Abdominal lymphoma symptoms prognosis. Lymphoma - what is it and how long will a person live

Lymphoma is a malignant disease of the human lymphatic system. Lymphoma is characterized by the presence of tumors in the lymphatic system or in the internal organs.

Lymphoma Symptoms

Usually, an early symptom of lymphoma is enlargement of lymph nodes in the armpits, groin, or neck. Nodules do not shrink over time and are not treatable with antibiotics. Lymph nodes do not cause pain. If increased internal organs(liver, spleen), there may be distension in the abdomen, respiratory failure, pain in the lower back.

Other symptoms of lymphoma include weakness, sweating, high fever, susceptibility to infectious diseases, indigestion, and weight loss.

Types of lymphomas

There are two types of tumors: Hodgkin's lymphoma and non-Hodgkin's lymphomas.

Hodgkin's lymphoma is characterized by the presence in the body of a special type of cells, which are also called Sternberg-Reed cells. These cells can be identified by examining the lymphoid tissue under a microscope. Treatment for Hodgkin's lymphoma differs from treatment for non-Hodgkin's lymphomas, so proper diagnosis is important.

Hodgkin's lymphoma most often occurs at a young age. So far, the exact cause of the disease has not been identified.

Risk factors for the development of Hodgkin's lymphoma are a decrease in immunity, infection with the Epstein-Barr virus, which causes infectious mononucleosis.

The main symptom of Hodgkin's lymphoma is an increase in lymph nodes in the groin, neck and armpits. In addition, there is a high temperature, sweating at night, coughing, weight loss, itching, fatigue.

Non-Hodgkin's lymphomas

Non-Hodgkin's lymphomas include a fairly large group of lymphomas. They have subspecies that differ in the course of the disease and prognosis.

Indolent lymphomas are characterized by a long course and a favorable prognosis. These types of tumors do not require treatment, but require constant monitoring by a doctor.

Aggressive lymphomas are the exact opposite of indolent ones. This type of tumor requires immediate treatment due to the rapid progression and increase in symptoms.

Extranodal lymphomas are characterized by the development of the disease not in the lymph nodes, but in the internal organs: the intestines, spleen, lungs, stomach, and brain.

30-40% of all non-Hodgkin's lymphomas are diffuse large B-cell lymphoma. Large cell lymphoma most often affects older people, but children can also get sick. The main symptom of large cell lymphoma is the rapid enlargement of the tumor. Diffuse large B-cell lymphoma is an aggressive form of lymphoma and requires immediate treatment.

Classification of lymphomas

The classification of lymphomas is quite extensive and includes a large number of types. All lymphomas can be conditionally divided depending on the following factors:

Appearance;

Mutations;

Grouping of cells: Some lymphomas form clusters - groups of cells, others are scattered throughout the lymph node or body organs;

The cell type that caused the tumor;

A type of protein on the surface of a lymphoma cell;

Which organ is affected by lymphoma.

Stages of lymphoma

There are four stages of lymphoma.

The first stage is characterized by the defeat of one area of ​​the lymph nodes.

The second stage is characterized by the defeat of two or more areas on one side of the diaphragm.

The third stage is characterized by damage to the lymph nodes on both sides of the diaphragm.

The fourth stage is characterized by the generalization of the process.

Diagnosis of lymphoma

Various methods are used to diagnose lymphoma. The main diagnostic method for lymphoma is a biopsy. This method allows you to determine the presence of tumor cells in the tissue.

In addition, X-ray, CG or MRI are used, which allow not only to detect the presence of a tumor, but also to determine the stage of lymphoma.

A bone marrow examination is also performed to determine the presence of lymphoma cells in the bone tissue.

Lymphoma treatment

Treatment for lymphoma depends on the stage, form, and symptoms of the disease. Indolent forms of lymphoma in the absence of symptoms and the development of the disease do not require treatment. But when signs of growth appear, treatment of lymphoma begins. If the tumor is localized, radiotherapy is used. With a more severe and extensive course of the disease, chemotherapy is used.

Treatment of aggressive lymphomas requires a quick response to the situation. Most effective treatment this type of lymphoma is considered chemotherapy with several courses, and in case of failure, bone marrow or stem cell transplantation. Among the drugs for the treatment of lymphoma in an aggressive form, vincristine, cyclophosphamide, rituximab, chlorbutine and others are prescribed. The main goal of treating aggressive lymphoma is to improve the patient's well-being, since a complete cure is unlikely.

Prognosis of lymphomas

The prognosis for Hodgkin's lymphomas is good. Modern types of treatment of lymphoma can achieve good results. The five-year survival rate after treatment for Hodgkin's lymphoma is 80 to 90%.

The prognosis of non-Hodgkin's lymphomas with timely treatment and the use of modern methods and drugs is about 55% for adults and 80% for children.

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Lymphoma- a form of cancer that affects the lymphatic tissues. This disease is characterized by enlarged lymph nodes, in some cases a progressive disease affects the internal organs, where tumor lymphocytes begin to accumulate. They begin to multiply rapidly, and in the future they cannot perform their main duties. It is important to note that to name the exact causes of development this disease doctors are having a hard time. However, there are suggestions that weakening of the immune system, age and infectious diseases may increase the risk of developing lymphoma.

If we consider the features of the course of this disease, then there are 2 forms of this disease:

Hodgkin's lymphoma;

Non-Hodgkin's lymphoma.

So, what is this disease, and what types it is divided into.

Lymphoma is a malignant tumor that consists of lymphocytes. Lymphocytes, in turn, are cells of the immune system and are found in the blood or lymph. Depending on which lymphocytes form the tumor, there are several main types of lymphs.

Today in medicine, 2 types of lymphocytes are distinguished:

T-lymphocytes - take an active part in the fight against infections, are able to act directly on harmful carriers without resorting to antibodies.

B-lymphocytes - are responsible for the production of immunoglobulins, that is, antibodies that later fight infections, fungi and viruses.

Causes of lymphoma:

As noted above, the exact causes that can cause lymphoma have not been identified. However, doctors still identified a number of factors that can trigger the development of this malignant tumor.

1. Age.

It was found that the more guarded a person is, the higher the risk of developing lymphoma. In most cases, lymphoma develops in people over 55 years of age. However, there have been cases of detection of lymphoma in younger people, including children.

2. Viral infections.

Many viral diseases, such as Epstein-Barr, can cause infectious mononucleosis, which is later found in lymphoma cells. Special Studies have shown that people who develop this infectious mononucleosis are more likely to develop lymphoma. Also, HIV patients have an increased risk of developing this tumor.

3. Drugs that have a suppressive effect on the immune system.

It has been proven that such drugs, which have an unbearable load, leading to a weakening of the immune system, and these are chemotherapy drugs, significantly increase the likelihood of developing lymphoma.

4. Contact with chemicals.

People whose activities are based on long-term contact with chemicals such as pesticides, benzenes, herbicides are also at risk.

5. Autoimmune diseases can lead to lymphoma.

The criterion of heredity in this disease is not taken into account. Even if one of the closest relatives has been diagnosed with lymphoma, there is no danger for his relatives. The exception is identical twins. If one twin has lymphoma, the chance of developing the disease in the second child increases by 7 times.

Lymphoma Symptoms

Lymphoma can develop in any area of ​​the human body. What the lymphatic system includes is both lymphatic vessels and nodes, which are located on every part of the body. It is this factor that determines such a prevalence of lymphoma in the body. Symptoms and forms of manifestation of the disease come from the area in which it spreads.

Consider the symptoms of Hodgkin's lymphoma:

The very first symptom that signals the possibility of developing this type of disease is an increase in lymph nodes. This growth can occur in any area of ​​the body, but it often occurs in the neck and armpits. Such changes do not pain in a patient, but you can experience some discomfort after drinking alcohol.

With the progression of the disease, an increase in nodes leads to compression of neighboring organs. It causes cough, heart pain, shortness of breath, back pain.

The patient may complain of pain in the right hypochondrium, which may signal the growth of the spleen, liver, jaundice may develop.

Common symptoms for all cancers are nausea, sweating, weight loss, fever.

Often, with the development of Hodgkin's lymphoma, itching is observed, which may be characteristic of a certain area, or spread throughout the body.

If cancer tumor hit the bones, a person will be tormented by pain in the bones.

Signs and symptoms that indicate the development of non-Hodgkin's lymphoma:

1. The peculiarity of this type of lymphoma is that it can develop not only in the lymph nodes, but also in the organs. And here the symptoms will depend on the organ in which the process began to occur. If the changes have affected the stomach, spleen, mammary gland, the patient begins to suffer from heartburn, nausea, vomiting, pain in the stomach or intestines. Headaches are characteristic of lesions of the meninges.

2. This form is characterized by excessive enlargement of the lymph nodes. With the defeat of the nodes of the chest, abdominal cavity, the patient will experience a strong cough, swelling in the legs.

3. With the progression of the disease, malfunctions in the functioning of the liver may occur, severe pain in the bones is noted.

Diagnosis of lymphoma

So, if the doctor during the examination noticed an increase in the growth of the lymph nodes, he can refer the patient to a comprehensive series of examinations aimed at detecting the problem and the causes that led to such changes.

First of all, this is a general blood test, where deviations from the norm can give the doctor a signal about the likelihood of developing lymphoma.

Also effective method a chest x-ray is considered to reveal whether there is a mediastinal lymph node in this area.

MRI is an examination that allows the doctor to identify any changes that occur on the this stage in organism. If there is a place to be lymphoma, the disease will certainly be detected.

Lymphoma treatment

When choosing treatment tactics, the doctor is based on the stage and type of the disease. It is also worth considering the symptoms and age of the patient. The first thing that treatment methods should be aimed at is achieving remission, that is, the complete elimination of the causes and symptoms of the disease. However, it is not always possible to achieve such grandiose results. Then doctors try to achieve partial remission - to prevent the spread of the tumor throughout the body and significantly reduce it in size.

Prevention of lymphoma

Since the main causes of the development of lymphoma have not been identified, preventive measures regarding this disease are extensive. It is necessary to undergo regular check-ups with the main specialists. In infectious diseases, you must carefully follow the recommendations of doctors. If some concerns are noticed regarding their condition, the trip to the doctor should not be postponed for an infinite time. Do not forget about personal hygiene, proper nutrition and sports exercises. Physical activity and fresh air have never harmed anyone.

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Modern methods of treatment of malignant oncological pathologies have a more qualitative and radical effect on education, kill cancer cells and prevent the development of new ones.

But, despite the achievements of scientists, the disease has not yet been defeated - millions of people on the planet die every year from cancer.

Very often, treatment failure is determined too late diagnosis ailment. That is why it is so important, having noticed the first signs of the presence of a tumor, immediately contact the clinic.

Lymphoma is one of the manifestations of cancers in the blood cells. Pathology begins to develop in the lymphoid tissues, which determined its name.

This type of cancer is characterized by an aggressive course and an extremely unfavorable prognosis for survival, since its first stages are almost asymptomatic.

Through the lymphatic flows, cancer quickly spreads throughout the human body, affecting vital departments and systems.

Manifestations

Like any oncological disease, lymphoma in adults has certain symptomatic signs, by the presence of which this pathology can be diagnosed with a high degree of probability. Allocate general and local features.

Common symptoms include symptoms that are inherent in any cancerous manifestation, regardless of its location. To local - signs indicating the defeat of malignant tumors of a particular organ.

If we analyze the symptoms of the course of the disease as a whole, we can identify a number of the most important manifestations, the presence of which should alert a person and encourage him to go to the clinic.

Enlarged lymph nodes

Several dozen diagnoses have been identified in which the lymphatic system reacts to their development with inflammation of the nodal joints. However, in this case, the picture of their condition is specific - the increase is not infectious.

Almost until the late stages of cancer, they do not cause pain, with the exception of pronounced discomfort against the background of drinking alcoholic beverages.

In this case, the reason for the increase is their overload as a filtering substance with toxins, which are the product of the vital activity of cancer-affected cells. Settling on its walls, they are firmly fixed and begin to randomly divide, multiplying in volume.

In proportion to these processes, the lymph nodes also swell. With lymphoma in adults, the submandibular and axillary zones of the system are most susceptible to this phenomenon.

With ultrasound, it is possible to determine the presence of a tumor precisely by their condition - normally, the node, even in a state of inflammation, has pronounced gaps in its central part, and if the cause of the increase is oncology, the entire department will be darkened. Very often, it is on this symptom that the pathology is diagnosed.

Sweating at night

Many patients do not understand the connection between night sweats and cancer. In fact, everything is simple - the body, even at night, is in a state of constant struggle with a dangerous formation. At this point, nothing distracts him from trying to help himself, which is manifested in excessive sweating.

This is especially pronounced when the processes of metastasis are actively working, squeezing the brain sections of the back in combination with the therapy of analgesics of the opioid class.

In the body of the patient, endocrine functions fail, the temperature rises.- and as a result - sweating. The armpits, face, upper and lower extremities are most affected.

Periodic increase in temperature

The symptom belongs to the category of general and accompanies almost all oncological diagnoses. At the same time, its manifestation is somewhat specific. As a rule, the indicator of temperature increase against the background of the development of a cancerous anomaly is very insignificant - it rises by only a few divisions.

In the case of this disease, everything is different - a thermometer reaches a mark of 38.5 - 39 ° C and can be kept at this level for several weeks. At the same time, it is almost impossible to stop it - after the end of the drug, the temperature rises again.

Accompanied by sweating, alternating with chills. The symptom itself is favorable, since the fact of an increase in temperature is immune emissions with which the body tries to protect itself and suppress the tumor.

