Piia Pauliina
  • Non-Hodgkin’s Lymphoma – A Diffuse Large B-cell Lymphoma

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    Non-Hodgkin’s lymphoma is a type of cancer.  The cancer starts in the lymphatic system, a part of the body that helps to fight against infections.

    The lymphatic system is a major part of the immune system.  Lymph and lymph nodes contain white blood cells called lymphocytes and antibodies that defend the body against infection. The lymphocytes are made in the bone marrow.  When they are mature they are released into the bloodstream and migrate into the lymphatic system.

    There are three types of mature lymphocytes:

    • B-lymphocytes which make antibodies that attack infecting bacteria, viruses, etc.
    • T-lymphocytes have various functions including helping the B-lymphocytes to make antibodies.
    • Natural killer lymphocytes play a major role in the rejection of tumors and cells infected by viruses. They are capable of binding to and killing virus-infected cells and some tumor cells by releasing cytotoxins.

    The non- Hodgkin’s lymphoma starts in lymphocytes.  A single lymphocyte loses control and divides over and over again.  Eventually, a solid lump of lymphocytes forms. This lump is the cancer called non-Hodgkin’s lymphoma.  Most non-Hodgkin’s lymphomas start in lymph nodes.  The lymph nodes are normally too small to feel, however the cancerous lymph nodes can grow big enough to feel through your skin.  Non-Hodgkin’s lymphomas can grow in lymph nodes near your skin, such as those in your neck, groin and armpits.  They can also grow in lymph nodes deep inside your body where you can’t feel them, such as those in your chest and abdomen.  Some non-Hodgkin’s lymphomas can grow outside your lymph nodes.  A common place to find these is the stomach or intestines.  They can also grow in the brain, thyroid glands, lungs, bone, bone marrow, testicles, sinuses and breast.

    So what is the diffuse large B-cell lymphoma that I have?

    According to the Lymphoma Research Foundation: “The diffuse large B-cell lymphoma is the most common of the non-Hodgkin lymphomas, accounting for up to 30 percent of newly diagnosed cases. Diffuse large B-cell lymphoma is an aggressive, or fast-growing lymphoma.  It can arise in lymph nodes or outside of the lymphatic system, in the gastrointestinal tract, testes, thyroid, skin, breast, bone or brain. Often, the first sign of diffuse large B-cell lymphoma is a painless or even painful rapid swelling in the neck, armpit or groin caused by enlarged lymph nodes.  Other symptoms include night sweats, unexplained fevers and weight loss.”

    You can see my raised chest and the swelling of the lymph nodes in my neck.

    You can see my raised chest and the swelling of the lymph nodes in my neck.

    The stage of non-Hodgkin lymphoma describes how many groups of lymph nodes are affected, where they are in the body, and whether other organs such as the bone marrow or liver are involved.

    Stage 1 The lymphoma is only in one group of lymph nodes, in one particular area of the body.

    Stage 2 More than one group of lymph nodes is affected, but all the affected nodes are contained within either the upper half or the lower half of the body. The upper half of the body is above the diaphragm (the sheet of muscle underneath the lungs), and the lower half is below it.

    Stage 3 The lymphoma is in lymph nodes above and below the diaphragm. The spleen is considered a lymph node in this staging system.

    Stage 4 The lymphoma has spread beyond lymph nodes – for example, to sites such as the bones, liver or lungs.

    The stage usually includes the letter A or B, which describes whether or not any B symptoms are present (eg stage 2B). Sometimes the lymphoma can start in areas outside the lymph nodes, and this is represented by the letter E, which stands for extranodal (eg stage 3AE).

    When I was diagnosed, I was staged ‘2B’, i.e. all the cancer was still above the diaphragm, avoiding the vital organs, such as the liver, kidneys, and the spleen.

    Please note: I did not make any of this up.  I blatantly took the info from the links below:

    http://www.patient.co.uk/health/Lymphoma-Non-Hodgkin’s.htm

    http://www.lymphoma.org/atf/cf/%7B0363CDD6-51B5-427B-BE48-E6AF871ACEC9%7D/DIFFUSE%20LARGE%20B-CELL.PDF

    http://www.guardian.co.uk/lifeandstyle/non-hodgkins-lymphoma

    http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Lymphomanon-Hodgkin/TypesofNHL/DiffuselargeB-cell.aspx#DynamicJumpMenuManager_6_Anchor_5