Lymphoma is a group of blood cancers that develop from lymphocytes (a type of white blood cell). This name often refers only to cancer versions of all such tumors. Signs and symptoms may include enlarged lymph nodes, fever, sweat droplets, unwanted weight loss, itching, and constant fatigue. Enlarged lymph nodes are usually painless. Sweat is most common at night.
There are dozens of lymphoma subtypes. The two main categories of lymphoma are Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL). The World Health Organization (WHO) includes two other categories as a type of lymphoma: multiple myeloma and immunoproliferative diseases. About 90% of lymphomas are non-Hodgkin's lymphoma. Lymphoma and leukemia are part of a wider tumor group of hematopoietic and lymphoid tissues.
Risk factors for Hodgkin's lymphoma include infection with Epstein-Barr virus and family history of disease. Risk factors for common types of non-Hodgkin's lymphoma include autoimmune diseases, HIV/AIDS, human T-lymphotrophic virus infections, immunosuppressant drugs, and some pesticides. Eating large amounts of red meat and smoking tobacco may also increase the risk. Diagnosis, if enlarged lymph nodes are present, usually with lymph node biopsy. Blood tests, urine, and bone marrow can also be useful in diagnosis. Medical imaging can then be done to determine whether and where the cancer has spread. Lymphoma most commonly spreads to the lungs, liver, and brain.
Treatment may involve one or more of the following: chemotherapy, radiation therapy, targeted therapy, and surgery. In some non-Hodgkin's lymphoma, an increase in the amount of protein produced by the lymphoma cells causes the blood to become so thick that plasmapheresis is performed to remove the protein. Watch waiting may be appropriate for a particular type. The result depends on subtypes with some that can be cured and the treatment prolongs the greatest survival. The five-year survival rate in the United States for all Hodgkin's lymphoma subtypes is 85%, whereas for non-Hodgkin's lymphoma is 69%. Around the world, lymphoma develops in 566,000 people by 2012 and causes 305,000 deaths. They make up 3-4% of all cancers, making them the seventh most common form. In children, they are the third most common cancer. They appear more often in developed countries than in the developing world.
Video Lymphoma
Signs and symptoms
Lymphomas may present with certain non-specific symptoms; if symptoms persist, evaluation to determine the cause, including possible lymphoma, should be done.
- Lymphadenopathy or swollen lymph nodes, is a major presentation of lymphoma.
- Symptoms B (systemic symptoms) - may be associated with Hodgkin's lymphoma and non-Hodgkin's lymphoma. They consist of:
- Fever
- Overnight
- Weight
- Other symptoms:
- Loss of appetite or anorexia
- Fatigue
- Respiratory distress or dyspnea
- Itch
Maps Lymphoma
Diagnosis
Lymphoma is definitively diagnosed by a lymph node biopsy, meaning partial or total excision of the lymph nodes examined under a microscope. This examination shows a histopathological picture that may indicate lymphoma. Once the lymphoma is diagnosed, various tests can be performed to look for specific traits that have characteristics of different types of lymphoma. These include:
- Immunophenotyping
- Flow cytometry
- Fluorescence test in situ hybridization
Classification
Lymphoma in the strictest sense is the neoplasm of the lymphatic tissue ( lymphocytes - <-> --oma ). The major classes are malignant neoplasms (ie, cancer) lymphocytes, a type of white blood cells possessed by lymph nodes and blood and cover both. Thus, lymphoma and leukemia are tumors of hematopoietic and lymphoid tissue, and as lympho- lifective disorders, lymphoma and lymphoid leukemia are closely related, to the extent that some of them are entities of unity disease that can be called by good name (eg adult Leukemia cells/lymphoma).
Several classification systems exist for lymphomas, which use histology and other findings to divide lymphomas into different categories. Classification of lymphoma can affect treatment and prognosis. Classification systems generally classify lymphomas according to:
- What is Hodgkin's lymphoma
- Whether the replicating cell is a T cell or B cell
- The site from which it appears
Lymphomas can also spread to the central nervous system, often around the brain in the meninges, known as lymphematous meningitis (LM).
Hodgkin's lymphoma
Hodgkin lymphoma accounts for about 15% of lymphomas. This differs from other forms of lymphoma in its prognosis and some pathological characteristics. The division of Hodgkin and non-Hodgkin lymphoma is used in some older classification systems. Hodgkin's lymphoma is characterized by a cell type called Reed-Sternberg cells.
Non-Hodgkin's lymphoma
Non-Hodgkin's lymphoma, defined as all lymphoma except Hodgkin's lymphoma, is more common than Hodgkin's lymphoma. Various lymphomas are in this class, and the cause, the type of cells involved, and the prognosis varies by species. The incidence of non-Hodgkin's lymphoma increases with age. This is subdivided into subtypes.
WHO Classification
The WHO classification, published in 2001 and updated in 2008, is based on a foundation laid in the "revised European-Revised Lymphoma Classification" (REAL). This system classifies lymphoma by cell type (ie the most normal tumor-like cell type) and defines phenotypic, molecular or cytogenetic characteristics. The five groups are shown in the table. Hodgkin's lymphoma is considered separately within the WHO and earlier classifications, although recognized as tumors, although abnormal mature B-cell lymphocytes.
Of the many forms of lymphoma, some are categorized as indolent (eg small lymphocytic lymphoma), compatible with longevity even without treatment, while other forms are aggressive (eg Burkitt's lymphoma), leading to rapid deterioration and death. However, most aggressive lymphomas respond well to treatment and can be cured. The prognosis, therefore, depends on the correct diagnosis and classification of the disease, established after a biopsy examination by a pathologist (usually a hematologist).
Previous classification
Several previous classifications have been used, including Rappaport 1956, Lennert/Kiel 1974, BNLI, Working formulation (1982), and REAL (1994).
The 1982 Working Formulation is a classification of non-Hodgkin's lymphoma. This excludes Hodgkin's lymphoma and divides the remaining lymphomas into four classes (low, medium, high, and various) associated with prognosis, with subdivisions further on the size and shape of affected cells. This pure histologic classification does not include information about cell surface markers, or genetics, and makes no distinction between T cell lymphoma and B-cell lymphoma. It was widely accepted at the time of publication, but is now obsolete. It is still used by some cancer agents for compilation of lymphoma statistics and comparison of historical rates.
In 1994, the Revised European-American Lymphoma (REAL) classification implements immunophenotypic and genetic features in identifying different clinicopathologic entities among all lymphomas except Hodgkin's lymphoma. For coding purposes, ICD-O (code 9590-9999) and ICD-10 (C81-C96 codes) are available.
Staging
After diagnosis and before treatment, cancer is staged. This refers to determining whether the cancer has spread, and if so, whether local or to a distant place. Staging is reported as a value between I (limited) and IV (spread). Staging is done because the stage of cancer affects the prognosis and its treatment.
The Ann Arbor staging system is routinely used for HL and NHL staging. In this staging system, I represent localized disease in the lymph node group, II indicates the presence of lymphomas in two or more groups of lymph nodes, III indicates the spread of lymphoma to group lymph nodes on both sides of the diaphragm, and IV shows spread to the tissues outside the lymphatic system. Different suffixes imply the involvement of different organs, eg S for the spleen and H for the liver. Extra-lymphatic involvement is expressed with the letter E. In addition, the presence of symptoms B or its absence is expressed by B and A, respectively. Symptom B is defined as the presence of one of three symptoms: Unintentional weight of 10% weight in the last 6 months, night sweats, and persistent fever of 38 ° C or more.
CT scans or PET scanning modalities are used to treat cancer. PET scans are recommended for avid FDG lymphoma, such as Hodgkins Lymphoma as a staging device that can even replace bone marrow biopsy. For other CT lymphoma examinations recommended for staging.
Poor age and performance status is also a poor prognostic factor.
Treatment
The prognosis and treatment differ for HL and between all different NHL forms, and also depending on tumor level, referring to how quickly the cancer replicates. Paradoxically, high-grade lymphomas are more easily treated and have a better prognosis: Burkitt's lymphoma, for example, is a high-grade tumor known to increase twice in a few days, and is highly responsive to treatment. Lymphoma can be cured if detected at an early stage with modern medicine.