It is characteristic that at the final stages of the course of the disease in adult patients, when defensive forces the body is already running out, temperature fluctuations have not been detected.

Sudden weight loss

Occurs without any reason and manifests itself in a sharp decrease in body weight, more than 10% of the previously existing weight. As a rule, 1.5 - 2 months is enough for a person to lose such a number of kilograms against the background of the development of pathology.

A sharp decrease in body weight occurs in this case, for the following reasons:

• decreased appetite- the human body intuitively reacts to any deviations in its functioning, and trying to rid itself of an additional load (and self-combating pathology is a load!), As a result, the daily dose of nutrients and calories is reduced;
• forced loss of nutrients- in our case, with sweating;
• increased energy demand- the main forces are expended on the fight against cancer, the energy of which is hardly restored by a rather meager diet.

Constant fatigue

In this case, constant fatigue and lethargy manifests itself as a paralyzing sensation that occurs sporadically, for no apparent reason - person even with minimal physical activity feels tired, and this state persists already at the moment of morning awakening.

This phenomenon does not depend on the energy expended during the day. In this case, often, the inability to focus and concentrate on something specific causes spontaneous bouts of nausea.

Constant fatigue is a consequence of the ability of this type of oncological anomaly to release protein cytotoxins, which, being in normal concentration, effectively resist pests, and in excess - exude the body's strength.

Fever

Fever almost 100% accompanies lymphoma in an adult. It is the result of an attached infection that occurs against the background of a growing malignant tumor of the organ.

Education actively produces pyrogenic components, which, in turn, cause fever, negatively affecting the thermoregulation zones. In addition, pronounced necrosis of tissues affected by the cell mutation plays an important role in this process.

Skin rashes

Skin rashes are characteristic only of certain types of oncological pathologies. The specificity of this form of cancer is its rapid spread throughout the body due to the fact that pathological cells freely germinate into other organs, flowing through the human body with lymphatic and blood flows.

Against the background of a sharp decrease in the immune forces of the sick organism, the pathology with blood enters any zones and departments, manifesting itself with epithelial rashes, redness and skin manifestations.

The nature of this symptom is hidden in the irresistible desire of the body to get rid of toxins by forcibly removing them to the outside through penetration through the epithelial tissues. This process, in fact, is a rash that removes toxic elements.

Types and distinctive manifestations

Under this term, a number of oncological pathologies affecting the lymphatic tissues are concentrated. Thanks to their precise classification, it is possible to develop an optimal therapeutic scheme for eliminating the tumor:

• Hodgkin's lymphoma- it is distinguished by specific cells localized in the affected tissue fragments. The disease spreads sequentially, by the gradual transition of cancerous components from one node to another. It has a more optimistic prognosis and is relatively easy to treat;
• non-Hodgkin's lymphomas- consist of subspecies of anomaly, different in the area of ​​​​education, and differing in specific manifestations for each type of tissue. All of them are characterized by an individual clinical picture, atypical histology, which determines the optimal scheme for the therapeutic effect on the tumor;

lymphedema- pathologies affecting the area of ​​\u200b\u200bthe limbs due to severe hypoplasia of the lymph node connections. Moderate lymphedema develops in the process of outflow of lymphatic fluid into the inner subcutaneous layers. The more the disease progresses, the more pronounced the processes of swelling of soft tissues.

It can be either congenital, at the genetic level, or acquired against the background of developed oncology lymphoma in adult patients. A distinctive feature of the anomaly is a symmetrical sequential lesion of the limbs from the bottom, to their base;

lymphangiosarcoma- a malignant pathology occurring in the lymphatic endothelium. The disease is extremely rare, but deadly for a sick person. It is usually preceded by a long time period of lymphostasis, which has an extremely negative effect on the quality of the walls of the system and vascular tissues.

They develop after the patient has already been treated for lymphoma by surgical excision. A characteristic feature of the disease is that it most often affects the female half of the adult population diagnosed with lymphoma.

The nature of this phenomenon has not yet been substantiated. To save the patient's life, an urgent radical intervention is required, otherwise the lethal outcome from the defeat of this form of malignant formation of the system can occur very quickly.

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Lymphoma is considered to be a malignant tumor of lymphoid tissue that develops outside the bone marrow. For most ordinary people, the term is associated with heavy cancer, the essence of which is difficult to understand, as well as to understand the types of this tumor. Enlargement of lymph nodes is considered an invariable sign of lymphoma., while the general symptoms of a malignant lesion may be absent for a long time with a relatively favorable course or progress rapidly with aggressive low-grade tumors.

Lymphoma occurs in people of all ages, but specific varieties are more often diagnosed at certain intervals of life. There are more men among the patients, but there is no explanation for this gender difference yet. The disease is more often affected by the white population, and for certain forms of the tumor, a clear relationship has been established with the geographical area, for most forms - with genetic abnormalities and viral infection.

Lymphomas are extremely diverse in their characteristics, ranging from the morphological features of tumor cells to clinical manifestations.

Thus, the same type of tumor in patients of different sex and age may manifest itself differently, determining different prognosis and overall life expectancy. In addition, such individual characteristics as the nature of genetic abnormalities, the presence or absence of a viral infection, and the location of the lesion play a significant role.

To date, scientists have not been able to develop a clear and comprehensive classification of lymphomas, questions still remain, and modern methods diagnostics contribute to the identification of new varieties of neoplasms. In this article, we will try to understand the terminology and main types of lymphomas, the features of their course, without delving into the complex mechanisms of tumor development and the numerous forms encountered by oncologists.

Causes and types of tumors of lymphoid tissue

large knots human body affected by lymphoma

Our body in the process of life constantly encounters many harmful factors and influences, foreign agents and microorganisms, which are protected from by lymphoid tissue. A giant network of lymph nodes is scattered throughout the body, connected by thin vessels and acting as a kind of filter, trapping everything alien and dangerous from the lymph. Also lymph nodes also retain tumor cells in cancer of various localizations, then they talk about.

To perform barrier functions and participate in immune defense lymph nodes are supplied with a whole complex of mature and maturing cells of the lymphoid series, which themselves can become a source of a malignant tumor. Under unfavorable conditions or the presence of mutations, the process of differentiation (maturation) of lymphocytes, the immature forms of which constitute the neoplasm, is disrupted.

Lymphoma always grows outside the bone marrow, affecting the lymph nodes or internal organs- spleen, stomach and intestines, lungs, liver. As the tumor develops, its cells can move out of the primary localization, metastasizing like cancer and getting into other organs and the bone marrow (lymphoma leukemization).

figure: stage 4 lymphoma, target organs are affected by metastases, leukemization of lymphoma is shown

The causes of lymphomas and lymphosarcomas are:

• Viral infection (infection with the Epstein-Barr virus, T-lymphotropic virus, HIV, hepatitis C virus, etc.).
• Immunodeficiencies - congenital or acquired on the background of HIV infection, after radiation therapy or the use of cytostatics.
• Autoimmune diseases - systemic lupus erythematosus, rheumatoid arthritis.
• Genetic anomalies - translocations, when genes move from one chromosome to another, breaks in DNA sequences, etc., as a result of which cell division and maturation of lymphocytes are disrupted.
• External carcinogenic factors - polyvinyl chlorides, dioxin, some herbicides.

