lymphoma
Introduction
Introduction to lymphoma Lymphoma is a malignant tumor originating from lymph nodes or lymphoid tissues. It is clinically characterized by painless and progressive lymphadenopathy. The disease can occur at any age, but the peak age of onset is 31 to 40 years old, and the peak of non-Hodgkin's lymphoma is slightly advanced. The ratio of male to female is: 2~3:1. The cause of the disease 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 autoimmune diseases. Malignant lymphoma is a large class of tumors with considerable heterogeneity. Although it occurs in lymph nodes, due to the distribution of lymphatic system, lymphoma is a systemic disease that can invade almost any tissue and organ in the body. Therefore, the clinical manifestations of malignant lymphoma have certain common characteristics, and there are great differences according to different pathological types, affected sites and ranges. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: bacterial infection
Cause
Lymphoma cause
Cause
Only two viruses in humans are clearly associated with lymphoma, namely Epstein-Barr virus and human T-cell lymphoma/leukemia virus (HTLV-1), which are classified into Hodgkin's disease (HD) and non-Hodgkin's lymphoma based on their pathological features. (NHL).
Prevention
Lymphoma prevention
Because the exact cause of malignant lymphoma is still unclear, 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 for high-risk groups may help. In order to delay or block the occurrence of the disease, if a prophylactic or therapeutic measure is given to patients who have achieved complete remission after treatment, it may prolong the remission period or even prevent their recurrence. Therefore, attention should be paid to the prevention and treatment of lymphoma. Several aspects.
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.
Complication
Lymphoma complications Complications bacterial infection
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.
Symptom
Lymphoma Symptoms Common Symptoms Loss of Powerless Lymphs Out of Appetite, Abdominal Pain, Night Sweat, Abdominal, Abdominal Tumors, Hard Lymph Nodes, Congestion, Dysphagia
First, lymph node and lymphoid tissue onset
Superficial lymph node onset is the majority, and HD is more than NHL, the affected lymph nodes are the most in the neck, followed by the armpit, groin, generally painless, progressive enlargement, moderate hardness, early activity, late Adhesion and multiple enlarged lymph nodes merge into a block. 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, but also can compress the trachea, esophagus, recurrent laryngeal nerve and corresponding dyspnea, swallowing difficulties and hoarseness Other symptoms, mediastinal NHL complicated with lymphosarcoma cell leukemia are more common, while young women with mediastinal first-onset HD are mostly nodular sclerosis, often unsatisfied with 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 pharyngeal lymphatic ring is more common in NHL, and often accompanied by underarm 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 be affected, which is 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 chronic Diarrhea can also occur with steatorrhea and can also cause intestinal obstruction.
Third, systemic symptoms
Often there is general weakness, weight loss, loss of appetite, night sweats and irregular fever, a small number of HD can have periodic fever.
Examine
Lymphoma examination
First, the blood.
There is no special in the early stage. Anemia is seen in the late stage or combined with hemolytic anemia. Leukocytes are normal except for bone marrow involvement. Eosinophilia is common in HD.
Second, the bone marrow.
Before the bone marrow is not invaded by lymphoma, there is generally no abnormality. It is valuable to find a Reed-sternberg cell in the bone marrow smear of HD.
Third, biochemical examination.
Elevated erythrocyte sedimentation rate indicates that the disease is active; serum copper and ferritin are elevated when the disease progresses, and the remission period is decreased; zinc is opposite, sputum phosphatase may have liver or bone involvement, and liver involvement may be accompanied by 5- Increased nucleotidase, hypercalcemia suggests bone invasion.
Fourth, immunological abnormalities.
HD patients have reduced reactivity with tuberculin and other stimuli, and lymphocyte transformation rate is reduced in vitro, the extent of which is related to the progression of the disease.
Sixth, living tissue examination.
In order to confirm the indispensable examination method for diagnosis, the lymph nodes of the lower neck or ankle should generally be selected.
Seven, mediastinoscopy.
The mediastinoscope can be inserted into the mediastinum through the pleural for biopsy, which is relatively simple and safe.
Eight, CT, nuclear magnetic resonance and sound image examination.
Intrathoracic, retroperitoneal, mesenteric lymph node lesions and hepatosplenic lesions can be found.
Nine, laparotomy.
It can be confirmed whether the spleen, liver and intra-abdominal lymph nodes are involved. It is necessary to determine the irradiation field by radiotherapy (pathological staging). For example, simultaneous splenectomy can also avoid damage to adjacent tissues and organs caused by radiotherapy in the spleen area.
Diagnosis
Lymphoma diagnosis and differentiation
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, skin lesions of the lymph glands, and from the patient's clinical course, the duration of lymphadenopathy, size, hardness changes and 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.
