Lymph node cancer is also called malignant lymphoma and is a malignant disease of the lymphatic system, also called the lymphatic system. This consists of the lymphatic channels, lymphoid organs (such as lymph nodes, lymphoid tissue in the spleen, bone marrow, gastrointestinal tract, and throat), and the thymus gland. Lymphocytes are the cells of the lymphatic system. As part of the white blood cells, they have a central role in immune defense. Depending on the site of maturation, the lymphocytes are divided into the 2 groups of B lymphocytes (maturation in the bone marrow or “bone marrow”; responsible for the formation of antibodies) and T lymphocytes (maturation in the thymus).^1,2

Lymph node cancer originates from pathologically altered lymphocytes. The formation of lymphocytes is uncontrolled or maturation processes are not (completely) completed. Depending on which formation or maturation step of the lymphocytes is interrupted, a surplus of different pathological blood cells develops, which cannot fulfill their actual function. For this reason, no uniform clinical pictures are apparent in lymphomas. Nowadays, about 100 different subtypes are distinguished, some with very different disease progression and varying malignancy (slow growth to very aggressive forms of cancer). The lymph node cancer subtypes are roughly divided into Hodgkin’s lymphoma and non-Hodgkin’s lymphoma, respectively. While Hodgkin’s lymphomas are recognizable under the microscope by characteristic giant cells with multiple nuclei, non-Hodgkin’s lymphomas include all lymphomas that do not have these typical histological characteristics.^1,2

Compared to other cancers, malignant lymphomas occur rarely (about 5% of all cancers).² An example of a non-Hodgkin’s lymphoma is multiple myeloma, which is one of the most common cancers of the hematopoietic and lymphatic systems. It is characterized by a proliferation of plasma cells in the bone marrow and presents with multiform and often nonspecific symptoms, such as bone pain, fatigue, increased tendency to infection, weight loss, or deterioration of kidney function. The median age of onset is 72-74 years.³

Another example of common non-Hodgkin’s lymphoma is follicular lymphoma, affecting approximately 20-35% of all newly diagnosed non-Hodgkin’s lymphoma patients. The peak age of disease is 60-65 years. In most cases, follicular lymphoma is diagnosed at an advanced stage. Typical symptoms are usually painless lymph node enlargement, fever, weight loss, night sweats and inadequate hematopoiesis.⁴

Another non-Hodgkin’s lymphoma is the mantle cell lymphoma, which normally spreads very slowly, but in some cases shows a rapidly progressive course. It comprises 5-7% of malignant lymphomas in Europe. The median age of onset is 65 years with a marked male predominance. Typical, as in all lymphomas, is lymph node enlargement, often rapidly increasing, and symptoms of splenomegaly (enlarged spleen).⁵

Lymphoma patients are treated by specialists which are specialised in the field of haemato-oncology in a specialized focus centre.⁶ The therapeutic decision is based on the type of lymphoma, the stage and course of the disease, and individual factors (age, any concomitant diseases, and the patient’s general state of health). Chemotherapy, often a combination of different cytostatic drugs, is one of the standard treatments for most forms of lymphoma. Apart from cytostatics, other drug therapy options, such as immunomodulatory agents, are used. Radiation therapy or stem cell transplantation is also used for some forms of lymphoma. The prognosis of malignant lymphomas is increasingly improving.^1,3-5

¹ Public Health Portal of Austria (ed.). Lymphomas. Available at: https://www.gesundheit.gv.at/krankheiten/krebs/lymphome/inhalt (accessed 30.05.2022) 

² Oncology Guide (ed.). Lymph node cancer (malignant lymphoma). Available at: https://www.oncology-guide.com/erkrankung/lymphdruesenkrebs/#:~:text=Lymphdr%C3%BCsenkrebs%2C%20auch%20malignes%20Lymphom%20genannt%2C%20ist%20eine%20b%C3%B6sartige,die%20Lymphknoten%2C%20die%20Milz%20und%20die%20Thymusdr%C3%BCse%20angeh%C3%B6ren (accessed 30.05.2022)

³ Wörmann et al, Onkopedia Multiple Myeloma Guideline. May 2018. Available at: https://www.onkopedia.com/de/onkopedia/guidelines/multiples-myelom/@@guideline/html/index.html#ID0EVDBI (accessed 30.05.2022)

⁴ Buske et al., Onkopedia guideline follicular lymphoma. March 2022. Available at: https://www.onkopedia.com/de/onkopedia/guidelines/follikulaeres-lymphom/@@guideline/html/index.html (accessed 30.05.2022)

⁵ Dreyling et al., Onkopedia guideline mantle cell lymphoma. May 2021. Available at: https://www.onkopedia.com/de/onkopedia/guidelines/mantelzell-lymphom/@@guideline/html/index.html (accessed 30.05.2022)

⁶ Austrian Society of Hematology & Medical Oncology. Available at:  https://www.oegho.at/ (accessed 30.05.2022)