Some terminology

To understand the variety of tumors of lymphoid tissue, you need to know what terms it is customary to call their varieties.

The term " lymphoma» usually used for all tumors of the lymph nodes and lymphoid tissue, but means it is mostly neoplasia of mature lymphocytes or prolymphocytes, that is, such a tumor is mature, and downstream can be quite benign, for many years without making itself felt, except for an increase in the lymph node. Transition of lymphoma to a malignant analogue ( lymphosarcoma or ) occurs quite rarely and after many years and even decades from the moment of its occurrence.

For absolutely benign neoplasms from mature lymphocytes, the term " lymphocytoma”, but often it is replaced by the familiar “lymphoma”.

All malignant neoplasias from lymphoblasts that develop in the lymph nodes or lymphatic tissue of the internal organs are called lymphosarcomas. This term very well reflects the malignancy of such tumors, because it is known that they always consist of immature cells and are accompanied by all the signs of an oncological process. Lymphosarcomas are manifested not only by an increase in lymph nodes, but also by general symptoms, such as fever, weight loss, metastasis, and bone marrow damage.

The use of the word "cancer" is not correct in relation to tumors of the lymphatic system, but is often used by people far from medicine, for whom this definition indicates the undoubted malignancy of the process. "Cancer of the lymph nodes" is nothing more than high-grade lymphoma or lymphosarcoma. Such terminological subtleties are available only to doctors, so it is excusable for the layman not to know them.

should be distinguished from true lymphomas cancer metastases in the lymph nodes when tumor cells get there with the lymph flow from the focus of neoplasia growth. As a rule, such lesions are found first of all near the organ in which the cancerous tumor grows. For example, with possible enlargement of the lymph nodes around the trachea and bronchi, and a histological examination will clearly show the presence of tumor complexes of the epithelial structure in them, and not pathological proliferation of lymphocytes, as in the case of lymphoma.

Video: medical animation of lymphoma using the example of non-Hodgkin's

Features of the classification

There are many types of lymphomas, and it is not so easy to understand them. Until recently, the division into non-Hodgkin's lymphomas (NHL) and Hodgkin's disease was considered generally accepted., but such a contraposition of one disease to all other tumors is not entirely successful and does not reflect the features different types lymphomas, and even more so does not help in determining the prognosis or treatment tactics.

In 1982, it was proposed to divide non-Hodgkin's lymphomas into low-grade and high-grade neoplasms., and within each of this group to distinguish types depending on the morphological features of tumor cells. This classification was useful for clinical application oncologists and hematologists, but today it is outdated, since it includes only 16 subtypes of non-Hodgkin's lymphomas.

The most modern is the WHO classification, developed in 2008 on the basis of the European-American classification, proposed and refined at the end of the last century. More than 80 varieties of non-Hodgkin's lymphomas are grouped according to the degree of maturity of tumor cells and their origin (T-cell, B-cell, large cell, etc.).

Hodgkin's lymphoma (lymphogranulomatosis), although it is called lymphoma, but, in fact, it is not, since the neoplasm is composed of cells of macrophage and monocytic origin, and not lymphocytes and their predecessors, therefore, the disease is usually considered separately from other lymphomas, formerly referred to as non-Hodgkin's, but within the framework of malignant neoplasms of the lymphoid tissue in which it develops. Lymphogranulomatosis is accompanied by the formation of peculiar nodules (granulomas) from specific tumor cells, so this name more accurately defines the essence of the disease, but still the well-established "Hodgkin's lymphoma" is more familiar and widely used to this day.

According to the prevalence of the tumor, there are:

• Nodular lymphoma (a similarity of lymphoid follicles is found in the cortical and medulla of the lymph node).
• Diffuse tumor (diffuse tumor lesion of many lymph nodes and internal organs).

By origin and source of growth of lymphoma are:

1. Primary.
2. Secondary.
3. T-cell.
4. B-cell.

The degree of differentiation of tumor cells implies the isolation of neoplasms:

• Low degree of malignancy.
• High degree of malignancy.

Learn more about the types of non-Hodgkin's lymphomas

Non-Hodgkin's lymphoma is a rather broad concept, so the suspicion of such a tumor always requires clarification of the degree of its malignancy and the source of education.

There are two groups of lymphocytes in lymphoid tissue: T-lymphocytes and B-lymphocytes.. The former are necessary for the implementation of cellular immunity, that is, they themselves are directly involved in the capture and inactivation of foreign particles, B-lymphocytes are able to form antibodies - specific proteins that bind to a foreign agent (virus, bacterium, fungus) and neutralize it. In lymphoid tissue, these cells are grouped into follicles (nodules), where the center is predominantly B-lymphocytic, and the periphery is T-cell. Under appropriate conditions, inadequate reproduction of cells of a particular zone occurs, which is reflected in the definition of the type of neoplasm.

Depending on the maturity of the tumor cells, lymphomas can be low or high degree of malignancy. The first group includes neoplasms that develop from small or large lymphocytes, cells with split nuclei, and the second group includes immunoblastic, lymphoblastic sarcomas, Burkitt's lymphoma, etc., the source of which is immature cells of the lymphoid series.

If a lymphosarcoma grows from an already existing benign lymphoma, then it will be called secondary. In cases where the root cause of the tumor cannot be established, that is, a previous mature lymphoid tumor is not detected, they speak of primary lymphoma.

Mature cell lymphomas (lymphocytomas)

Relatively benign lymphomas originate from mature lymphocytes, so many years can be almost asymptomatic, and the only sign of the disease will be an increase in lymph nodes. Since this is not accompanied by any painful sensations, and lymphadenopathy or lymphadenitis with various infections is a fairly frequent phenomenon, it does not cause due attention from the patient. At further development disease, there are signs of tumor intoxication, weakness, the patient begins to lose weight, which makes him go to the doctor.

Approximately a quarter of all mature cell lymphomas eventually transform into lymphosarcoma, which will respond well to treatment. A local change in the lymphoid tissue or damage to any one organ, an increase in the number of lymphocytes in the blood test, as well as the presence of rapidly multiplying mature lymphocytes in the affected lymph node should be the reason for the timely treatment of a still benign tumor.

B-cell non-Hodgkin's lymphomas

The most common variant of non-Hodgkin B-cell lymphoma is neoplasia from the cells of the center of the lymphoid follicle, which makes up about half of all the NHL.

Such a tumor of the lymph nodes is diagnosed more often in older people and does not always have the same manifestations. The maturity of tumor cells predetermines either a non-progressive course for a long time, when patients 4-6 years old feel relatively well and practically do not complain, or the tumor behaves aggressively from the very beginning and quickly spreads to various groups of lymph nodes.

Lymphocytoma of the spleen It also predominantly affects the elderly. Being relatively benign, for a long time it is manifested only by an increase in some groups of lymph nodes (cervical, axillary) and the spleen. A feature of this type of lymphoma is the stabilization of the condition of patients and long-term remission after removal of the spleen.

In some cases, the tumor lesion is found in the mucous membranes gastrointestinal tract, respiratory system, in the skin, thyroid gland. Such lymphomas are called MALT-omas and are considered low-grade neoplasms. Symptoms of this type of lymphoma, localized in the gastrointestinal tract, may resemble a stomach or duodenal ulcer, and they can even be detected by chance during endoscopic examination for gastritis or ulcers. Lymphoma of the stomach is associated with the carriage of Helicobacter pylori infection, causing a response from the mucous membrane in the form of an increase and the formation of new lymphoid follicles, when the likelihood of a tumor due to the multiplication of lymphocytes increases.

"Cancer of the lymph nodes in the neck" patients can name a tumor from the cells of the mantle zone of the lymphoid follicle, in which a typical symptom is an increase in lymph nodes on the neck and under lower jaw. The tonsils may also be involved in the pathological process. The disease proceeds with symptoms of intoxication, fever, headaches, signs of damage to the liver, spleen and gastrointestinal tract.

T-cell lymphomas

T-cell lymphomas often affect the skin and are represented by mycosis fungoides and Cesari's syndrome. Like most of these tumors, they are more common in men over 55 years of age.

Fungal mycosis is a T-cell lymphoma of the skin, accompanied by its redness, bluishness, severe itching, peeling and blistering, which lead to induration, the appearance of mushroom-like growths that tend to ulcerate and cause pain. An increase in peripheral lymph nodes is characteristic, and with the progression of the tumor, its sections can also be found in the internal organs. In the advanced stage of the disease, symptoms of tumor intoxication are pronounced.

manifestations of various forms of lymphoma

Cesari disease manifested by a diffuse lesion of the skin, which becomes bright red, flaky, itchy, hair loss occurs and the structure of the nails is disturbed. For characteristic appearance these manifestations are sometimes referred to as the "red man" symptom. Today, many scientists tend to consider Cesari's disease as one of the stages of mycosis fungoides, when tumor cells reach the bone marrow due to tumor progression (lymphoma leukemization).

It is worth noting that skin forms have a more favorable prognosis in the absence of involvement of the lymph nodes, and the most dangerous option is the one that is accompanied by damage to the internal organs - the liver, lungs, spleen. Patients with this form of T-cell cutaneous lymphoma live on average for about a year. In addition to the tumor itself, the cause of death of patients is often infectious complications, the conditions for which are created on the skin affected by the tumor.

T- and B-cell lymphosarcomas

Lymphosarcomas, that is, malignant tumors from immature lymphocytes, are accompanied by damage to many lymph nodes, including the mediastinum and abdominal cavity, spleen, skin, and tumor intoxication. Such neoplasms metastasize rather quickly, grow into the surrounding tissue and disrupt the outflow of lymph, which leads to severe edema. Like mature lymphomas, they can be either B-cell or T-cell.

diffuseB-large cell lymphosarcoma lymph nodes account for about a third of all cases of non-Hodgkin's lymphoma, more often diagnosed in people over 60 years of age, growing rapidly and rapidly, but about half of the patients can be cured completely.

The disease begins with an increase in the supraclavicular and cervical lymph nodes, which thicken, form conglomerates and grow into the surrounding tissue, so it is no longer possible to determine their boundaries at this stage. Compression of the veins and lymphatic vessels leads to swelling, and nerve involvement causes severe pain.

Follicular lymphoma, unlike the previous form, grows slowly, develops from the cells of the central part of the lymphoid follicle, but over time it can go into a diffuse form with rapid progression of the disease.

In addition to the lymph nodes, B-cell lymphosarcomas can affect the mediastinum (more often in young women), the thymus, stomach, lungs, small intestine, myocardium, and even the brain. The symptoms of the tumor will be determined by its localization: cough, chest pain in pulmonary form, abdominal pain and stool disorders in case of damage to the intestines and stomach, impaired swallowing and breathing due to compression of the mediastinal organs, headaches with nausea and vomiting, focal neurological symptoms in lymphosarcoma brain, etc.

A peculiar type of undifferentiated malignant tumors of lymphoid tissue is Burkitt's lymphoma, which is most common among residents of Central Africa, especially children and young men. The disease is caused by the Epstein-Barr virus, which can be found in approximately 95% of patients. Interest in this lymphoma is due to the fact that new cases of it began to be recorded during the spread of HIV infection, and then, in addition to the inhabitants of the African continent, Europeans and Americans began to appear among patients.

atypical lymphocytes in Epstein-Barr virus infection

A characteristic feature of Burkitt's lymphoma is the defeat of the predominantly facial skeleton, which leads to tumor growths in the upper jaw, orbit, severe edema and deformation of facial tissues ( shown in the photo above.). Quite often tumor nodes are found in an abdominal cavity, ovaries, mammary glands and covers of a brain.

The progressive course of the tumor leads to rapid exhaustion, patients experience fever, weakness, severe sweating, and pain is also possible.

With HIV infection in the AIDS stage (final stage), pronounced immunodeficiency contributes not only to the introduction of tumor-causing viruses into the body, but also to a significant weakening of the natural antitumor defense, therefore, lymphomas are often a marker of the terminal phase of the disease.

T-lymphoblastic lymphoma is much less common, than B-cell tumors, their symptoms are very similar, but neoplasias originating from T-cells progress faster and are accompanied by a more severe course.

Summing up, we can identify the main features and symptoms of lymphoma:

• Mature tumors are characterized by a long benign course, while malignant lymphosarcomas, originating from poorly or undifferentiated cells, are characterized by rapid progression, damage to many organs, involvement of surrounding tissues and metastasis.
• Lymphomas often transform into lymphosarcomas, but at the same time they retain high sensitivity to therapy and the likelihood of long-term remission or complete cure.
• Symptoms of lymphomas and lymphosarcomas include:
  1. obligatory damage to the lymph nodes or lymphoid tissue of internal organs - one or many groups, both peripheral and located inside the body (in the abdominal cavity, mediastinum);
  2. signs of intoxication and the oncological process - weight loss, weakness, fever, sweating, loss of appetite;
  3. swelling of tissues due to impaired lymph flow through the lymph nodes affected by the tumor;
  4. symptoms of damage to internal organs and skin with appropriate localization of the tumor or its metastases (shortness of breath, cough, nausea, vomiting, gastric or intestinal bleeding, signs of damage to the nervous system, etc.);
  5. anemia, thrombocytopenia with bleeding, impaired immune defense when colonized by tumor cells in the bone marrow and the transition of lymphoma to leukemia.

