Lymphoma is a malignant tumor originating from the lymphatic hematopoietic system, mainly characterized by painless lymphadenopathy, hepatosplenomegaly, and involvement of various tissues and organs throughout the body, accompanied by systemic symptoms such as fever, night sweats, weight loss, and itching. This disease can occur at any age.
According to tumor cells, it is divided into two types: non Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL). The pathological features of Hodgkin lymphoma include lymphocytes, eosinophils, plasma cells, and specific Reed Steinberg cells in the tumor tissue. HL is classified into nodular lymphocyte rich type and classical type according to pathological type, the latter including lymphocyte dominant type, nodular sclerosis type, mixed cell type, and lymphocyte depletion type. The incidence rate of NHL is far higher than that of HL. It is the sum of a group of independent diseases with strong heterogeneity. Pathologically, it is mainly lymphocytes, histiocytes or reticular cells with different degrees of differentiation. According to the natural course of NHL, it can be classified into three major clinical types, namely, highly aggressive, aggressive and inert lymphoma. According to the different origins of lymphocytes, they can be divided into B-cell, T-cell, and NK cell lymphomas.
1、 Cause
The cause is unclear. It is generally believed that it may be related to genetic mutations, as well as viral and other pathogen infections, radiation, chemical drugs, and combined autoimmune diseases.
2、 Local manifestations
The compression and infiltration of lymphoma masses in different parts can cause different local manifestations. If it occurs in the nasal cavity, it can cause symptoms such as nasal congestion and bloody nose. Mediastinal masses may have symptoms such as suffocation and compression of the superior vena cava. Pulmonary infiltration can cause coughing, suffocation, coughing up blood, etc. Different parts can cause different symptoms.
3、 Systemic manifestations include: Malignant lymphoma may present with systemic symptoms such as fever, itching, night sweats, and weight loss before or at the same time as lymph node enlargement.
Immune and hematological manifestations: When diagnosing malignant lymphoma, 10% to 20% may have anemia, some patients may have increased white blood cell count and platelets, rapid erythrocyte sedimentation rate, and some patients may have leukemia like reactions with significantly increased neutrophils. The elevation of lactate dehydrogenase is related to tumor burden. Some patients, especially those in advanced stages, exhibit immune dysfunction. In B-cell NHL, varying amounts of monoclonal immunoglobulin can be detected in the serum of some patients.
Skin lesions: Patients with malignant lymphoma may have a series of non-specific skin manifestations, with polymorphic skin lesions such as erythema, blisters, erosions, etc. Patients with advanced malignant lymphoma have a low immune status, and skin infections often persist in ulceration and exudation, forming systemic scattered skin thickening and shedding.
4、 Diagnosis
Perform pathological section examination (biopsy) of lymph nodes or other affected tissues or organs to confirm the diagnosis.
5、 Treatment methods
Lymphoma has high heterogeneity, and treatment effects vary greatly. Lymphoma of different pathological types and stages have significant differences in treatment intensity and prognosis. The treatment methods for lymphoma mainly include the following, but specific patients should be analyzed based on their actual situation.
Radiation therapy: Some types of lymphoma can be treated with radiation therapy in the early stages. Radiotherapy can also be used for consolidation therapy after chemotherapy and as an adjuvant therapy during transplantation.
Immunochemotherapy: Lymphoma chemotherapy often uses combination chemotherapy, which can be combined with targeted therapy drugs and biologics. In recent years, the chemotherapy regimen for lymphoma has been greatly improved, and the survival time of many types of lymphoma has been greatly enhanced.
Bone marrow transplantation: For medium to high-risk patients who can tolerate high-dose chemotherapy, autologous hematopoietic stem cell transplantation may be considered. Some patients also need to consider allogeneic hematopoietic stem cell transplantation.
Cellular immunotherapy and new drugs: Car-T cell therapy has achieved good results in clinical practice. Multiple new small molecule drugs have shown good efficacy in the treatment of lymphoma.
6、 Lymphoma has a strong curative effect, and most patients can be cured. This requires us to build confidence, actively cooperate with doctors for treatment, be more self disciplined and optimistic in life, and be able to overcome the disease.