Is lymphoma cancer or not? Treatment of lymphoma folk remedies. Treatment of lung lymphoma in Russia, Israel and Germany. Surgical treatment of lymphoma

Pulmonary lymphoma is a leader among diseases in the field of pulmonology. The disease affects, as a rule, the older age group of the population, however, some varieties occur not only in young people, but also in very small patients.

Until now, doctors around the world are struggling to understand the true nature of the disease, to track down possible risk groups. On this moment the only official version is that pathology is provoked by gene mutations that occur in the human body.

Lymphoma is an oncological neoplasm that affects the tissues of the lymphatic system. Is different pronounced enlargement of the lymph nodes, rapidly affects the most important internal organs, concentrating in them abnormal accumulations of lymphocytes - the main component of the body's immune defense.

During illness by chaotic division affected blood cells, lymphoma can "settle" both in the lungs, bronchi, and in neighboring organs. This term covers several various groups tumors, with their symptoms, external manifestations and methods of treatment.

Causes

According to the dynamics of its development, lung lymphoma has many common signs and causes that provoke its appearance with similar pathologies of other organs. Therefore, the causes of the disease will be similar:

• Prolonged contact with carcinogens- fertilizers, pesticides, solvents used in hazardous production. A person constantly inhales toxic fumes, which, settling on the internal soft tissues of the lung, lead to the appearance of such a dangerous disease:
• failures in the autoimmune system- occur against the background of lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome;
• incorrect and too long cytostatic therapy, as well as the influence of radiation, radiation treatment, as a way to eliminate oncology of other parts of the body;
• taking immunosuppressant drugs and diseases associated with a sharp decrease in the body's defenses - HIV - infections, AIDS, viral hepatitis;
• transfer internal organs ;
• genetic and chromosomal abnormalities- the nature and relationship of which with the onset of a lung tumor has not yet been reliably studied;
• nicotine addiction- it has been proven that smoking can directly affect the development malignant neoplasms broncho-pulmonary system.

Kinds

IN medical practice the following classification of the disease is defined:

• Hodgkin's disease– five variants were identified that have a common specificity, the difference between which is determined only at the molecular microscopic level. Diagnosed by means of special genetic markers;

lymphosarcomas- B - and T - cellular. In the first case, there is a large percentage of cancers that multiply rapidly and chaotically. Positive dynamics from treatment is manifested in the early stages of diagnosis.

In the second case, the disease affects mainly the elderly and is extremely rare in children. In addition, men suffer from lung lymphosarcoma several times more often than women. The nature of this factor is also still inexplicable;

• secondary neoplasms in the lungs- appear as a result of the movement of cancer-affected cells to other body systems;
• plasmacytoma- is diagnosed very rarely, almost always patients are men. It is isolated from B-lymphocytes. The most common cause is an infection. A distinctive feature is the increase in not one node, but the whole group at once.

Clinical and morphological forms

Pulmonary lymphomas are diseases that combine knowledge and medical research in the fields of pulmonology, clinical oncology and hematology. According to the conclusions scientific works practicing specialized specialists, as well as the knowledge accumulated on this problem, the disease manifests itself in the following forms:

• knotty- characterized by accumulation in the lower pulmonary part of nodular formations - both single and multiple;
• peribronchial- the appearance of strands in the bronchial region, against the background of which interstitial pneumonia subsequently appears, the focal distribution of which is huge and can completely stop the whole lung;
• exudative- provokes the development of lobar pneumonia;
• miliary- accompanied by a multiple scattering of small focal nodules growing into the tissues of the lung.

Stages and symptoms

Based on laboratory tests and general examination of the patient, the doctor diagnoses the stage of the disease. This is necessary to select the optimal treatment regimen and understand what are the chances of a person for full recovery. Based on the size of the tumor, the rate of its spread, there are four stages of oncology:

• first- Pathology is concentrated only in a single lymph node. Less often - in several, but always in one area. Their organs are affected only by the lungs. The disease may have an incubation period of up to several years;
• second- lymphoma is localized further along the system, moving to the upper sector of the diaphragm. In addition to the lungs, others important organs not affected at this stage;
• third- the tumor moves to almost all the nodal connections of the system - the neck, groin, there is a high probability that the formation will spread to the bronchi and other neighboring organs;
• fourth- the lymphatic system has multiple focal lesions, metastases penetrate into the bone marrow, almost complete pulmonary insufficiency is observed. Dysfunction of the main organs begins.

A lot of useful information about the symptoms of lung cancer can be found in this video:

It is difficult to single out clear symptoms for each specific stage, since the nature of their manifestation is different for each and there are no clear boundaries here.

To have a complete clinical picture of accompanying signs, symbols indicating the presence of the following symptoms are added to the description of the stage of lymphoma:

• "A"- the patient is practically absent external manifestations diseases, no discomfort. Intoxication, weight loss, sweating, uncontrolled temperature changes are not observed;
• "IN"- appearance primary symptoms oncology of the lungs - the patient loses his appetite, quickly loses weight, night sweats and fever, difficult to correct;
• "E"- weakness, itching, sometimes nausea and vomiting, frequent coughing with blood, pain in the sternum, bronchial infections;
• "D"- soreness of the lymph nodes, shortness of breath, sharp pains in the lungs (as a rule, both organs are already affected at this stage). Metastatic lesion occurs gastric tract, thyroid gland, bone marrow - these are the systems that are affected by lung lymphoma.

Diagnostics

The main methods of diagnosing the disease are radiation studies. Initially, the patient is given biplanar chest x-ray.

If pathology is detected, for a more objective clinical picture, spiral computed tomography(SCT) of the lungs is a rapid step-by-step scanning technique. Done using a special ray tube, the procedure takes only half a minute, while giving a complete three-dimensional picture of the sternum cavity.

Computed tomography is also shown - the principle of diagnosing the condition of the lungs, based on a layered image of the organ. A fairly accurate method, determines the size of the tumor as reliably as possible.

In modern pulmonology and oncology, the presence of a neoplasm must have histological confirmation. For this purpose, the patient undergoes a transbronchial or transthoracic lung biopsy - for the cytological study of the material of the organ. The biopsy taken for research is studied at the chemical level.

Such an accurate diagnosis is necessary for the selection of the most effective methods of treatment.

Treatment

The main task in the treatment of lung lymphoma is to eliminate the tumor and prevent the release of metastases to neighboring organs.

With earlier diagnosis of the tumor, when the lymphoma is still isolated and the stage of the disease is not started, surgical intervention- the most acceptable option. A lobectomy is performed - the segment of the lung affected by oncology is cut off.

If the disease progresses, and the organ is completely damaged - the only way out to save the patient's life at this stage is pneumoectomy - the complete removal of the organ.

Before and after the operation, for the purposes of the rehabilitation program, the patient is shown a course of radiation exposure. This is necessary in order for the cancer cells to be completely immobilized and localized. This will prevent their further growth and spread to other parts of the body. The maximum course for lung neoplasms is 3 weeks.

Symptomatic measures are also carried out - their task is to relieve the pain syndrome that prevents the normalization of pulmonary function.

Chemotherapy involves the use of a complex of drugs, the spectrum of action of which is aimed at the destruction of oncology at the cellular level. It is systemic in nature, since drugs are injected directly into the blood.

This is the only way to deliver the medicine to all points of the body and prevent their appearance not only in the lungs, but also in other places. Such treatment is carried out only in a hospital setting.

Sometimes used polychemotherapy as a component of complex treatment together with monoclonal antibodies and rutuximab.

Forecast

The patient's prognosis is different in each specific situation and depends on the stage and type of lung lymphoma:

• Hodgkin's (lymphogranulomatosis) tumors, detected in time and successfully treated at an early stage, are a good chance to return to full life. Percentage of recovery and survival - 95% . Therapy at a more advanced stage - 65 – 70% survival for five years;
• non-Hodgin (primary) formations - the prognosis is somewhat worse. If the disease managed to be driven into remission - 70 % survival statistics. If the tumor is aggressive, the chance to prolong a person's life is reduced to 25 – 30%;
• lymphogranulomatosis - timely started therapy - almost 100% recovery, and there are no relapses for more than one decade;
• plasmacytoma - complete return to normal life impossible. With high-quality treatment - several years of remission. There are cases when people after such diagnostics live 8-10 years old.

Rehabilitation

The rehabilitation period, depending on the method of treatment and the type of oncology takes several weeks. To exclude complications, accelerated mobilization is carried out.

With a certain regularity, an X-ray examination of the breast is carried out - to ensure the full functioning of the organ. On the first day after the operation to remove the formation, infusion therapy.

In addition, for the first time, the patient will experience pain in the affected area - they are stopped by painkillers. Normally, the pain will go away after 3-4 weeks.

After discharge, at least 3 times a year to be shown to the attending doctor and once a quarter to do a computed tomography.

Depending on location lymphomas classified into many types. Since the lymphatic system "permeates" the entire body, the tumor can be located in any organ. The location of the lymphoma largely determines the nature of the symptoms that bother the patient. Also, the localization of the neoplasm affects the course and prognosis of the disease.

There are the following types of lymphoma, depending on where they are located:

• spleen;

• abdominal department;
• mediastinum;
• brain.

Stomach lymphoma

Lymphoma of the stomach is malignancy, which is formed in the lymphoid tissue of this organ. The disease is more typical for men aged 55 - 60 years. The symptomatology of the pathology is similar to other diseases of the gastrointestinal tract, therefore, stomach lymphoma is often found in the final stages.

Classification
Lymphoma of the stomach can be like Hodgkin's lymphoma ( Hodgkin's disease), and non-Hodgkin's lymphoma. There is also such a definition as pseudolymphoma - a benign tumor that affects the gastric mucosa. Lack of proper intervention can lead to the degeneration of this neoplasm into a malignant form.

Lymphoma of the stomach can be primary or secondary. In the first case, the neoplasm initially forms in the stomach, often as a result of prolonged inflammation. Secondary lymphoma is the result of the germination of tumors that are located in neighboring organs or tissues.

In addition, the tumor may be polyploid or nodular. Polyploid lymphoma grows into the lumen of the stomach, while nodular lymphoma affects the walls of the stomach. There is also ulcerative lymphoma, which is characterized by high aggressiveness and rapid spread.

Symptoms
Common symptoms that are characteristic of all forms of lymphoma ( swollen lymph nodes, fever, sweating) are also characteristic of gastric lymphoma. Also, this form of lymphoma is accompanied by specific symptoms, which manifests itself from the digestive system.

There are the following specific symptoms of gastric lymphoma:

• Pain. On early stages patients feel periodic pain weak or moderate intensity in the abdomen. After eating, in many patients, the pain syndrome intensifies. As the lymphoma grows, the pain becomes more noticeable and persistent.
• Nausea, vomiting. Feelings of nausea and vomiting are common in patients with stomach lymphoma. These symptoms usually appear after eating, especially after overeating ( even light). In cases where the tumor affects the blood vessels, blood clots are present in the vomit.
• Loss of appetite. In patients with this disease, the appetite becomes sluggish, as they try to avoid meals so as not to induce vomiting. The presence of a tumor in the stomach provokes a rapid false saturation, so the amount of food consumed is significantly reduced.
• Weight loss. A poor diet leads to the fact that patients with stomach lymphoma begin to rapidly lose weight, sometimes reaching critical values. Anorexia ( pathological thinness, life-threatening) is common problem patients with this pathology, especially late stages.

Forecast
The prognosis for this disease is considered the most favorable in comparison with many other types of lymphoma. If a tumor is detected at the first stage and receives competent treatment, 95 percent of patients achieve stable remission ( subsidence of symptoms), which can continue without exacerbations for 5 years or more. In the second stage, the probability of a successful cure reaches 75 percent. Life expectancy of 5 years or more with stages 3 and 4 of the disease is observed in approximately 10 percent of all patients.

Lymphoma of the spleen

Lymphoma of the spleen is a rare disease and is equally diagnosed in both men and women of different ages. In addition to adults, this pathology also occurs in children. Lymphoma of the spleen refers to tumors with a sluggish character and in most cases is detected during preventive examinations.

Classification
The defeat of the lymphatic structures of the spleen can be either Hodgkin's lymphoma or non-Hodgkin's lymphoma. The first type of the disease is more common in male patients aged 15 to 50 years. Symptoms of Hodgkin's lymphoma appear only at the end of the second stage of the disease.
Non-Hodgkin's lymphoma of the spleen is characterized by diffuse invasion into the blood vessels, which provokes internal bleeding. The tumor quickly increases in size and affects other organs.

Symptoms
In the early stages, splenic lymphoma rarely shows any obvious signs. The first pronounced symptoms begin to disturb the patient after a few months ( and sometimes years) after the onset of the disease. Increasing in size, the tumor begins to put pressure on the nearby stomach and intestines, so the main signs appear from these organs.

Patients note a feeling of rapid satiety and a deterioration in appetite, and therefore lose weight, experience weakness. Such general symptoms as an increase in temperature and night sweats are also characteristic of splenic lymphoma. In the hypochondrium zone on the right side, patients experience a feeling of heaviness, to which pain syndrome joins over time. indicative symptom for lymphoma of the spleen is an abnormal enlargement of the organ in the later stages.

Forecast
Lymphoma of the spleen refers to tumors with a favorable prognosis. With proper therapy, even at stage 3 of the disease, stable remission ( subsidence of symptoms) is observed in 75 percent of patients. The probability of an unfavorable outcome increases significantly if other organs are also involved in the tumor process. In this case, the life expectancy of the patient is reduced and in about 70 percent of cases does not exceed 5 years.

Intestinal lymphoma

Intestinal lymphoma occupies about one percent of all diagnosed malignant tumors. The disease is typical for men whose age varies from 50 to 60 years. In 80% of cases, lymphoma is located in small intestine, 20 percent of tumors are found in the large intestine.

Classification
Intestinal lymphoma can be either Hodgkin's lymphoma or non-Hodgkin's lymphoma. Intestinal tumors are also classified according to their structure. In addition, lymphomas of this type have a special topographic criterion.

Hodgkin's lymphoma, as a rule, is initially large in size and can simultaneously affect the sections of the large and small intestines. This tumor is characterized by a multivariate manifestation. The neoplasm may take the form of polyps ( rise above the mucosa), grow into mucous tissues or form ulcers. Patients with this pathology are less concerned about diarrhea and related complications, since the elasticity of the intestine is not disturbed as much as with other types of this lymphoma.

Non-Hodgkin's lymphoma can be B-cell or T-cell. With B-cell lymphoma, tumors in the form of polyps form in the intestine, which can be either single ( more often in the ileum), and multiple. Characteristic symptoms for this form of lymphoma are frequent intestinal bleeding and intestinal obstruction. T-cell lymphoma is different high level aggressiveness and most often it affects the small intestine, from where it spreads to other parts of the gastrointestinal tract. In this disease, the intestinal lumen is blocked by a large tumor, which leads to atrophy of the organ and, as a result, to frequent diarrhea and other complications.

Depending on the structure, there are the following forms of intestinal lymphoma:

• Nodal. Outwardly, such a tumor resembles a knot and can be both in the sole and in plural. A characteristic feature of this lymphoma is a rapid period of development.
• diffuse. This form of tumor is more typical for non-Hodgkin's lymphoma. It grows through the intestinal wall and affects adjacent tissues.
• Scattered. It represents several tumor-like formations that can be located at some distance from each other, which provokes great difficulties in diagnosing. Disseminated intestinal lymphoma is characterized by slow growth and poor symptoms.

According to the topographic feature, Western-type lymphoma is distinguished, which is diagnosed in residents of the western part of Europe. This tumor is located in most cases in the ileum, begins to grow in the layer that is under the mucosa, and then grows to the entire intestinal wall. A characteristic characteristic of Western lymphoma is rapid penetration into the spleen. Lymphoma is also isolated, which is characteristic of the population of the Middle East and North Africa. This type of lymphoma occurs in the proximal intestine and duodenum.

Symptoms
The disease has a number of specific symptoms that manifest themselves from the intestines. Due to the growth of the tumor, the tone of the intestinal walls decreases, which provokes diarrhea, which is permanent. Frequent liquid stool causes malabsorption syndrome impaired digestion and absorption of food). With this syndrome, the amount of feces increases significantly, it acquires a mushy texture, becomes fetid. Against the background of all this, the patient loses weight, sometimes reaching life-threatening forms of exhaustion.

With intestinal lymphoma, mucus clots may be present in the feces, which are dead epithelium, whose mass rejection is provoked by increased growth and reproduction of bacteria. Also, patients note abdominal pain, sometimes intestinal bleeding. There are other symptoms that are characteristic of intestinal lymphoma.

There are the following specific signs intestinal lymphomas:

• feeling of a full stomach;
• mild pain below the navel;
• increased gas formation and, as a result, bloated abdomen;
• constipation ( in the later stages of the disease), which can last 1-2 weeks.

Common symptoms such as enlarged lymph nodes, subfebrile condition ( persistent temperature around 37 degrees) are also characteristic of intestinal lymphoma. The mesenteric and retroperitoneal lymph nodes are enlarged in most cases. The enlargement of the cervical and subclavian lymph nodes, characteristic of lymphoma, is rarely found in this disease. Subfebrile temperature in intestinal lymphoma is more pronounced than in other forms of this disease, and is constant.

Forecast
If detected in the early stages and competent therapy is carried out, the achievement of complete remission ( subsidence of symptoms) occurs in 90 percent of cases, of which only 15 percent relapse ( repeated exacerbations) in the next few years.

Liver lymphoma

Liver lymphoma is a common pathology, and among all cases of diagnosed lymphoma, this disease accounts for 10 percent. Average age of patients ( more often than men) with this disease ranges from 50 to 60 years. Liver lymphoma is very rarely primary and occurs in about 15 percent of cases.