In the process of the spread of tumor cells throughout the body, it is possible for them to enter the bone marrow (lymphoma leukemization), then the manifestations and response to the treatment will correspond to leukemia. The likelihood of such a development of events is greater in aggressive immature types of lymphosarcomas, which are prone to metastasis and damage to many internal organs.

Hodgkin's disease (lymphogranulomatosis)

Hodgkin's lymphoma was first described in early XIX century by Thomas Hodgkin, but the development medical science of those times involved the observation of symptoms and clinical features of the disease, while there was no laboratory "reinforcement" of the diagnosis yet. Today it is possible not only to make a diagnosis based on a microscopic examination of the lymph nodes, but also to conduct immunophenotyping in order to identify specific surface proteins of tumor cells, and the result of a detailed study of tumor tissues will be the determination of the stage and variant of the disease, which will affect both treatment tactics and prognosis.

As noted above, until recently, Hodgkin's disease was opposed to all other types of lymphomas, and this made a certain sense. The fact is that with lymphogranulomatosis in the lymphoid organs, a specific tumor process is observed with the appearance of peculiar cells that are not found in any other type of lymphoma. In addition, a feature that distinguishes lymphogranulomatosis from other lymphomas is the monocyte-macrophage origin of the parent tumor cell, and in lymphomas, the tumor always grows from lymphocytes, whether undifferentiated, young or already mature forms.

Causes and forms of Hodgkin's disease

Disputes about the causes of lymphogranulomatosis (LGM) do not subside to this day. Most scientists are inclined to the viral nature of the disease, but the influence of radiation, immune suppression, genetic predisposition is also discussed.

In more than half of patients, Epstein-Barr virus DNA can be detected in tumor tissues, which indirectly indicates the role of infection in the development of neoplasia. Among the sick, men are more common, especially Caucasians. The peak incidence occurs at a young age (20-30 years) and after 55 years.

The main change that reliably indicates Hodgkin's disease is the detection in the affected lymph nodes of large Reed-Berezovsky-Sternberg cells and small Hodgkin cells, which are the predecessors of the former.

Depending on the cellular composition of the lymph nodes, there are:

• Lymphohistiocytic variant of LGM, when mature forms of lymphocytes predominate in the lymph nodes. This type of disease is considered the most favorable, most often found on early stage and allows the patient to live 10-15 years or more.
• The nodular-sclerotic form of LGM, which accounts for about half of all cases of the disease, is more common in young women and is characterized by thickening of the lymph nodes due to sclerosis (proliferation of connective tissue). The prognosis is usually good.
• The mixed cell variant is diagnosed in childhood or old age, the lymph nodes have a diverse cellular composition (lymphocytes, plasma cells, eosinophilic leukocytes, fibroblasts), and the tumor is prone to generalization. With this form of Hodgkin's lymphoma, the prognosis is very serious - the average life expectancy after diagnosis is about 3-4 years, the symptoms of a generalized lesion are rapidly growing and are accompanied by the involvement of many internal organs.
• The LGM variant with suppression of lymphoid tissue is the rarest and, at the same time, the most severe, corresponding to stage IV of the disease. With this form of Hodgkin's disease, lymphocytes in the lymph nodes are not detected at all, fibrosis is characteristic, and the five-year survival rate is only about 35%.

stages of lymphoma, depending on the degree of organ damage

The stages of Hodgkin's lymphoma (I-IV) are determined by the number and localization of the affected lymph nodes or organs, as well as on the basis of the patient's examination, clarification of complaints and symptoms with the involvement of laboratory and instrumental diagnostic methods. Be sure to indicate the presence or absence of symptoms of intoxication that affect the determination of the prognosis.

Manifestations of lymphogranulomatosis

LGM has quite diverse clinical signs, and even the onset of the disease in different patients can proceed in different ways. In most cases, there is an increase in peripheral lymph nodes - cervical, supraclavicular, axillary and other groups. At first, such lymph nodes are mobile, do not cause pain and anxiety, but in the future they become denser, merge with each other, the skin above them may become red. In some cases, the lymph nodes can be painful, especially after drinking alcohol. An increase in body temperature and intoxication are not typical in the initial stages of the disease.

Approximately one-fifth of patients call the appearance of dry cough, shortness of breath, chest pain, swelling of the neck veins as the first signs of trouble. Such symptoms give an increase in the lymph nodes of the mediastinum.

Less commonly, the disease begins suddenly, among full health with fever, sweating, rapid weight loss. The acute onset of LGM indicates a very poor prognosis.

As the tumor process progresses, a phase of detailed clinical manifestations begins, in which there is:

1. Enlargement of lymph nodes of different groups.
2. Sharp weakness.
3. Decreased performance.
4. Sweating, especially strong at night and during periods of fluctuations in body temperature.
5. Pain in the bones.
6. Fever.
7. Skin itching, both in the area of ​​the affected lymph nodes, and throughout the body.

In addition to such "general" symptoms, enlarged lymph nodes can cause other disorders, squeezing blood vessels, gland ducts, and internal organs. The advanced stage of LGM patients can call "cancer of the lymphatic system", since there is a lesion of the lymphoid organs, which can no longer be confused with banal lymphadenitis or lymphadenopathy, there is a tendency to progress and worsen the patient's condition.

Enlarged lymph nodes are found in different parts of the body, they are dense, form conglomerates, but are never associated with the skin. Almost always, such changes are observed on the neck, in the axillary region. If the lymph nodes of the abdominal cavity are affected, jaundice may occur due to compression of the gallbladder duct. Sometimes the lymph nodes increase to such a size that they can be easily felt through the anterior abdominal wall.

Signs of a tumor process in the pelvic, inguinal lymph nodes can be pronounced swelling of the legs, since the outflow of lymph from the lower extremities is sharply hampered. Retroperitoneal lymph nodes can compress the spinal cord and ureters.

The spread of the tumor from the lymph nodes to the internal organs leads to the addition of more and more new symptoms. So, with the defeat of the gastrointestinal tract, patients experience pain, diarrhea, bloating, which increases exhaustion and can lead to dehydration. Involvement of the liver is considered a bad sign and is manifested by jaundice, bitterness in the mouth, enlargement of the liver. Almost half of the patients suffer from lung damage, which is manifested by cough, shortness of breath, chest pain. The spleen in the period of a widespread tumor process increases almost always.

Tumor cells with lymph flow can move from the lymph nodes or internal organs to the bones, which is quite typical for all variants of the course of LGM. Usually, the spine, ribs, pelvic bones and sternum are exposed to tumor damage. Bone pain is the main sign of metastasis of a malignant tumor in them.

Diagnosis and treatment of tumors of the lymphatic system

Diagnosis of tumors of the lymphatic system requires a thorough examination of the patient and the involvement of all kinds of laboratory and instrumental methods. In some cases, complex and rather expensive cyto- and molecular-genetic, immunohistochemical studies may be required to establish the exact type of tumor.

