Non-Hodgkin's lymphomas include tumorous malignant lymphoproliferative nature, with different developmental scenarios and an unforeseen reaction to medication.
A similar form of tumoral formations is characterized by a particular malignancy, because only a quarter of patients are cured of it. A distinctive feature of such lymphomas is the lack of proper response to the therapeutic measures traditionally used in the therapeutic process of Hodgkin's lymphoma.
What is non-Hodgkin's lymphoma?
Malignant species of lymphatic tumors begins formation in tissues of lymphoid origin, but in comparison with Hodgkin's pathology, the further behavior of such tumors can not be predicted by .
The photo shows the non-Hodgkin's lymphoma of the eye's orbit
. In general, the predictions depend on the specific histological version of non-Hodgkin's education, the adequacy of therapy and the stage of lymphatic tumors.
Case history
Non-Hodgkin's lymphoma has biological and morphological properties other than other malignancies, clinic and prognosis. Since the 70s of the last century, the tumor in medical circles has been officially called non-Hodgkin's or malignant.
Epidemiology
About 25 thousand cases of lymphoma are detected and officially diagnosed among Russians annually, which is only 4% of the total number of pathologies of cancer origin.
Most patients show non-Hodgkin's lymphoma, and only 12% suffer from Hodgkin's lymphoma.
Reasons for
The predominant number of such cancers is formed from B cells, the source of the remaining non-Hodgkin's lymphomas are T cells, which are also called natural killers.
It is impossible to name the specific cause of lymphosarcoma formation, we can only identify a number of specific factors that contribute to the formation and development of the pathological process. These include:
- Defects of a viral origin such as hepatitis or Epstein-Barr, the immunodeficiency virus , etc.;
- Helicobacter pylori , which is often blamed for the development of gastric ulcers, can also provoke non-Hodgkin's lymphoma, localized in the stomach tissues;
- Elderly and obese , immunodeficiencies of various etiologies also contribute to the formation of lymphosarcoma;
- Transplantation of any organs, chemotherapy or radiation exposure e in the treatment of oncological pathologies;
- Effect of carcinogens , such as herbicides, insecticides, benzenes;
- Autoimmune thyroiditis often leads to the formation of thyroid lymphoma.
Symptoms of
The main symptoms of non-Hodgkin's lymphoma is a typical increase in the size of the lymph nodes, which brings painful sensations. Similar manifestations are observed mainly in the inguinal, axillary, or cervical lymph nodes.
There are other signs of lymphosarcoma:
- Weight loss, down to exhaustion;
- Chronic fatigue;
- Overnight hyperdrive;
- Itching sensation on the entire surface of the body;
- Fever;
- Symptoms of anemia.
Types of
The lymphatic system resists infectious agents with three different types of lymphocyte cell structures: B-, T-cells and NK cells( they are also called natural killers).
B-cell tumors
B-cell lymphoma is characterized by high malignancy and rapid extranodal spread. Treatment is effective if it is initiated at the initial stages of the pathology.
In general, B-cell lymphosarcoma are divided into:
- Large-cell - when there is a characteristic increase in the cervical or axillary lymph nodes;
- Follicular - when persistent hyperthermia is observed and the inguinal, axillary and cervical lymph nodes swell, which causes intense soreness;
- Diffuse large cell B-cell lymphomas - characterized by the formation of specific ulcers and plaque-like rashes on the surface of the skin;
- Lymphosarcomas of the marginal zone - tumors, accompanied by a special soreness at the site of localization, can be hidden, prefers the abdominal cavity.
T- and NK
T / NK-cell lymphomas are considered by specialists as aggressive lymphosarcomas, accounts for about 12% of clinical cases among the total number of diagnosed non-Hodgkin's lymphomas .
For mature T / NK-cell lymphosarcomas, the prognosis of a five-year survival rate is about one-third of the total number of patients.
T-cell
T-cell forms of lymphosarcoma are most common in men, more often affect lymph nodes and skin cell structures. There are such types of T-cell non-Hodgkin's lymphomas:
- T-lymphoblastic lymphoma;
- Peripheral lymphoma;
- T-cell angioimmunoblastic lymphoma;
- Cutaneous lymphoma.
Classification of
Non-Hodgkin's lymphomas are classified according to several parameters:
- On the rate of progression, non-Hodgkin's lymphomas are:
- Indoleent ( lymphoplasmocytic lymphoma, etc.) - characterized by slow and favorable development;
- Aggressive ;
- Highly aggressive - have the most unfavorable prognosis and usually end up lethal;
- In accordance with the site of localization, lymphosarcomas are divided into:
- Nodal - when the tumor forms in the lymph nodes;
- Extranodal - when the lymphosarcoma develops in some other organ;
- Depending on the cytological structure of lymphomas, there are:
- Small-celled;
- Large cell;
- According to the type of histology, there are:
- Lymphosarcomas;
- Immunoblastoma;
- T-cell lymphoblastoma;
- Mushroomed mycosis;
- Reticulosarcomas;
- Nodular lymphosarcomas;
- Follicular lymphomas;
- Primary nervous system lymphomas;
- Large cell diffuse lymphosarcoma;
- Cutaneous lymphomas;
- Burkitt's lymphomas, etc.
Lymphoblastic
For lymphoblastic lymphoma, the formation of large cancers in the abdominal region is typical.
Usually, pathology develops secretly with an erased or absent symptomatology, because it is more often found at relatively late stages of development.
