Introduction to lymphoma

Introduction:

LymphomaIt is a malignant tumor that originates in lymph nodes or lymphoid tissues. The clinical manifestations are painless and progressive lymphadenopathy. The disease can occur at any age, but the peak age of onset is 31 to 40 years old.Hodgkin's lymphomaThe peak is moving forward slightly. The ratio of male to female is: 2~3:1.

Cause:

The cause of human lymphoma is not clear. Only two viruses in humans are clearly associated with lymphoma, namely Epstein-Barr virus and human T-cell lymphoma/leukemia virus (HTLV-1). According to its pathological features, it is divided into Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL).

symptom:

First, lymph node and lymphoid tissue onset

Superficial lymph nodes are the majority, and HD is more than NHL. The affected lymph nodes are the most in the neck, followed by the infraorbital and groin. Generally painless, progressive swelling, moderate hardness. It is active in the early stage, and more adhesions occur in the late stage and multiple swollen lymph nodes merge into pieces. In some HD patients, lymphadenopathy can temporarily pause or even shrink at a certain time, so that it is misdiagnosed as lymphadenitis or lymphatic tuberculosis.

Deep lymph node onset, mediastinal lymph nodes are more common, swollen lymph nodes can compress the superior vena cava, causing superior vena cava syndrome. It can also compress the trachea, esophagus, and recurrent laryngeal nerves and have symptoms such as difficulty breathing, difficulty swallowing, and hoarseness. Mediastinal NHL complicated by lymphosarcoma cell leukemia is more common. The HD of young women in the mediastinum is mostly nodular sclerosis, which is often unsatisfactory for the treatment response.

Malignant lymphoma originating from the retroperitoneal lymph nodes is more common with NHL, which can cause long-term, unexplained fever, which makes clinical diagnosis difficult.

Lymphoma that originates in the lymphatic ring of the pharynx is more common in the NHL and is often accompanied by an axillary invasion. Symptoms include sore throat, foreign body sensation, poor breathing, and hoarseness.

Second, the onset of the disease

In addition to lymphoid tissue, any part of the body can develop disease, of which the most common in the gastrointestinal tract, stomach and high intestinal lymphoma may have upper abdominal pain, vomiting and other symptoms. Small intestinal lymphoma occurs in the ileocecal area, often with chronic diarrhea, steatorrhea, and intestinal obstruction.

Third, systemic symptoms

Often there is general weakness, weight loss, loss of appetite, night sweats and irregular fever. A small number of HDs can have periodic fever.

diagnosis:

The so-called "plaque enlargement", whether it shows a malignant cancer disease, needs to be carefully distinguished, because some relatively non-risk diseases, such as lymph node inflammation or other infections, may also cause swelling of the lymph glands, so we The first one to deal with lymphadenopathy must be carefully examined to distinguish the size, hardness, and skin lesions of the lymph glands, and from the patient's clinical course, the duration, size, and hardness of the lymph nodes, including weight loss, missed There is no reason for fever or night sweats, as well as itchy skin and other symptoms to determine what it is.

complication:

There were no obvious complications in the early stage of lymphoma, and the clinical manifestations of infection and corresponding tissue and organ invasion occurred in the late stage with the progression of the lesion.

treatment:

The treatment of lymphoma has made significant progress in recent years, and most of HD can be cured. Although NHL is not as effective as HD, some cases have been cured.

First, radiation therapy:

(1) IA and IIA of HD can be used alone for sub-lymphatic irradiation.

(2) NHL low IA and IIA should be treated with chemotherapy after radiotherapy (January).

Second, chemotherapy:

(1) Patients with HDIIIB~V should be treated with chemotherapy and combined with chemotherapy for MOPP for 6 courses. The complete remission rate can reach 60-80%, and 1/2~1/3 cases can maintain long-term remission, and some can last for 15 years.

(2) Low and moderate NHL stage III, VI and high-grade stage I~IV are suitable for chemotherapy. After the tumor is relieved, regional radiotherapy is performed as appropriate.

Third, surgical treatment: the following conditions are feasible surgical radicalization, followed by radiotherapy and chemotherapy: 1 limited body surface extranodal lesions; 2 digestive tract lymphoma; 3 genitourinary lymphoma; 4 primary spleen lymph tumor.

Fourth, bone marrow transplantation: the efficacy of bone marrow transplantation on lymphoma needs to be assessed.

prevention:

The exact cause of malignant lymphoma is still unclear, and it is difficult to take active and effective measures to prevent its occurrence. Clinically, according to the current research results of malignant lymphoma, appropriate prevention of high-risk groups may help delay or block the occurrence of the disease. For patients who have achieved complete remission after treatment, if prophylactic or therapeutic measures are given, it is possible to prolong the remission period or even prevent recurrence. Therefore, the following aspects should be noted for the prevention and treatment of lymphoma.

1. Pay attention to climate change, prevent and actively treat viral infections.

2. Pay close attention to the changes of superficial lymph nodes, and be more vigilant for patients with similar diseases in family members.

3. Strengthen physical exercise and improve the body's immunity and disease resistance.

4. Actively treat other chronic diseases that may be associated with the development of this disease, such as chronic lymphadenitis, autoimmune diseases, etc.

5. For superficial lesions, care should be taken to clean the skin and avoid unnecessary damage or irritation.