Since all tumors of lymphoid tissue are accompanied by an increase in lymph nodes, the detection of such a sign should always be alarming. Of course, you should not immediately panic and think about the worst if, for example, the submandibular or inguinal lymph nodes have increased, because this often happens against the background of various infections and fairly common diseases (tonsillitis, infections of the genital tract). Pet lovers can find enlarged lymph nodes after a cat scratch, and those who do not follow oral hygiene almost constantly feel enlarged lymph nodes under the lower jaw.

In the case of the infectious nature of lymphadenopathy, the appointment of antibiotics always leads to subsidence. inflammatory process and shrinkage of the lymph nodes. If this does not happen, then there is a need for a detailed examination.

First of all, the doctor will find out in detail the nature of the complaints, the time of their occurrence and duration, the presence of signs of intoxication in the form of weight loss, unexplained temperature rises or night sweats.

Laboratory confirmation of the diagnosis involves : a general blood test, in which you can detect an increase in the number of lymphocytes with some leukopenia, an acceleration of ESR.

The main and most reliable way to diagnose lymphomas is considered to be a biopsy of the lymph node. when its fragment is taken for microscopic examination for the presence of tumor cells. Sometimes it becomes necessary to re-take material for research or remove the entire lymph node.

lymph node biopsy

To further clarify the diagnosis, establish its stage, prevalence and nature of changes in the internal organs, use:

• X-ray of the chest organs.
• CT, MRI (for examining the liver, spleen, brain, lungs, neck, etc.)
• Fibroesophagogastroscopy (with suspected primary lymphomas or the spread of the tumor process from other organs).
• Radioisotope bone scan.
• Puncture with bone marrow biopsy.

diagnostic image of a patient with lymphoma, pos. B - the result of 3 months of chemotherapy

The choice of the examination scheme depends on the type and localization of the tumor and is determined by the oncologist individually for each patient. When the diagnosis is made, it is necessary to decide on the further treatment of lymphoma, which involves the appointment of chemotherapy drugs, radiation, and even surgery.

Surgical treatment has very limited use in lymphomas and is used more often in isolated forms of tumors or to alleviate the patient's condition in advanced stages, reduce pain or pressure from enlarged lymph nodes on internal organs. In the case of a primary lesion of the spleen, they resort to its removal, which gives a very good therapeutic effect and even a complete cure for the tumor.

- the main and most effective way to deal with tumors of the lymphatic system. The administration of chemotherapy drugs makes it possible to achieve long-term remission in many patients, even with aggressive high-grade lymphomas. Elderly and debilitated patients may be prescribed a single antitumor drug, while blast forms in young people require the use of programs for the treatment of acute lymphocytic leukemia.

With aggressive low-grade tumors, the simultaneous administration of 5-6 drugs shows itself well. Of course, this treatment comes with risks. side effects, but the correction of emerging disorders, monitoring of blood counts, the appointment of antiemetics, antibiotics, vitamins and trace elements contribute to its better tolerability.

Radiation may be given in parallel with or before chemotherapy, especially in cases of local lesions, as well as the spread of the tumor in the bones, mediastinal organs.

Bone marrow transplantation may be a promising way to fight the tumor or individual blood cells of both the patient and the donor. If the lymphoma has spread to the bone marrow, only a donor organ can be used.

As regards self-employment and folk remedies, so loved by many, then once again you just need to be reminded that cancer is not the case when you can abandon official medicine in favor of alternative medicine. Such neglect of one's health can cost one's life.

In conclusion, I would like to note that most lymphomas still respond well to treatment provided timely diagnosis and initiation of therapy. Do not waste time, wait until it “passes by itself” or trust your health to traditional healers. In case of any trouble, you should immediately contact an oncologist who is able to provide qualified assistance aimed at prolonging life and healing.

Video: lymphoma in the program “Live Healthy!”

The author selectively answers adequate questions from readers within his competence and only within the limits of the OncoLib.ru resource. Face-to-face consultations and assistance in organizing treatment are not currently provided.

Lymphoma is diagnosed when the lymphatic system is affected by malignant tumors. As a result, all lymph nodes increase, “tumor” lymphocytes accumulate in the internal organs. Lymphoma has a focus, it can create metastases, spread throughout the body. Specialists distinguish between Hodgkin's lymphoma and non-Hodgkin's lymphoma. To learn how to distinguish the disease, to cope with it, read our article.

About the lymphatic system

The lymphatic system - part of the vascular system, consists of a network of lymphatic vessels through which colorless lymph flows (consists of lymphocytes). Vessels pass through the whole body, along their length there are lymph nodes (lymphocytes multiply in their follicles). Thanks to the lymphatic system, the body defends itself by producing antibodies. Fluid drains from the space between the cells through the lymphatic vessels, entering the bloodstream. Here lymphocytes are created, proteins and fats are absorbed.

Features of Hodgkin's lymphoma or lymphogranulomatosis

The disease often affects young men and sometimes children under 15 years of age. It is believed that pathology develops due to genetic characteristics, a predisposition to it. Epstein-Barr virus, a long-term effect on the body, can also become provocateurs chemical substances(lymph cells eventually turn into malignant).

Symptoms of lymphogranulomatosis

Peripheral lymph nodes grow first. The lesion affects the lymph nodes in front and behind the neck, then above and below the collarbone, under the armpits, in the groin. Lymph nodes become dense, solder to each other or tissues around. When the lymph nodes of the chest and abdomen are affected, there is a hacking cough with shortness of breath, poor appetite, pain in the chest and abdomen (plus heaviness). If not treated, the lymph nodes become larger, they can squeeze and displace the stomach, kidneys, responding with pain in the back and in the pit of the stomach. When the bones are affected, they are very sore both at rest and in motion. In addition, regardless of the place of development of tumors, body temperature rises, night sweats appear with weakness, there is almost no appetite, the skin itches, weight is lost sharply and the body is more likely to succumb to infections.

Stages of Hodgkin's lymphoma

If the tumor has developed in the lymph nodes of one part of the body or one organ not in the lymph nodes (for example, in the armpits) - this is stage I. Involvement of lymph nodes or organs in several parts of the body on one side of the diaphragm (up or down) indicates stage II. The tumor may develop in the lymph nodes on both sides of the diaphragm (stage III), plus at the same time, the organ itself is sometimes affected (ІІІE), or , spleen (IIIS), or all together: art. III(1) - the tumor is located at the top of the abdominal cavity; Art. III(2) - the lymph nodes of the pelvis and along the abdominal aorta are affected. Pathology often involves not only the lymph nodes, but also the bone marrow with the kidneys, liver, and intestines. In addition to the numbers of the stage of development of the disease, letters are additionally used. For example, the letter A means that there are no symptoms, B - there are one or more symptoms (sweating with hot flashes, an unexplained increase in body temperature above 38 ° C, weight loss by 10% or more within six months). Using the letter E, experts indicate that the tumor has developed in organs and tissues close to the affected large lymph nodes. S is attributed to lesions of the spleen, and X denotes a large mass.