Therefore, patients with a similar diagnosis in 9 out of 10 cases get to the doctor when the medicine can not help them anymore.
A similar form of non-Hodgkin's lymphoma is characterized by active and extensive metastasis, which leads to intra-organic lesions of liver, kidney, spleen, spinal cord, ovaries, etc. The thermal stage of lymphoblastic lymphoma is often accompanied by a nervous system paralysis, which invariably entails fatal consequences.
Lymphocytic
Lymphocytic lymphomas are characterized by painless symptoms accompanied by generalized or local swelling of the lymph nodes. Such lymphomas consist of finally matured B-lymphocyte cells. Pathology is characteristic of elderly patients and representatives of the middle age group.
Usually, when diagnosing a similar lymphoma, almost all patients have a bone marrow injury, and the tumor itself is in 4 stages of development.
Characteristic signs of the tumor are an increase in the spleen and liver, the presence of gastrointestinal lesions. Already at the initial stages of the tumor process, pulmonary, punctate lesions and other parenchymal foci may occur.
Intestinal lymphoma
Among non-Hodgkin's lymphomas of extranodal nature, the most common non-Hodgkin's tumors are the GIT system. Usually, this localization of the tumor process is secondary, resulting from the metastasis of lymphoma from the spleen and other internal structures. For lymphoma of the intestine, the symptoms are:
- The presence of dyspeptic symptoms;
- Painful sensations in the abdomen;
- Enlargement of the spleen;
- Flatulence;
- Signs of intestinal obstruction;
- Nauseous urge;
- Blood masses may be found in feces;
- Loss of appetite.
A feature of this type of lymphoma is its cytological origin. Typically, such tumors are formed from B-cell structures. Such tumors develop mainly on the background of Crohn's disease, HIV, protein deficiency in the blood.
NHL spleen
Lymphoma of the spleen of the non-Hodgkin variety is found mainly in the elderly. Tumor process usually begins in the marginal area of the spleen.
At first the pathology develops asymptomatically, but with the progression of the tumor process there are such symptoms of lymphoma of the spleen:
- Weight Loss;
- Feeling of heaviness in the zone of the right hypochondrium;
- Hyperbolism at night;
- Anemia;
- Fast saturation even after absorption of a small portion of food, which is due to the compression effect of the tumor on the stomach;
- Frequent hyperthermia, especially in the evening and night.
When the tumor starts to germinate into neighboring tissues, pain symptoms will appear. At the later stages of the disease, the spleen becomes dangerously large, which is the most characteristic sign of pathology.
Gradually, the cancer process encompasses bone and cerebral structures, which is determined during diagnostic tests.
Stages of the disease and prognosis of
If the severity of malignancy in non-Hodgkin's lymphomas is three, high, low and intermediate, the developmental stages are four:
- The initial stage of is characterized by a single lymph node or intraorganic parenchymal lesion that does not have a characteristic external symptomatology;
- In 2 stages of , several lymph node structures are affected simultaneously in the patients or extranodal lesion of several organs is developed, but only localized on one side with respect to the diaphragm. Symptoms may be partially absent;
- The third stage involves the presence of non-Hodgkin's lymphoma located on both sides of the diaphragm, localized in the thoracic region and extending into the peritoneal region;
- The terminal ( 4) stage of non-Hodgkin's lymphoma is characterized by a severe condition and a prognosis, in which the initial location of the tumor process is absolutely irrelevant, because the cancer cells have already penetrated into the nervous system structures and bone marrow, and involved bone marrow skeleton in oncopherology.
Diagnosis
Diagnosis of non-Hodgkin's lymphoma is managed by oncohematologists, who prescribe the necessary procedures:
- Lymph node tissue biopsy;
- Thoracoscopic examination;
- Bone puncture;
- Laparoscopy;
- ultrasound;
- Radiography; A
- MRI or CT;
- Lymphoscintigraphy, etc.
Treatment of
Therapeutic treatments for non-Hodgkin's lymphoma are based on the use of radiation therapy, chemotherapy or surgery.
Surgical operation is used if the cancer lesion is of an isolated-localized nature. Irradiation treatment is effective when non-Hodgkin's lymphoma is characterized by a low malignancy and is of a localized nature.
Sometimes radiation therapy is used when the use of chemotherapeutic treatment is impossible or contraindicated.
Although most often the main method of treating lymphomas is polychemotherapy. Often, this technique is used in conjunction with irradiation, although it is also effective as an independent treatment. Such a combination of different techniques helps to achieve a more stable and prolonged remission period. Sometimes in the treatment process include hormonal treatment.
Alternatively, immunotherapy with interferon preparations, bone marrow transplantation, monoclonal antibody therapy, and the use of stem cells are often used.
Today, effective treatment regimens have been developed, based on the integrated use of medication, targeted drugs, radiation, etc. And as a result of a multi-chemotherapy approach based on the use of several medications, it is possible to successfully cope with abnormally developed lymphocytes.
How many live with NHL
In general, the prognosis of lymphatic formations of non-Hodgkin's lymphoma is determined by a peculiar tumor scale, where one bad point is awarded for each adverse trait, and then all points are summed up.
- When estimating 0-2 points, the outlook is favorable;
- 2-3 points - undefined;3-5 points - negative forecast.
Usually a favorable prognosis is more typical for B-cell lymphocytes, which can not be confirmed with the T-cell origin of education. Significantly aggravate the forecasting of late stages, high rates of malignancy, elderly age and some types of tumor formations.
Video on the causes of lymphoma, types and stages: