Lymphoma of the lung is a disease characterized by both common signs of malignant neoplasms and symptoms of the bronchopulmonary system.
The oncological lesion of the lymphoid apparatus is most often detected in the elderly, although the last decades have revealed a tendency to the formation of lymphomas in children.
Concept of the disease
Lymphoid formation in the lungs begins to form due to an error in the functioning of the lymphoid tissue. Atypical lymphocytes accumulate in the lymph nodes and lung tissue, which leads to the appearance of a new growth.
Primary lymphomas of the bronchopulmonary system , that is, those that begin to form in these organs without the previous defeat of other systems, are extremely rare. And susceptible to this kind of lymphomas are mostly elderly people.
Secondary lymphomas that damage the lung tissue of are the result of metastasis of cancer cells from other foci with malignant neoplasm. In this case, most often primarily under the influence of altered lymphocytes, a malignant tumor grows in the bronchi, trachea, and mammary glands.
Lymphoma of the lung according to the etiology of its development has many similarities and with the structures of a similar structure in other organs of the human body. Therefore, almost identical causes of this disease are put forward, regardless of the part of the human body in which the progressive growth of lymphoid tissue is diagnosed.
The main reasons leading to these changes include:
- Prolonged contact with a number of carcinogens, including some types of fertilizers, solvents, chemicals used in different industries. In part, fertilizers are delayed in plant food and therefore the use of such products can be partly considered a culprit for lymphomas.
- Autoimmune diseases.
- Use of immunosuppressive therapy for a long time.
- Transplantation of bone marrow and internal organs.
- Disease that occurs under the influence of chromosomal abnormalities.
Studies have shown that some malignant lymphomas develop along with viral diseases. Part of the patients have herpes simplex type 8, HIV, Epstein-Barr virus, hepatitis C.
With the development of lymphoma of the lungs, it is impossible to ignore the effect on lung tissue and such an unfavorable factor as tobacco tar.
Genetic predisposition is also noted. Patients with lymphomas often have relatives suffering from malignant lesions of the immune and hematopoietic systems.
Lymphoma of the lung is divided into different species on the same basis as malignant formations involving lymphocytes from other organs.
The main classification divides these tumors into the following subspecies:
- Lymphosarcomas, also they are designated as non-Hodgkin's lymphomas and mostly they are primary. In turn, lymphosarcomas can be B-cell( mantle lymphoma, MALT-lymphoma) and T-cell.
- Hodgkin's disease or lymphogranulomatosis.
- Lymphoproliferative secondary tumor-lymphoma of the lung, formed during the passage of cancer cells from malignant lymphomas of other body systems.
The most frequent variant of extranodal, that is located outside the lymph nodes, lymphoma is MALT-lymphoma. Basically, it has limited localization, and bone marrow damage with this variant of the disease course is detected only in 5% of cases.
MALT-lymphoma predominantly develops in people who have a history of chronic bronchopulmonary pathologies or auto-allergies - systemic lupus erythematosus, Sjogren's disease, multiple sclerosis. This tumor has the lowest degree of malignancy, but under the influence of some( until the end of unexplained) causes can degenerate into a tumor with an aggressive course.
Used in medicine and classification of lung lymphogranulomatosis, this kind of lymphoma has several morphological forms:
- Knothy lymphogranulomatosis is exposed when several nodes are detected in the lungs, usually up to 5. Most often these nodes are located in the lower lobe of the organ, a significant increase in them leads to compression of the bronchi and then the patient has signs of abscessing pneumonia or purulent bronchitis.
- Peripheral Hodgkin's disease is characterized by the formation of granulomatous cords, localized in the bronchi. If these sprains affect the septa of the pulmonary alveoli, then interstitial pneumonia develops.
- Exudative lymphogranulomatosis is manifested by granulomatous pneumonia.
- The miliary form of the disease is exhibited when the granulomatous nodules of the milder form are scattered throughout the lung tissue.
Symptoms of lymphoma of the lung
Lymphogenous oncological neoplasms of the lung develop long enough, especially for primary tumors. The asymptomatic course of the disease in some patients can last for several months, in others it takes up to ten years.
As the malignant neoplasm progresses, signs of bronchial obstruction or atelectasis, that is, lung sagging, begin to appear. Lymphoma of the lungs causes the following symptoms:
- Cough with a small amount of sputum. At the last stages of the discharge become purulent-bloody.
- Shortness of breath. Initially, it is expressed with physical exertion, at later stages of development of lymphoma can be disturbed constantly.
In addition to the signs that indicate the pathological changes in the lungs, the patient has symptoms that are characteristic of all lymphomas. To their group include:
- Almost constant weakness of and rapid onset of fatigue.
- Increased body temperature , not caused by infections or benign inflammatory changes.
- Heavy night sweats.
- Decreased appetite , losing weight in a short period.
- Itching itch.
- Tumor formation in the lymph nodes. The lymph nodes of the neck, abdominal region, inguinal are most often affected. When they feel, pain does not arise. A distinctive feature is sometimes pain in the lymph nodes, fixed after taking alcohol. Such a sign is revealed in patients with Hodgkin's lymphomas.
Lymphomas promote and increase the spleen and liver. Growing organs lead to the displacement of other structures in the abdominal region, and this causes uncomfortable sensations, colic, bursting pain.
Progression of lung lymphoma leads to metastases in the mediastinum, digestive organs, mammary glands, bone and spinal cord, thyroid gland, testicles. Accordingly, a clinic of violations of the organ with lymphoma appears.
Plasmocytoma is seen in patients rarely and predominantly develops in men, a tumor in most cases is a knot around which the lung tissue is not changed. Plasma cell lymphoma with malignant course gives a meager clinical picture of the disease and can develop over the years.
If such formation is one, then after its removal a full recovery comes. In a generalized process, such an outcome is unlikely.
A patient with signs not excluding lung lymphoma is offered to undergo a comprehensive examination. First of all, a chest x-ray is assigned, and the pictures show if there are any changes in the lungs.
To confirm or disprove a suspected diagnosis, if atypical lesions in the lungs are detected use:
- Computed tomography. Layered examination of the lungs allows to determine the exact location of the tumor, its size, structure.
- Biopsy study. Material for immunohistochemical and cytological is obtained with bronchoscopy or transthoracic access.
- If necessary, a lymph node biopsy is performed.
- Blood tests show the severity of the inflammatory process.
- If it is assumed that the tumor is primary, then the spinal cord is punctured.
When suspected of metastasis, ultrasound of internal organs is prescribed. Lymphoma of the lungs must be differentiated from tuberculosis, bronchoalveolar cancer, sarcoidosis, lymphoid hyperplasia with benign course and even from a number of similar diseases.
Methods of treatment
Oncologists treat their patients with lung lymphomas only after a complete examination. The goal of therapy is to remove the tumor and prevent the appearance of metastases in other organs.
If lymphoma is isolated and identified at a local stage, then surgical intervention is mandatory. Conduct a lobectomy, that is, removal of the affected lobe of the lung, or pneumonectomy - the whole body.
Before the operation and after it, several sessions of radiation therapy are prescribed, they are necessary to destroy the existing cancer cells and to limit their growth and spread in the body in the future.
Radiotherapy with chemotherapy or polychemotherapy with Rituximab( monoclonal antibody) is necessary in the following cases:
- If lymphoma is bilateral.
- With the generalized process.
- High grade malignancy formation.
- Aggressive course of the disease.
Treatment of lymphomas consists in the appointment of symptomatic therapy aimed at eliminating pain, impairment of the pulmonary system.
If a patient has primary MALT-lymphoma, the doctor can give a good chance of recovery.