Non-Hodgkin lymphoma

Non-Hodgkin lymphoma

Non-Hodgkin lymphoma is a blood cancer that affects the lymphatic system. It begins in the white blood cells called lymphocytes. It is sometimes called non‑Hodgkin’s disease.

Most commonly, non-Hodgkin lymphoma starts in a lymph node at one or more places in the body. It can spread through the lymphatic system from one group of lymph nodes to another. It can also spread to other lymph tissue, particularly in the bone marrow, spleen and liver.

Sometimes non-Hodgkin lymphoma starts in or spreads to tissues in other parts of the body, such as the stomach, bone, skin, brain and spinal cord (central nervous system). This is known as extranodal disease.

– Read Karen’s story

Learn more about:

What is blood cancer?

Cancer is a disease of the cells, which are the body’s basic building blocks. Our bodies constantly make new cells to help us grow, replace worn-out tissue and heal damaged cells after an injury. Normally, cells grow, multiply and die in an orderly way.

Sometimes cells don’t grow, divide and die in the usual way. This may cause different kinds of cancer. Most cancers, such as breast or bowel cancer, are solid cancers. In these, the abnormal cells form a lump called a tumour.

Other cancers that affect the blood, bone marrow and lymphatic system are know as blood cancers. There are three main groups of blood cancers: leukaemia, lymphoma and myeloma.

The blood is made up of different types of blood cells. Blood cells are made in the bone marrow – a spongy material in the middle of our bones. The main types of blood cells are red blood cells, white blood cells and platelets. Each of these cell types has a different function in the body.

Blood cancers develop when blood cells aren’t made properly. In most blood cancers, an abnormal type of blood cell grows out of control and upsets normal cell production.

This can reduce the bone marrow’s ability to produce normal levels of other blood cells, which affects the way that the rest of the body works. Meanwhile, the abnormal cells spill out into the bloodstream or the lymphatic system. Without treatment, many of the body’s key functions will be increasingly affected.

Lymphoma is a term used to describe cancers that develop in the lymphatic system. Lymphomas begin in a type of white blood cell called lymphocytes. When lymphocytes become malignant, they grow and multiply uncontrollably, commonly causing enlarged lymph nodes.

If these abnormal cells continue to build up, they can spread to any part of the lymphatic system. As the damaged lymphocytes multiply and replace normal cells, the body’s immune system becomes less able to fight infections.

Sometimes other types of cancer spread to the lymph nodes. This is not lymphoma. For example, breast cancer that has spread to the lymph nodes is called secondary or metastatic breast cancer.

The lymphatic system

Non-Hodgkin lymphoma is a cancer that starts in the lymphatic system. The lymphatic system is a key part of the immune system, which helps protect the body against disease and infection.

It consists of:

Lymph vessels – These thin tubes form a large network throughout the body. Lymph vessels carry lymph fluid around the body.

Lymph fluid – This clear fluid travels from the tissues in the body, through the lymph vessels, before being emptied into the bloodstream. It carries nutrients, antibodies and immune cells.

Lymph nodes (glands) – These small, bean-shaped structures are found along the lymph vessels. Lymph nodes are located throughout the body, including the neck, underarms, chest, abdomen and groin. Lymphocytes in the lymph nodes clean the lymph fluid as it passes through the body, helping to remove and destroy bacteria, viruses and other harmful substances.

When germs become trapped in the lymph nodes, the lymph nodes swell, which is a sign that lymphocytes have multiplied to fight off the germs. For example, the glands in your neck may swell when you have a sore throat.

Lymph tissue – This is found throughout the body, e.g. in the lymph nodes, spleen, bone marrow, thymus and tonsils.

Lymphocytes – Lymph fluid, lymph nodes and lymph tissue all contain white blood cells called lymphocytes, which help protect the body against disease and infection. The three main types of lymphocytes – B-cells, T-cells and NK-cells – are produced in the bone marrow. Non-Hodgkin lymphoma starts in these blood cells.

Anatomy of the lymphatic system

Anatomy of the lymphatic system

The lymphatic organs include:

Bone marrow – This is the soft, spongy material inside bones. Bone marrow produces three types of blood cells: red blood cells; white blood cells (including some types of lymphocytes); and platelets. In non‑Hodgkin lymphoma, abnormal cells multiply and crowd the bone marrow, reducing its ability to make normal blood cells.

Thymus gland – This is found inside the rib cage, behind the breastbone. The thymus gland helps produce lymphocytes.