Low-grade lymphoma
Many low-grade lymphomas remain indolent for years. Treatment in asymptomatic patients is often avoided. In the form of this lymphoma, such as follicular lymphoma, watchful waiting is often the initial action. This is done because the dangers and risks of treatment outweigh the benefits. If low-grade lymphomas become symptomatic, radiotherapy or chemotherapy is the treatment of choice; although they do not cure lymphoma, they can relieve symptoms, especially painful lymphadenopathy. Patients with this type of lymphoma can live almost normally, but the disease can not be cured. Some centers advocate the use of single agent rituximab in the treatment of follicular lymphoma rather than wait and watch approaches. Vigilant waiting is not a good strategy for all patients, as it causes significant disturbance and anxiety in some patients. It has been likened to hours and worry.
High-grade lymphoma
Treatment of some other types of more aggressive lymphomas can cause healing in most cases, but the prognosis for patients with poorer therapy responses is worse. Treatment for this type of lymphoma usually consists of aggressive chemotherapy, including CHOP or R-CHOP regimens. Some people are cured with first-line chemotherapy. Most recurrences occur within the first two years, and the risk of relapse drops significantly later. For people relapsing, high-dose chemotherapy followed by autologous stem cell transplantation is a proven approach.
Hodgkin's lymphoma
Hodgkin's lymphoma is usually treated with radiotherapy alone, as long as it is localized.
Advanced Hodgkin's disease requires systemic chemotherapy, sometimes combined with radiotherapy. The chemotherapy used includes the ABVD regimen, commonly used in the United States. Other regimens used in the management of Hodgkin's lymphoma include BEACOPP and Stanford V. There is considerable controversy regarding the use of ABVD or BEACOPP. In summary, both of these regimens are effective, but BEACOPP is associated with more toxicity. Surprisingly, a large number of people who relapse after ABVD can still be saved by stem cell transplantation.
Palliative care
Palliative care, special medical care focusing on symptoms, pain, and stress of serious illness, recommended by some national cancer treatment guidelines as advisory for curative care for people with lymphoma. It is used to treat the direct symptoms of lymphoma and many unwanted side effects arising from the treatment. Palliative care can be very helpful for children who develop lymphoma, helping children and their families cope with the physical and emotional symptoms of the disease. For this reason, palliative care is essential for patients who require bone marrow transplantation.
Prognosis
Epidemiology
Lymphoma is the most common form of hematologic malignancy, or "blood cancer", in developed countries.
Together, the lymphoma represents 5.3% of all cancers (excluding simple basal cells and squamous cell skin cancer) in the United States and 55.6% of all blood cancers.
According to the US National Institutes of Health, lymphoma accounts for about 5%, and Hodgkin's lymphoma typically accounts for less than 1% of all cancer cases in the United States.
Because the entire system is part of the immune system, patients with weakened immune systems such as from HIV infection or from certain drugs or medications also have a higher incidence of lymphoma.
History
Thomas Hodgkin published the first description of lymphoma in 1832, in particular a form named after him. Since then, many other forms of lymphoma have been described.
Research
Two types of lymphoma research are clinical or translation research and basic research. Clinical/translational studies focus on studying the disease in the prescribed manner and generally apply directly to the patient, such as testing a new drug in a patient. Studies may focus on effective ways of treatment, better ways to treat illness, improve patient quality of life, or proper care in forgiveness or after healing. Hundreds of clinical trials are being planned or performed at any given time.
Basic science studies study distant disease processes, such as seeing whether a suspected carcinogen can cause healthy cells to turn into lymphoma cells in the laboratory or how DNA changes inside the lymphoma cells as the disease progresses. The results of basic research studies are generally less immediately useful for patients with disease, but can improve scientists' understanding of lymphomas and form the basis for future care, more effectively.
Other animals
References
External links
- Lymphoma in Curlie (based on DMOZ)
Source of the article : Wikipedia
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