Classification
Liver lymphoma is very rarely primary, and among all episodes of this disease, secondary tumors account for approximately 85 percent of cases. Primary lymphoma is most often diagnosed in patients with a history of pathologies such as cirrhosis of the liver ( destruction of healthy organ structure), immunodeficiency syndrome ( AIDS). Primary lymphoma also occurs in people who have had a liver transplant.

Secondary lymphoma is a daughter tumor of a neoplasm located in another organ. The tumor may consist of several foci or be represented by one massive formation.

Symptoms
Symptoms of lymphoma such as night sweats and subfebrile temperature observed in about half of the patients. If the disease is primary, then the enlargement of the lymph nodes may be weak or absent altogether. The picture of specific symptoms of liver lymphoma is very extensive and has similar features with hepatitis and other liver pathologies.

There are the following specific symptoms of liver lymphoma:

• Nausea. Refers to the early signs of the disease, manifests itself more often in morning time regardless of meals. With the progression of the disease, regular vomiting joins nausea, which causes the patient to lose weight.
• Anemia. Manifested by a feeling of chilliness in the limbs, constant weakness and lethargy. Such a condition with lymphoma is not eliminated by taking drugs that are traditionally prescribed for anemia.
• Pain. Pain with liver lymphoma, the patient is disturbed under the ribs on the right side. In the initial stages, pain provokes the intake of alcoholic beverages, fatty foods, and certain medications. Subsequently, this sign appears for no reason and becomes especially strong at night.
• Enlargement of the liver. This symptom is detected by palpation ( feeling). The organ reaches such a size that it begins to protrude under the ribs. On palpation, a dense, bumpy surface is detected.
• Chair disorder. With liver lymphoma, the patient may experience both severe difficulty with bowel movements and copious watery stools. Constipation can last 1 - 2 weeks, and then abruptly, without visible reasons to be replaced by diarrhea.
• Jaundice. In the primary stages of the disease, there is a slight yellowing of the skin and eye sclera. The reason for this is an increased level of bilirubin in the blood, which occurs due to poor liver function. As the tumor grows, the yellowish tint becomes more saturated.
• Change in color of urine and feces. This symptom manifests itself in the later stages of liver lymphoma. The stool becomes lighter ( sometimes almost white), and the color of urine, on the contrary, darkens.
• Change in food habits. Many patients with this disease have a dislike for meat and foods with a high fat content.
• Small hemorrhages on the abdomen. On the skin of the abdomen in patients with liver damage, there are small spider veins, which, as they spread tumor process form a continuous network. Often, patients also experience bleeding from the nose.
• Enlargement of the abdomen. In the last stages of the disease in the patient's body, the outflow of fluid is disturbed, due to which water accumulates in the abdominal cavity.

Forecast
When diagnosing a disease in the early stages ( which rarely happens) treatment ends with a successful outcome in 70 percent of cases. When carrying out treatment at stage 2 of the disease, positive results can be achieved in 60 percent of cases. At stage 3, achieving stable remission ( subsidence of symptoms) is observed in 30 percent of patients. Liver lymphoma grows rapidly and, if left untreated, it takes only a few months for the initial stage of the disease to flow into the final one.

Abdominal lymphoma

Abdominal lymphoma is a group of diseases that combines lesions of the lymphatic structures of those organs that are in the abdominal cavity. The composition of the abdominal organs includes the intestines, stomach, pancreas, spleen, liver.

Symptoms
The nature of the signs of the disease depends on which particular organ was affected by lymphoma. But there are also common signs, which are characteristic of almost every abdominal organ affected by lymphoma.

There are the following signs of abdominal lymphoma:

• feeling of false satiety after taking even small portions of food;
• pain in the abdomen ( localization of pain depends on which organ is affected);
• nausea, vomiting, loss of appetite;
• problems with defecation may present with prolonged constipation, and/or regular diarrhea);
• bloated belly due to increased gas formation.

Also, for lymphoma of the abdominal cavity, signs common to all lymphomas are also characteristic, namely enlarged lymph nodes, subfebrile condition, night sweats.

Forecast
The favorable outcome for abdominal lymphoma depends on the affected organ, timely diagnosis, and the state of the patient's immune system. The most positive prognosis for lymphoma of the spleen and stomach, since such tumors are characterized by low aggressiveness. The most unfavorable prognosis is for liver lymphoma, because neoplasms in this organ are characterized by a rapid growth rate.

