Sternberg cells. NHL is much more common than Hodgkin Lymphoma and can arise in lymph nodes throughout the body as well as in organs outside the lymphatic system.
Beyond the cellular type, lymphomas are categorized by how fast they grow and spread.
These are slow growing cancers. Patients may have the disease for years without experiencing severe symptoms. Follicular lymphoma is a common example. Because they grow slowly, they are often not treated immediately but monitored closely. However, they are generally considered harder to cure completely than aggressive types, often becoming a chronic condition.
These are fast growing cancers that can progress rapidly over weeks or months. Diffuse Large B Cell Lymphoma (DLBCL) is the most common aggressive form. While they require immediate and intensive treatment, they are often more responsive to chemotherapy and can frequently be cured.
Non Hodgkin Lymphoma is further broken down into more than 60 specific subtypes, each with unique genetic markers.
These account for about 85 percent of all NHL cases. Examples include Diffuse Large B Cell Lymphoma, Follicular Lymphoma, Mantle Cell Lymphoma, and Burkitt Lymphoma.
These are rarer and often more difficult to treat. Examples include Peripheral T Cell Lymphoma and Cutaneous T Cell Lymphoma (Mycosis Fungoides), which primarily affects the skin.
Lymphoma begins when a lymphocyte develops a genetic mutation that tells the cell to multiply rapidly.
In many lymphomas, pieces of chromosomes break off and reattach to other chromosomes. For example, in Burkitt Lymphoma, a specific translocation activates a gene that drives rapid cell division.
Normal cells have a programmed death cycle called apoptosis. Lymphoma cells lose this ability, allowing them to survive longer than normal cells and accumulate, forming masses that crowd out healthy cells and impair the immune system.
Lymphoma is a significant global health issue, affecting people of all ages, races, and backgrounds.
Hodgkin Lymphoma has a bimodal age distribution, peaking first in young adulthood (ages 15 to 35) and then again in older adults (over 55). Non Hodgkin Lymphoma risk generally increases with age, being most common in people over 60.
Generally, lymphoma is slightly more common in men than in women, although certain subtypes are more prevalent in women
While lymphoma starts in the lymphatic system, it can affect almost any organ.
This occurs when the lymphoma originates in an organ other than a lymph node, such as the stomach, skin, brain, or thyroid.
This occurs when the lymphoma spreads from the lymph nodes to other organs, such as the liver, lungs, or bone marrow, in advanced stages of the disease.
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A urologist is a surgeon trained to treat conditions of the urinary tract in both men and women. A urogynecologist has specific training in female pelvic medicine and reconstructive surgery, focusing on conditions like bladder prolapse and female incontinence.
The bladder lining (urothelium) has a high regenerative capacity and heals quickly after minor trauma or infection. However, the muscle layer (detrusor) does not regenerate well. If the muscle is damaged by chronic overdistention or fibrosis, the loss of function is often permanent.
Yes, psychological stress can exacerbate bladder symptoms. The bladder has many nerve receptors sensitive to stress hormones. “Stress incontinence” refers to physical pressure (coughing/sneezing), but anxiety can trigger “urgency” and frequency, mimicking Overactive Bladder symptoms.
Yes, the bladder’s functional capacity tends to decrease with age. Furthermore, the elasticity of the bladder wall reduces, and the kidneys produce more urine at night (nocturnal polyuria), leading to increased nighttime urination in older adults.
Neurogenic bladder is a term used when the nerve control of the bladder is disrupted due to a brain, spinal cord, or nerve condition (like diabetes or MS). This can cause the bladder to either be unable to hold urine (incontinence) or unable to empty it (retention).
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