Spleen – The spleen is found on the left side of the abdomen, under the ribs. It stores lymphocytes, filters waste products from the blood, and destroys old cells, abnormal cells and bacteria.

Tonsils – The tonsils are two small collections of lymphatic tissue at the back of the throat. They trap inhaled or ingested germs.

Different types of lymphoma
There are two main types of lymphoma: non-Hodgkin and Hodgkin. Non-Hodgkin lymphoma is more common. The two types look different when the diseased cells are examined under a microscope. A type of lymphocyte called a Reed-Sternberg cell is usually found in Hodgkin lymphoma, but not in non-Hodgkin lymphoma. For more on this, call Cancer Council 13 11 20 or download Understanding Hodgkin Lymphoma.

Types of non-Hodgkin lymphoma

There are many different types of non-Hodgkin lymphoma. It is classified according to whether the cancer started in B-cell, T-cell or NK-cell lymphocytes.

Below we describe some of the more commonly diagnosed types of non-Hodgkin lymphoma. NK‑cell lymphomas are very rare.

Non-Hodgkin lymphoma can also be classified by how fast it is growing.

Common types of non-Hodgkin lymphoma:

B-cell lymphomas (around 85% of cases)

  • diffuse large B-cell — a fast-growing cancer that often starts in lymph nodes; the most common type of non-Hodgkin lymphoma in Australia; an intermediate-grade lymphoma.
  • follicular — cancer cells grow slowly in lymph nodes in circular groups called follicles; may be low or intermediate-grade.
  • small lymphocytic — a slow-growing cancer that is similar to chronic lymphocytic leukaemia; a low‑grade lymphoma.
  • mantle cell — develops in the outer edge (mantle zone) of B-cells in the lymph nodes; although a low-grade lymphoma, it often acts like a high-grade lymphoma and grows quickly.

T-cell lymphomas (around 15% of cases)

  • precursor T-lymphoblastic — starts in immature (precursor) T-cells in the lymph nodes and the spleen; a high-grade lymphoma.
  • peripheral T-cell — often occurs as widespread enlarged, painless lymph nodes; an intermediate or high-grade lymphoma.
  • cutaneous T-cell — primarily affects the skin and starts as red, scaly patches or raised bumps that can be itchy; a low-grade lymphoma.

What causes non-Hodgkin lymphoma?

In most cases of non-Hodgkin lymphoma, the cause is unknown. However, there are some factors that may increase the risk of a person developing non-Hodgkin lymphoma:

Weakened immune system – The immune system is weakened in people with HIV and people taking medicines called immunosuppressants. These include drugs to treat HIV and drugs that are given to people after an organ transplant. People with autoimmune diseases, such as rheumatoid arthritis and coeliac disease, also have a weakened immune system.

Infections – Some infections can slightly increase the risk of non-Hodgkin lymphoma. These include Helicobacter pylori, HTLV-1 (human T-lymphotropic virus 1), hepatitis C, Epstein-Barr virus and human herpesvirus 8.

Family history – Having a parent, brother or sister who has had non-Hodgkin lymphoma slightly increases a person’s risk of developing it. However, this family link is rare and most people with non-Hodgkin lymphoma do not have a family history.

Many people with known risk factors don’t develop non-Hodgkin lymphoma, and some people who do get it have no known risk factors. Non-Hodgkin lymphoma is not contagious.

Who gets non-Hodgkin lymphoma?

Each year in NSW, about 1700 people are diagnosed with non-Hodgkin lymphoma. It is more common in men than women. Most cases occur in adults aged 60 and older. However, non-Hodgkin lymphoma can also occur in young adults and children.

Click on the icon below to download a PDF booklet on Non Hodgkin Lymphoma

Printed copies are available for free - Call 13 11 20 to order

Instructions for downloading and reading EPUB files

Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

Need more help? Visit:


To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit:

Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

Need more help? Visit:

Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit
For more information on accessing a PDF on your Kindle™, visit, log in to your account and click on Personal Document Settings.
Need more help? Visit

Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.

This information was last reviewed in December 2017
View who reviewed this content
View our editorial policy

Support services

Coping with cancer?
Speak to a health professional or to someone who has been there, or find a support group or forum

Need legal and financial assistance?
Pro bono services, financial and legal assistance, and no interest loans

Looking for transport, accommodation or home help?
Practical advice and support during and after treatment

Cancer information

What is cancer?
How cancer starts and spreads

Dealing with the diagnosis
Common reactions to a cancer diagnosis and how to find hope

View our publications
Guides and fact sheets for people with cancer, their families and friends