Lymphoma of the lungs

Lymphoma of the lungs is one of the most common pathologies and among all lung tumors it occupies a leading position. Among all extranodal lymphomas ( those that appear outside the lymph node) lung lymphoma also occupies a major position. As a rule, lymphoma affects the bronchi or lung parenchyma. More common in the elderly, but when we are talking about the secondary form, it is also detected in young children.

Classification
As with other organs, pulmonary lymphoma can be primary or secondary. The most common primary pulmonary lymphoma is lymphosarcoma ( non-Hodgkin's lymphoma). The disease develops against the background of chronic infections of the respiratory system or autoimmune diseases. This type of pulmonary lymphoma is characterized by a low degree of malignancy ( growing slowly), but in some cases, for no apparent reason, it can transform into an aggressive tumor that quickly spreads to neighboring organs. Hodgkin's lymphoma can also affect the lungs and in its form can occur in several forms.

There are the following forms of Hodgkin's lymphoma in the lungs:

• Knotty. The disease develops with the formation of one or more nodules in the lower lobe of the lung. Increasing, the tumor begins to compress the bronchi, which leads to the development of purulent bronchitis, which is accompanied by severe shortness of breath ( at rest and in motion), the appearance of pus in expectorated sputum when coughing, bad breath.
• Peribronchial. With this disease, strands form on the bronchi ( longitudinal seals), which are prone to enlargement and may extend to the alveolar septa ( lung fragments). In this case, there is a high chance of developing interstitial pneumonia, which is characterized by a mild dry cough, severe chest pain, an increase in the terminal phalanges of the fingers ( fingers of hippocrates).
• miliary. With this type of lymphoma, lung surface there is a scattering of small nodules that grow into the lung tissue.

Symptoms
The first signs of the disease appear quite late, and the asymptomatic period can last from several months to several years. The clinical picture combines both common signs of lymphoma ( subfebrile condition, sweating) and specific symptoms that are manifested by damage to the respiratory tract.
Patients are concerned about dry cough, which may be accompanied by expectoration of blood clots, shortness of breath, chest pain. Lung damage impairs the function of the respiratory system, so patients often have recurrent ( recurring) cases of bronchitis, pleurisy and other infectious diseases.

Forecast
With timely detected Hodgkin's lymphoma in the lungs, the proportion of patients who achieve stable remission ( subsidence of symptoms) without relapses ( repeated exacerbations) for many years ( sometimes decades) reaches 95 percent. If treatment was started at stages 2-3, the number of patients with positive results varies from 60 to 70 percent. For non-Hodgkin's lymphoma lung prognosis less favorable. The proportion of patients with successful outcomes with early treatment is about 70 percent.

mediastinal lymphoma

Mediastinal lymphoma is a lesion of the lymphatic structures of those organs that are part of the mediastinum. The mediastinum itself is an area in the chest, the boundary of which is the chest in front, and the thoracic spine in the back. On the sides, the mediastinum is bounded by the pleura, below - by the diaphragm, above - by the upper line of the chest. This zone covers the thymus gland, esophagus, trachea, bronchi, heart. Also in the mediastinum are many large blood vessels (carotid arteries, pulmonary arteries and veins), nerves and lymph nodes. Mediastinal lymphoma is a disease that is typical for young patients, aged 20 to 40 years.

Classification
Among all mediastinal lymphomas, both primary and secondary neoplasms occur with the same frequency. Lesions of the lymphatic tissue of the mediastinal organs can be represented by Hodgkin's lymphoma or non-Hodgkin's tumor.

Hodgkin's lymphoma is characterized by vague symptoms and relatively latent ( slow flow). It is diagnosed mainly in young patients. Non-Hodgkin's lymphoma of the mediastinum can also be diagnosed in older patients. Such tumors are characterized fast growth and metastasis to other organs. Signs of non-Hodgkin's lymphoma of the mediastinum appear earlier and are more pronounced. Such tumors are quite sensitive to chemotherapy and other conservative methods of treatment.

Symptoms
Mediastinal lymphomas in the early stages proceed with little to no symptoms, especially Hodgkin's lymphoma. Then there are signs characteristic of all lymphomas - a slight increase in temperature, sweating, itching, fatigue. Lymph nodes in the neck and armpits increase quite strongly. Often, a dry cough appears in the early stages, which is subsequently supplemented by such signs as a hoarse voice, a feeling of lack of air, and difficulty swallowing. Also, depending on the form of lymphoma and the stage, other symptoms may appear.

