T-Cell Lymphoma: A Guide

Medically Reviewed By Brett Barlow, MD
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T-cell lymphoma, which is a type of non-Hodgkin lymphoma, is a form of cancer that starts in the immune system, or the lymph system. This is a complex structure of lymph vessels, organs, lymph ducts, and lymph nodes all over your body that helps protect you from invaders such as viruses. When you contact a doctor with an illness, they may feel the sides of your neck under your chin or toward the back of your head to determine if your lymph nodes are swollen. This happens naturally when your body fights off illness. Sometimes, however, a swollen lymph node can point to something more serious, such as T-cell lymphoma.

This article goes into more detail about T-cell lymphoma, including the types, symptoms, treatments, and outlook.

T-cell lymphoma explained

a clinician is helping an older man in a hospital bed
Hernandez & Sorokina/Stocksy United

The lymph system, or immune system, is where non-Hodgkin lymphoma cancer starts.

T-cell lymphoma is a relatively rare form of non-Hodgkin lymphoma. For a better sense of how rare it is, all types of non-Hodgkin lymphoma together make up about 4% of the total number of cancers in the United States. T-cell lymphoma makes up less than 15% of those non-Hodgkin lymphoma cases.

T-cell lymphoma starts in the white blood cells, which are part of your body’s immune system.

Causes of T-cell lymphoma

Lymph is the fluid that travels around your lymph system. It carries white blood cells called lymphocytes, including B lymphocytes, T lymphocytes (or T cells), and natural killer cells.

T-cell lymphoma starts when a T cell develops unusually and divides, making more atypical cells that can spread.

T-cell lymphoma is classified as a type of non-Hodgkin lymphoma that can affect the lymph tissues, such as the lymph nodes, or the spleen. However, it can also develop outside of those tissues — such as in the skin, liver, and other places — as lymph tissue exists outside of the lymph system. In fact, the skin contains an estimated 20 billion T cells. This is about twice that of anywhere else in the body.

Types of T-cell lymphoma

There are many different types of T-cell lymphoma, including the following.

T-lymphoblastic lymphoma/leukemiaThis type occurs in immature, early T cells.
Cutaneous T-cell lymphomaThis type occurs in the T cells on the surface of the skin, and doctors most often categorize it as mycosis fungoides, or Sézary syndrome. Sézary syndrome most commonly affects people older than 60 years of age.
Anaplastic large cell lymphoma (ALCL)This type occurs in about 16% of all T-cell lymphomas. It often falls into one of two categories: cutaneous (skin) or systemic (whole-body).
Doctors diagnose ALCL by taking a small amount of skin or tumor tissue and examining it under a microscope. More tests can then help doctors see how advanced it is and determine how aggressively to treat it.
Peripheral T-cell lymphomaThis type occurs in mature T cells and accounts for about 20% of T-cell lymphomas.
Adult T-cell leukemia/lymphoma (ATLL)This type can occur in the blood (leukemia), lymph nodes (lymphoma), skin, or other areas. There are four further subtypes of ATLL: acute, lymphomatous, chronic, and smoldering.
Angioimmunoblastic T-cell lymphomaThis type is rare and aggressive, making up about 4% of T-cell lymphoma cases, and it usually affects older adults.
Enteropathy-associated intestinal T-cell lymphoma (EATL)This type occurs in the intestine lining, most commonly in the small intestine but also in the colon. Sometimes, EATL affects people with celiac disease.
Extranodal natural killer/T-cell lymphomaThis is a rare type of T-cell lymphoma that involves the nose or upper throat. It occurs more often in Asia and South America.

Learn more about the different types of lymphoma here.

Symptoms of T-cell lymphoma

General symptoms of T-cell lymphoma include:

T-cell lymphoma appearance

Cutaneous T-cell lymphoma, which is a rare form of T-cell lymphoma, can cause a rash in addition to the other general symptoms.

Mycosis fungoides, which is the most common type, typically gets worse over time and can seem like psoriasis or eczema. Specifically, it looks like patches of flushed, red, or pink scaly areas that might itch. These symptoms can come and go or stay the same over time. Sometimes, the patches can progress to larger plaques, which are usually red, purple, or brown and itchy, and plaques can progress to become tumors.

Sézary syndrome is much more aggressive than mycosis fungoides and appears as a very itchy rash with flushed skin that covers a large part of the body. People often have hair loss, unusual fingernails and toenails, and skin swelling

with Sézary syndrome.

T-cell lymphoma treatment

Depending on the type, stage, and nature of the T-cell lymphoma you have, doctors will collaborate to create the most appropriate treatment plan to fight that type of cancer.

Treatments can include a combination of:

Chemotherapy timing

T-cell lymphoma and acute lymphoblastic leukemia can be fast-growing cancers that often require chemotherapy. T-cell lymphoma involves rapidly dividing cancer cells, so clinicians usually administer the first treatment in the hospital under supervision to watch for tumor lysis syndrome (TLS).

TLS can happen when a large number of cancer cells die at once and release their contents into the blood. This can overwhelm the kidneys with toxins, so medical professionals try to prevent it with IV fluids and medications.

Lymphoma of the skin

For cutaneous lymphoma of the skin, doctors may recommend a combination of:

Learn more about treating leukemia and lymphoma here.

T-cell lymphoma survival rate

As forms of non-Hodgkin lymphoma, T-cell lymphoma cases are categorizable as either indolent or aggressive.

Indolent means that it is slow growing, and these T-cell lymphoma cases often have a long survival time. In fact, the median survival for all indolent non-Hodgkin lymphomas may be as long as 20 years, according to the National Cancer Institute (NCI).

Indolent lymphomas are slow moving but incurable. Treatment aims to slow or control the condition rather than cure it.

Aggressive lymphomas can be fast moving and deadly, but they are potentially curable with chemotherapy. In fact, the NCI also states that more than 50% of aggressive cases of non-Hodgkin lymphoma are curable, though the percentage for T-cell lymphomas alone may be slightly lower.

Overall, the 5-year survival rate with all forms of non-Hodgkin lymphoma is over 60%.

Summary

T-cell lymphoma, which is a type of non-Hodgkin lymphoma, starts most often in the immune system’s white blood cells. However, it can appear in many places all over the body.

With medical advances in treatment, T-cell lymphoma is often very treatable, with many different therapy options.

It is important to contact your doctor if you have any symptoms of T-cell lymphoma because, as with any cancer diagnosis, the earlier you receive a diagnosis, the better the outcome can be.

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Medical Reviewer: Brett Barlow, MD
Last Review Date: 2022 Mar 28
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