Non-Hodgkin's Lymphoma (NHL) is a group of malignant solid tumors found in the lymph glands and other lymphoid tissues, bone marrow, spleen, liver and gastrointestinal (GI) tract.

The cause of the condition is unknown; however, a virus is suspected as the cause of the condition.

The signs and symptoms of the condition may include:

• asymptomatic peripheral lymphadenopathy

• swollen lymph glands

• enlarged tonsils and adenoids

• painless, rubbery lymph nodes in the cervical supraclavicular area

• possible dyspnea and coughing

• anemia

• fatigue

• malaise

• weight loss

• night sweats

There may be multiple areas of involvement. Two common problems identified in NHL are congestion and edema of the face and neck. This may result in pressure on the superior vena cava. Urethral compression from the pelvic lymph nodes may interfere with urinary flow and cause secondary renal failure. 

Tests will be conducted to differentiate NHL from other conditions. The tests may include the following:

• histologic study of lymph tissue removed from the tonsils, bone marrow, liver, bowel, or skin

• immunophenotyping studies

• bone and chest x-rays

• lymphangiography

• liver and spleen scans

• computed tomography (CT) scan of the abdomen

• intravenous pyelography.

Laboratory tests may include the following:

• complete blood counts (CBC) including:

  • uric acid (which would be elevated or normal)

  • serum calcium (which would be elevated if bone lesions are present)

  • a normal serum protein

  • liver function tests 

The Rappaport histologic classification may be used to categorize lymphomas, and the Ann Arbor staging classification of NHL is used (Ann Arbor stages).

The treatment may depend on the type, grade, and stage of the disease. The treatment may include radiotherapy and chemotherapy, or a combination of radiation and chemotherapy. Stem cell transplantation and autologous transplantation may be used. The outcome of treatment depends on the number of risk factors present that would place the person in a low-to-high-risk group.

Long-term treatment is required. The person may have side effects from the treatment. During chemotherapy, the person may have adverse effects that might include: anorexia, nausea, vomiting, mouth ulcers, alopecia, fatigue, and bone marrow depression. There may also be adverse effects to radiation therapy which might include: hair loss, anorexia, nausea, vomiting and fatigue. The person should be monitored while treatment is taking place. Counseling may be needed for emotional support.

• Consider service connection on a presumptive basis as a condition associated with ionizing radiation exposure (38 CFR 3.307; §3.311).

• Consider service connection on a presumptive basis as a condition associated with herbicide exposure (38 CFR 3.307(a)(6); §3.307(d); §3.309(e)).

• Consider service connection on a presumptive basis (38 CFR 3.307(a)(6); §3.307(d); §3.309(e); §3.313) for Vietnam Service.

• Consider service connection on a presumptive basis as a condition associated with exposure to contaminated water at Camp Lejeune (38 CFR 3.307(a)(7); §3.307(d); §3.309(f)).

• A 100 percent evaluation shall continue beyond the cessation of any surgical therapy, radiation therapy, antineoplastic chemotherapy, or other therapeutic procedures. Two years after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any reduction in evaluation based upon that or any subsequent examination shall be subject to the provisions of 38 CFR 3.105(e). If there has been no recurrence, rate on residuals under the appropriate diagnostic code(s).