There are the following symptoms of mediastinal lymphoma:

• a pronounced venous pattern on the chest, due to dilated veins that appear through the skin;
• puffiness of the face, swelling of the neck;
• voice disorder ( insufficient voice power, timbre distortion);
• tickle, feeling foreign body in the throat;
• bluish skin tone.

Forecast
When conducting competent treatment in cases with local lymphoma ( when the tumor has not spread to other organs), which is more typical for Hodgkin's lymphoma, the number of patients with successful treatment results reaches 90 percent.

Skin lymphoma

Lymphoma of the skin refers to diseases characteristic of the elderly. Cases of detection of this pathology at a younger age, as well as in children, also exist, but are quite rare. This disease is manifested by a tumor on the skin, which is formed by malignant cells.

Classification
Depending on the type of cells from which the neoplasm is formed, there are T-cell and B-cell lymphomas of the skin. T-cell lymphomas have different form manifestations, and depending on this criterion are divided into several types.

There are the following types of T-cell lymphoma of the skin:

• Nodular. With this pathology, placers of small nodular formations of a yellowish or pink hue with a flat top appear on the patient's skin. Rashes may disappear on their own or decrease in size, and then recover. As the disease progresses, the nodules increase in size and darken.
• Small-nodular. This type of skin lymphoma is one of the rarest. characteristic manifestation pathology - small vesicles on the skin that merge with each other, forming large scaly plaques. After some time, larger nodules appear on the surface of the peeling, which gradually begin to be replaced by areas of dead tissue.
• Plaque ( 1 degree). With this form of lymphoma, yellow plaques appear on the skin, the size of which can reach 10 to 15 centimeters in diameter. Formations on the skin tend to increase. As the disease progresses, the plaques disappear, and dark areas with atrophied skin appear in their place, which resembles tissue paper.
• Plaque ( 2 degree). For this type of lymphoma ( also called mycosis fungoides) accounts for about 25 percent of all episodes of cutaneous lymphoma. First, raspberry-colored spots appear on the surface of the skin, the surface of which is flaky. After a while, the formations on the skin take the form of flat tumors ( sometimes this stage occurs after a few years), which are covered with ulcers.
• Erythrodermic. This type of lymphoma also known as Cesari syndrome), as a rule, develops against the background of prolonged eczema or neurodermatitis. The pathology is characterized by a long course, which can last 10-15 years. The patient's skin swells, and areas with redness appear on their surface, covered with white large scales.

B-cell lymphomas can present as a plaque or nodular form. In the first case, spots appear on the skin, which then take the form of a tumor. In the nodular type of B-cell lymphoma, hemispherical nodules appear on the skin, which can be the size of a walnut.
Among all skin lymphomas, T-cell tumors account for about 70 percent. The number of episodes with B-cell lymphomas is about 25 percent. In other cases, tumors are classified as lymphomas that cannot be classified.

Symptoms
In addition to the characteristic rashes, skin lymphoma has a number of other symptoms. So, all types of T-cell tumors are accompanied by severe itching from the initial stages of the disease. With B-cell lymphoma, itching occurs only by the third stage. Localization of skin changes can be different. In the erythrodermic form, itching and red spots initially appear on the lower extremities, and then spread throughout the body, including the scalp. This type of lymphoma is also characterized by hair loss, atrophy nail plates marked enlargement of the lymph nodes. In the plaque form, rashes are most often localized on the chest and between the shoulder blades on the back; in the nodular form, primary skin changes appear on the legs.

Forecast
Achieving sustained remission subsidence of symptoms) is possible in cases where therapy was started at stage 1 or 2 of the disease. If skin lymphoma is detected at the 3rd or 4th stage of development, the prognosis is considered unfavorable, and the onset of death is possible within 2 years.

Lymphoma of the brain

Cerebral lymphoma is a rare disease that accounts for 3% of all tumors of the central nervous system malignant and benign types. Most often, lymphoma is a secondary tumor, that is, a metastasis of a neoplasm from another organ. In the case of primary lymphoma, it rarely affects other body systems, but it has a high level of aggressiveness. More often than others, brain lymphoma is diagnosed in patients with acquired immunodeficiency syndrome ( AIDS).

Classification
There are 3 types of brain lymphoma, each with both differences and similar characteristics.

There are the following types of brain lymphoma:

• Reticulosarcoma. A rare form of brain lymphoma. Responds positively to radiation therapy, therefore, with timely detection, the prognosis for the patient is favorable.
• Microglioma. Among all cerebral lymphomas, microglioma accounts for about half of the cases. The tumor is different a high degree aggressive and almost untreatable.
• Diffuse histiocytic lymphoma. It also refers to aggressive tumors and is characterized by rapid growth. Despite this, with timely treatment, the chances of achieving a stable remission ( subsidence of symptoms) are quite high.

