Lymphoma - Hodgkin and non-Hodgkin: Nursing

Lymphoma is a tumor derived from lymphocytes, specifically B-cells and T-cells, which are white blood cells that mainly live in lymph nodes and move through the blood and the lymphatic system. Lymphomas can be broadly grouped into two categories; Hodgkin and non-Hodgkin lymphomas. Hodgkin lymphomas tend to spread in a contiguous manner, meaning they spread to nearby lymph nodes, but rarely involve extranodal sites. In contrast, non-Hodgkin lymphomas can sometimes spread non-contiguously, and can involve extranodal sites like the skin, gastrointestinal tract, and brain.

Now, let’s quickly review the anatomy and physiology of the lymphatic system. The lymphatic system protects the body from invaders, maintains the fluid level in the body, and absorbs dietary fat from the intestine. It is composed of lymph, lymphocytes, lymphatic vessels and plexuses, lymph nodes, and other lymphoid organs, such as the thymus, the bone marrow, the spleen, and the tonsils. The lymph is a clear, or slightly yellow, fluid that is transported through tubes similar to blood vessels, called lymphatic vessels. Lymphatic vessels drain lymph through lymph nodes and eventually into lymphatic trunks, which drain large regions of the body, like the subclavian trunks that drain the upper limbs.

Lymphatic trunks converge to form two bigger channels called lymphatic ducts, specifically the right lymphatic duct and the thoracic duct. Now, as lymph travels through lymphatic vessels, it encounters lymph nodes which filter the lymph and check to see if there are any foreign invaders the body needs to attack. In the case of an invader, the lymphocytes react and initiate an immune response. Typically, lymph nodes lie close to each other, forming groups that may lie superficial or deep within the body, such as the cervical lymph nodes, the mediastinal lymph nodes, and the axillary lymph nodes.