Brief Answer:
Here is some information.

Detailed Answer:
Hello Mr. XXXX,

I have been watching to see if your question would be answered by a HCM oncologist (cancer specialist); but after 4 hours of your question not being taken, I decided you might prefer to have some information now (from a family practice physician) than wait for an oncologist to see your question.

Lymphoma is a type of cancer of the lymphatic system - which is part of the immune system. Almost all lymphomas are either Non Hodgkins or Hodgkins.

Most lymphomas are Non Hodgkins and are cancers of B or T lymphocyte blood cells.

Most Hodgkins Lymphomas are cancers of a particular B cell.

The most common symptoms are swelling in the lymph nodes. When people get sore throats, they often feel tenderness in the lymph nodes of their neck as lymph nodes help clear infections. But after the infection resolves, the lymph nodes go back to their usual size. In lymphoma, the size does not decrease and the nodes are usually firm (and not tender, although they can be tender in some cases.)

There are lymph nodes all over the body so lymphoma can occur anywhere including internal organs, but the most common sites where they are first noticed are the neck, armpit, or groin.

Other symptoms can include sweating heavily while sleeping, intermittent fevers, sudden weight loss, itching (especially after drinking alcohol), decreased appetite, tiredness, and sometimes a cough, abdominal pain or vomiting.

Diagnosis is made by taking a biopsy of a suspicious lymph node, such as using a needle to pull out some cells, and then sending it to a lab to look at the tissue/cells under a microscope. Alternatively a doctor may remove the lymph node itself for examination.

If the biopsy result shows lymphoma (abnormal/cancerous lymphocytes), then more tests are done to see if other areas are affected and to "stage" the cancer.
These include CT ("CAT") scans or MRI (or sometimes ultrasound), PET scan to assess the activity of the cancer, and sometimes bone marrow biopsy and spinal tap if there is suspicion that it is in these places.

Blood tests will also be taken including:complete blood count (CBC), white blood count, protein levels, liver function tests, kidney function tests, uric acid level, and lactate dehydrogenase (LDH) level.

Depending on the location of the cancer, and stage (which is based on locations and other factors) there are various treatment options. Usually treatment consists of chemotherapy (medications that stop the multiplication of rapidly dividing cells or kill cancer cells) and sometimes also radiotherapy (focused radiation that destroys the cells). In some cases surgery is used to remove cancer if it is in a limited site or is large. Immunotherapy and stem cell therapy are newer forms of treatment that are used in certain circumstances.

Prognosis (outcome) for lymphomas have been improving in the past 25 years, and are better than with some other cancers, especially if caught in the earlier stages.

But I want to add another thought. I don't know what else is going on with your son's health, but with swollen joints occurring in multiple sites, this is more characteristic of an autoimmune/rheumatological disorder than lymphoma. Again, I don't know what his other symptoms are or what his lab work shows, but it is possible that it isn't a cancer. You will probably know soon after a joint aspiration (pulling fluid from a joint with a needle) is evaluated.

My 33 yr old nephew was recently diagnosed with Hodgkins Lymphoma stage B (had spread) and after 12 rounds of the traditional chemotherapy medications for this, he is doing well, cancer free, and requiring no further treatment other than monitoring. I offer this bit of information to let you know there is reason for hope and positivity, even if it does turn out to be lymphoma.

I hope this information is helpful and that you can find some peace of mind while your son undergoes evaluation. I am glad to hear that he will be seeing a specialist tomorrow. If there is any further information or clarification I can provide please let me know.

Best regards,
Bonnie Berger-Durnbaugh, MD

---