Diagnosis of lymphogranulomatosis

In addition to the standard survey, the specialist feels, examines, taps the location of the lymph nodes, listens to how the internal organs work. It is necessary to undergo a general blood test and biochemical (for proteins with liver tests, Coombs' test). An X-ray of the chest organs is also prescribed (straight and sideways), a small part of the bone marrow (myelogram and biopsy) is taken for examination. Additionally, if necessary, they recommend ultrasound of the abdominal cavity and the space behind the peritoneum, computed tomography (CT), thoracotomy (surgical opening of the chest), laparotomy (opening the abdominal cavity) - to determine the stage of the disease, remove the spleen (if required). Scintigraphy (radioactive isotopes are introduced into the body, a two-dimensional image is created on a special device). Examine immunity for antigens CD15 and CD30. The main criterion for making a diagnosis is the detection of Hodgkin or Reed-Berezovsky-Sternberg cells in the affected lymph nodes.

Treatment of Hodgkin's disease

Sometimes the disease proceeds malignantly for 4–6 months and leads to death, and sometimes it lasts for 15–20 years. Radiation and chemotherapy (cytostatics) are used in the treatment. Usually, a course of radiation therapy is prescribed for five days (the number of courses depends on individual characteristics). After such treatment, weakness with drowsiness is felt. Chemotherapy courses depend on the stage. The drug is injected into a vein or taken by mouth. In this case, the dose and time of administration are important. As soon as the course is completed, an examination is carried out to determine the effectiveness of the treatment. For those who have stages I and IIA, only radiation therapy is suitable. Radiation plus medications - II and IIIA stages. Only drugs are treated with IIIB and IV stages. With a possible damage to the bone marrow, its autotransplantation is needed (that is, the transplantation of the necessary parts from one's own body). In addition, antibiotics, antiviral and antifungal drugs, blood transfusions may be needed. Thanks to the treatment, started on time and carried out correctly, it is possible to achieve a five-year remission in 70-80% of cases (if the remission persists after five years, the person is considered cured). 30-35% relapse. Wherein effective ways no prevention yet.

Non-Hodgkin's lymphomas (NHL)

This group includes more than 30 malignant neoplastic diseases, which are similar in signs and nature. Often develop in older people (the risk is twice as high for men), rarely in children under three years of age.

Provocateurs and features of the development of pathology

The disease is considered to be associated with a genetic mutation in some kind of lymphocyte, so that it begins to multiply uncontrollably, does not perform its functions. The mutation, according to experts, is provoked by the Epstein-Barr virus, certain chemicals (pesticides, herbicides) and medicines with radiation. Affects the state of immunity. Tumor cells grow together into masses, accumulate in the lymph nodes, tonsils, spleen, thymus gland, lymphatic plaques of the intestine. It happens that the tumor is located in one place, but more often spreads with the lymph flow, affects other organs with tissues.

Types of NHL

Low-grade lymphomas include lymphocytic with diffuse, prolymphocytic, nodular lymphoplasmacytic types. The intermediate degree includes prolymphocytic-lymphoblastic and nodular types, as well as prolymphocytic, diffuse, prolymphocytic-lymphoblastic plus diffuse type. Highly malignant - immunoblastic with diffuse, lymphoblastic (macro-, micro-, twisted, non-twisted nucleus), diffuse types and Burkitt's tumor. Mycosis fungoides with plasmacytoma, reticulosarcomas (lymphoid and histiocytic variants), and unclassified lymphoma are isolated separately. Tissue is taken from the tumor focus.

NHL signs

Common signs include swollen lymph nodes, the appearance of tumor-like formations on the neck, above or below the collarbone, armpits, in the crooks of the elbows, in the groin. A tumor can develop in the chest, abdominal cavity and behind it, in organs with lymphoid tissue (for example, tonsils, spleen, etc.). Pathology sometimes affects the liver with metastases with lungs, bones and soft tissues, bone marrow. Common symptoms for all types of NHL include: high fever with night sweats, rapid weight loss, weakness, fatigue, poor sleep and appetite, irritability and apathy. Combination of the first three signs that indicate lymphoma are called "B"-symptoms. Of the specific signs, one can notice the growth of lymph nodes, their “solidity” with each other (there is no pain when touched, the skin color above them is normal). Signals for the defeat of the tonsils will be - a change in the timbre of the voice, difficult swallowing, an increase in the tonsils. Pain in the abdomen and organs with constipation or diarrhea, nausea and vomiting, loss of appetite - signs of a tumor in the lymph nodes of the abdominal cavity. When the lymph nodes of the chest cavity are affected, respiratory tract and thymus, there is a feeling of tightness, fullness in the chest, swallowing is difficult, there is a hacking cough, shortness of breath develops. A tumor in the bones responds to their pain. If the central nervous system, does not do without headaches, vomiting, convulsions, signs of paralysis of the cranial nerves. Bone marrow damage is indicated by susceptibility to infections that are difficult (the number of leukocytes in the blood drops), anemia appears (there are few red blood cells in the blood). Bleeding becomes frequent - punctate hemorrhages with hematomas, nosebleeds, long heavy menstruation, etc. (low platelet count). Non-Hodgkin's lymphomas can be noticed within a few weeks of onset.

NHL Diagnostics

To clarify the diagnosis, you need a complete blood count to determine the number of leukocytes, ultrasound, X-ray, MRI and CT, plus positron emission tomography, take cells from the cerebrospinal fluid to find out if there is a tumor. Examine enlarged lymph nodes (puncture) and ascitic fluid. Focusing on the type of tumor found, treatment is prescribed, forecasts are made. To determine the general condition, in order to avoid possible complications during treatment, it is possible to examine the kidneys, liver, protein fractions and heart.

NHL treatment

Chemotherapy with radiation therapy can be supplemented with bone marrow transplantation, removal of the tumor by surgeons. The stages of the disease are determined by the spread of the tumor, its size, age characteristics, etc. In chemotherapy, several drugs are often used in a large dose, in small courses. In general, treatment lasts 2-5 months. Cytostatics can be injected directly into the spinal cord. The drug Rituximab or MabThera is also effective. In parallel with chemotherapy therapy, symptomatic therapy is carried out, that is, the prevention and treatment of complications (antibiotics with blood transfusion, immunity strengthening). With therapy of six cytostatics, complete remission for five years is achieved in 75-80%.

When the spleen is affected, its removal helps. The part of the stomach where the tumor has developed can also be removed (resection). But lymphocytes do not require special therapy for a long time. Usually, monochemotherapy (Chlorbutine with Cyclophosphamide), steroid hormones (Prednisolone with Methylprednisolone), plus antihistamines, or surgery are used. The prognosis after treatment depends on the age of the person, the type of tumor and its size, satellite pathologies, and the neglect of the situation. There is no clear prevention strategy in medicine other than avoiding risk factors.

Elena Malysheva talks about lymphoma and how to treat it