Cancer types · Blood cancers
Lymphoma
Lymphomas are cancers of lymphocytes. They are divided into Hodgkin lymphoma and many types of non-Hodgkin lymphoma, such as diffuse large B-cell, follicular, mantle cell and T-cell lymphomas.
Accurate classification depends on expert pathology, immunohistochemistry and, in some types, cytogenetic or molecular tests.
Clinical and molecular questions that often arise
- Is the lymphoma subtype confirmed by expert haematopathology?
- Are MYC, BCL2 or BCL6 rearrangements relevant to the classification?
- What do PET-CT and other staging investigations show?
- At relapse, what new information would help?
Information that may be part of an individual assessment
- Excision or core biopsy with haematopathology.
- Immunohistochemistry and flow cytometry.
- FISH and molecular tests in selected subtypes.
- PET-CT and bone marrow assessment where indicated.
Which investigations are appropriate is decided by the treating team for each person.
Molecular profiling and biomarker interpretation
Depending on the setting, molecular and biomarker questions in lymphoma may involve:
- CD20, CD30 and other cell-surface markers
- MYC, BCL2 and BCL6 rearrangements
- Cell-of-origin subtype in DLBCL
- TP53 status in some subtypes
- ALK in anaplastic large cell lymphoma
- EBV status
Biomarkers, panels and available tests vary by subtype, disease setting, assay and guideline version. A detected alteration is not automatically actionable.
How KPCIRC pathways may apply
POAS
POAS may help interpret a lymphoma molecular report within the agreed haemato-oncology scope, particularly where uncertain variants or trial questions arise.
Molecular Tumour Board
MTB or haemato-oncology discussion may help where pathology is complex or the disease does not behave as expected.
Second opinion and progression review
A second opinion, including pathology review, may help confirm subtype. Progression review can organise relapse findings and prior treatment.
Hereditary risk and screening
Most lymphomas are not inherited. Family history may occasionally prompt discussion with a genetics professional.
How to access the relevant pathway
Patients and families
- Talk to your treating oncologist about whether an additional review may help.
- Request a consultation and tell us which question you want answered.
- Share records only when asked, through the secure route.
Referring doctors
- Define the clinical question and the pathway: POAS, MTB, second opinion or progression review.
- Start a case enquiry without patient identifiers.
- Scope, fees and timing are confirmed before any review proceeds.
Questions and limitations
Why might my biopsy be reviewed again?
Lymphoma classification is complex. A second pathology review can confirm the subtype, which shapes treatment questions.
What is “double-hit” lymphoma?
It refers to particular combinations of MYC and BCL2 rearrangements in some aggressive B-cell lymphomas; the classification has specific criteria.
Does this page apply to my situation?
This page is educational. It explains common questions but cannot account for individual circumstances. Your treating clinician is best placed to interpret your reports and plan your care.
Educational content reviewed against the KPCIRC service scope. It is not a diagnosis, a treatment recommendation or a statement that a specialist or service is available for this cancer type.