Non-Hodgkin's lymphoma is one of the most common types of cancer, which affects hundreds of people around the world. To understand how to recognize a disease and treat it, you should first understand what it is.
Non-Hodgkin's lymphoma is a collective concept, it denotes a whole group of oncological diseases in which malignant cells affect lymphoid tissues. In other words, all types of existing lymphomas, with the exception of Hodgkin's lymphoma, belong to this category. A distinctive characteristic of the latter is the presence of altered and multinucleated cells in the affected tissues.
Features of the disease
Non-Hodgkin lymphomas include about 80 different diseases that differ in aggressiveness and localization.
Among patients, approximately the same number of men and women, although in some varieties of the disease, dependence on gender is still traced. As for the age categories, older people have a slightly higher risk of developing oncology. Meanwhile, the disease is often diagnosed in children.
Since non-Hodgkin lymphomas are not one, but many diseases united by one characteristic, several forms and varieties should be considered at once. Such features as the duration and intensity of the course of therapy, the prognosis of treatment and possible concomitant diseases will directly depend on the characteristics of the disease.
B-cell form
The most common type of classification can be considered one that is adopted by the World Health Organization. It is based on the cellular composition of oncology. There are 2 large categories: B-cell and T-cell lymphomas. Each of them should be mentioned in more detail.
What is B-cell non-Hodgkin lymphoma? This is a malignant disease of lymphoid tissue in which B-lymphocytes are affected. Their main task is to generate antibodies, therefore, they are involved in the immune humoral response. Here you can distinguish several types of lymphomas:
- Nodal and splenic. These species are characterized by slow growth.
- Burkitt's lymphoma. According to medical statistics, it is men who are more than 30 years old who suffer from this form of the disease. Doctors are in no hurry to give favorable prognoses: with non-Hodgkin Burkitt's lymphoma, patients' survival for 5 years is only 50%.
- Follicular. In most cases, this cancer develops rather slowly, but can go into a diffuse form, which is characterized by rapid development.
- Lymphoma MALT marginal zone. This form extends to the stomach and increases at a slow pace. With all this treatment, it can be extremely difficult.
- Primary mediastinal (or mediastinal). This disease is most often affected by women, 5-year survival after treatment is 50%.
- Lymphocentric small cell. Development is slow, but the cure rate is quite low.
- Primary CNS lymphoma.
- Large-cell diffuse non-Hodgkin's lymphoma. This variety refers to rapidly progressive cancer.
Varieties of Non-Hodgkin T Cell Lymphoma
By T-cell lymphoma is understood a malignant disease during which an uncontrolled growth of T-lymphocytes occurs. Their production occurs in the thymus and they support the cellular (or barrier) immunity of the skin and mucous membrane.
- Lymphoblastic form. Most patients with this diagnosis are young men under 40 years old. A favorable treatment outcome is predicted only if the bone marrow is not involved in the process.
- Large cell non-Hodgkin lymphoma anaplastic. Most often, this disease occurs in young people, but with timely diagnosis, it can be treated well.
- Extranodal NHL. This form of the disease affects T-killers, its aggressiveness can vary.
- Cesari's syndrome (or cutaneous). This form is often called fungal mycosis and is formed mainly in older people (50-60 years).
- Lymphoma with enteropathy. It is noticed that this kind of cancer is characteristic of people with gluten intolerance. It is characterized as extremely aggressive and difficult to treat.
- Angioimmunoblastic. This type is difficult to treat, and therefore doctors do not make favorable prognoses for life.
- Non-Hodgkin's lymphoma is panniculite-like. Such oncology develops in the subcutaneous fat. A characteristic feature of this form is low sensitivity to chemotherapy, which makes treatment ineffective.
Types of aggressiveness
Another option for the classification of Neo-Hag lymphomas is the separation by process aggressiveness. This is very convenient for doctors, as it allows you to optimally choose the course of treatment and observation tactics.
- Aggressive NHL. This type of cancer includes rapid development, active spread and, in some cases, resistance to chemotherapy. The prognosis of treatment can be done here, relying mainly on the stage of oncology, at which non-Hodgkin's lymphoma was revealed. Relapses of these forms of the disease occur quite often.
- Indolent. Unlike the previous form, indolent lymphoma slowly grows and metastasizes. Sometimes cancers of this form may not manifest themselves for years (that is, not cause a person to have painful sensations and other symptoms of pathology). In general, with timely treatment of non-Hodgkin's lymphoma, the prognosis here is quite good.
- Intermediate. These types of diseases begin to develop slowly, but over time they increase the pace, more inclined to aggressive forms.
Development reasons
Until now, doctors have not been able to accurately identify the factors provoking the development of non-Hodgkin lymphoma of any type. However, the following point should be taken into account here. According to its origin, the disease is divided into:
- primary - oncology primarily affects lymphoid tissues (an independent focus), and then gives metastases to other organs;
- secondary - in this case, this disease appears in the form of metastases, therefore, the cause can be called the presence of malignant cells in the body.
If we talk about the causes of primary lymphoma, then in medicine several factors are distinguished:
- Infections in the body. Hepatitis C virus, HIV infection or human herpes virus (type 8) can provoke the appearance of abnormal cells. Epstein-Barr virus often causes Burkitt's lymphoma or a follicular form of the disease. In people exposed to the Helicobacter pylori bacteria (it provokes a stomach ulcer), the risk of developing MALT lymphoma increases markedly.
- Some genetic diseases. Among them are: ataxia-telangiectasia syndrome, Chediak-Higashi, as well as Klinefelter syndrome.
- Ionized radiation at any dose.
- The effect of benzenes, insecticides, herbicides and many other mutagens or chemical carcinogens.
- Autoimmune diseases. A typical example is rheumatoid arthritis or systemic lupus erythematosus.
- Long-term use of various immunosuppressants.
- Age-related changes in body tissues. With age, the risk of developing non-Hodgkin lymphoma increases markedly. A doctor's recommendation to reduce this risk is to undergo a regular physical examination. This will make it possible to identify the disease at an early stage and start treatment in a timely manner.
- Overweight.
It is worth noting that the presence of one or several factors from the above list does not at all mean the indispensable development of cancer. They only increase the risk of it.
Stage lymphoma
The entire period of the oncological disease is usually divided into 4 stages (stages), and lymphoma in this case is no exception.
1st stage. Non-Hodgkin lymphoma at this stage is represented by the defeat of one lymph node or the appearance of one independent focus. Local manifestations have not yet been observed.
2 stage. This stage includes a malignant neoplasm that has spread to two or more lymph nodes and also has gone beyond the lymph nodes, but is located only on one side of the diaphragm. So, a tumor can spread either only in the abdominal cavity or only in the chest.
3 stage. The next stage of development is the presence of foci on both sides of the diaphragm.
4 stage. This stage of lymphoma development is considered the last. At this time, the lesion focus extends to the bone marrow, skeleton and central nervous system. This stage is not in vain considered the last and most difficult for the patient. One of the manifestations is constant severe pain, which can no longer be stopped with the help of conventional analgesics.
Clinical picture
Symptoms of non-Hodgkin lymphoma are very diverse and depend on the form of the disease and localization. A common sign of malignant damage to lymphoid tissues is an increase in lymph nodes (common or local) and pain in this area. This condition is accompanied by symptoms of damage to a particular organ or signs of general intoxication of the body.
T-cell forms often manifest themselves as follows:
- enlarged lymph nodes ;
- there is an increase in the spleen and a violation of its work;
- lungs and skin are damaged.
There are several symptoms that are characteristic of non-Hodgkin lymphomas, but are absent in Hodgkin's lymphoma. Among them:
- damage to the lymph nodes of the mediastinum (the space of the chest cavity), there is swelling of the face and hyperemia (excessive blood flow to a certain part of the body);
- if malignant cells develop in the thymus, frequent shortness of breath and coughing occur;
- an increase in pelvic or retroperitoneal lymph nodes provokes renal failure or hydronephrosis (gradual atrophy of the kidneys).
However, it is impossible not to note the symptoms that accompany any cancer. With non-Hodgkin's lymphoma, they begin to appear at the 2 stages of the disease and gradually become brighter:
- a sharp decrease in working capacity, the appearance of weakness and fatigue;
- lack of appetite;
- weight loss;
- the appearance of irritability, apathy;
- constant strong sweating mainly at night;
- signs of anemia.
Diagnosis of lymphomas
The increase in lymph nodes indicates not only cancer, but also the presence of infection in the human body. If an infectious component is suspected, the patient is prescribed a drug designed to eliminate the focus. After some time, the inspection is repeated. If no improvement is observed, a number of laboratory tests and instrumental diagnostic procedures are prescribed. The doctor will choose the principles and methods of treatment for non-Hodgkin lymphoma based on the examination data.
- Blood tests to determine the condition of the body and search for pathology.
- Chest x-ray. According to the results of this procedure, the state of the lymph nodes of the chest is revealed.
- CT - computed tomography provides information about the condition of all lymph nodes and the possible presence of metastases in other organs.
- MRI Using magnetic resonance imaging, doctors determine the current state of the spinal cord and brain and the possible presence of malignant cells in them.
- PAT. Under this term is positron emission tomography diagnostic procedure. During it, a special substance is injected into the patient's vein, which helps to identify all cancer foci in the soft tissues.
- Gallium scan. This method effectively complements PET, as it reveals malignant cells in the bone tissue.
- Ultrasound gives information about the condition of internal organs.
- Biopsy. This diagnosis is the extraction of tumor cells and their further investigation in the laboratory. A biopsy can be carried out in different ways, therefore, excision, excision, puncture, spinal puncture and bone marrow aspiration are distinguished.
Treatment
In each case, the course of treatment is prescribed taking into account the results of the diagnosis. Some forms of lymphomas do not need treatment at first (this includes types of tumors with slow development and the absence of pronounced symptoms).
Chemotherapy. With non-Hodgkin's lymphoma, several courses of chemotherapy are prescribed. The therapeutic effect is achieved by the use of strong antitumor drugs, which are designed to block the growth and reproduction of pathological cells. The interval between courses is about 2 or 4 weeks. Dosage form: intravenous solutions or tablets.
Radiation therapy. The essence of treatment is reduced to the impact on the human body of ionized rays, which are fatal to a cancerous tumor. Such treatment of non-Hodgkin lymphoma in some cases is the main, but most often it is combined with chemotherapy.
Surgery. In the case of lymphomas, surgery is rarely used, due to its low efficiency. Its purpose makes sense only in the case of a limited spread of the tumor.
Immunotherapy. Treatment of non-Hodgkin lymphoma is often carried out with drugs, which contain interferon, monoclonal antibodies and chemotherapeutic agents. The essence of this effect is to deliver to the body those substances that the human body produces under ordinary conditions on its own. Such medications significantly reduce the size of the tumor, slow its growth and dramatically increase the human immunity to fight the disease.
Bone marrow transplantation. This treatment method is addressed when other treatments fail. Before transplantation, the patient undergoes high-dose radiation or chemotherapy. Subsequent transplantation is required because high doses of radiation or drugs kill not only cancer cells, but also healthy tissue. It is for the restoration of bone marrow that transplantation is prescribed.
Important! Self-medication with this diagnosis is strictly prohibited! Lymphomas of any type and nature are not treated with folk remedies, for this a professional approach and a set of measures to eliminate the tumor are needed.
Forecast
As medical statistics and medical reviews show, non-Hodgkin's lymphoma is effectively treated at stages 1 and 2 of development. In this case, patient survival over the next 5 years is about 80%. This is a fairly high indicator given the severity of the disease. In the case of treatment of patients with stage 3 oncology, survival is lower, since the tumor has time to spread far beyond the focus, and it is much more difficult to cope with it. At stage 4, the survival rate is low - only 20%.
Doctors emphasize: even constant development and research in this area does not allow the treatment of cancer with 100% effectiveness. That is why a lot depends on the patient himself. Early detection of the symptoms of the disease and going to the clinic significantly increase the chance of a full recovery.