Symptoms
In the initial stages, brain lymphoma is manifested by a minimal number of symptoms that are mild and occur periodically. As a rule, these are headaches that do not go away after taking traditional headache medicines. Also, the patient may feel mild drowsiness and mood swings for no apparent reason.

As the tumor grows, the list of symptoms increases. It should be noted that this form of lymphoma has one of the most diverse clinical pictures because the brain controls many functions and organs. The nature of the symptoms largely depends on where in the brain the tumor is located.

There are the following symptoms of brain lymphoma:

• blurred vision and/or hearing, speech ( especially characteristic of damage to the frontal lobe of the brain);
• increased intracranial pressure;
• memory problems;
• impaired coordination of movements;
• blurred consciousness, hallucinations;
• accumulation of fluid in the brain found on examination).

In the final stages, brain lymphoma leads to a complete change in personality, often with degradation. The patient becomes aggressive and unpredictable, may not recognize close people, commit acts that are not amenable to logical explanation.

Forecast
Cerebral lymphoma belongs to the category of diseases with a poor prognosis. The situation is worsened by the fact that pathology is rarely diagnosed in the initial stages. With timely treatment, approximately 75 percent of patients achieve long-term remission ( subsidence of symptoms) in the absence of other serious systemic diseases. For older patients, this figure drops to 40 percent.

Diagnosis of lymphoma

Diagnosis of lymphoma is based on a detailed study of the medical history ( history), patient complaints ( that is, the characteristic symptoms of the disease), inspection and additional research.

Common complaints of a patient with lymphoma are:

• fever;
• sweating;
• sudden weight loss;
• simultaneous or gradual increase lymph nodes in one or more areas.

Examination of the patient is of great diagnostic value. At the same time, the doctor pays special attention to the condition of the skin, namely the presence of a rash of scratching, nodular formations on them. On palpation ( medical feeling) determines the number of altered lymph nodes, their localization, size, cohesion between themselves and surrounding tissues, as well as the degree of pain. All accessible lymph nodes should be palpated.

The lymph nodes required for palpation include:

• occipital;
• submandibular;
• cervical;
• supraclavicular and subclavian;
• axillary;
• elbow;
• inguinal;
• femoral;
• popliteal.

The data obtained during the examination are necessarily supplemented and refined by laboratory and instrumental research. For this, a general blood test is performed, biochemical research, x-ray and, if possible, specific markers.

Additional tests in the diagnosis of lymphoma

Analyzes	Required laboratory parameters	Possible changes
General blood analysis	leukocyte formula;	decrease in red blood cells and hemoglobin; a decrease or, conversely, an increase in platelets; an increase in eosinophils and a decrease in lymphocytes.
Blood chemistry	total blood protein and its individual fractions; bilirubin; alkaline phosphatase; lactate dehydrogenase.	An increase in the enzyme lactate dehydrogenase ( LDH), alkaline phosphatase (AP) and creatinine.
Specific markers	beta2 microbulin.	A typical marker of lymphoma. The concentration of this marker correlates with the stage of the disease - the higher the concentration, the more severe the disease.
x-ray	Carried out in the anterior and lateral projections.	Widened shadow of the mediastinum, due to the enlarged lymph nodes that form it.
Ultrasonography(ultrasound)	Liver, spleen, kidneys, intestines.	It is carried out to determine the prevalence of the pathological process, that is, in order to determine changes in other organs.
CT scan(CT)	Internal organs and peripheral lymph nodes.	It is carried out in order to determine the structure of the lymph nodes and a more detailed study pathological changes in the organs.

Which doctor treats lymphoma?

Regarding the treatment of lymphoma, make an appointment with an oncologist. His competence also includes the diagnosis of the disease. An oncologist may specialize in a particular type of cancer. Also, oncologists are children's and adults, due to significant differences between lymphomas in adults and children.

Lymphoma treatment

The main treatments for lymphoma are radiation therapy and chemotherapy. A combination of these two methods is also carried out. It is important to understand that only timely and adequate treatment is the key to long-term remission ( subsidence of symptoms).

Treatment options for lymphoma include:

• Radiation therapy method- is carried out in patients with the first stage of the disease, without massive damage to the lymph nodes and without severe symptoms of intoxication.
• Chemotherapy- a method using special drugs called anticancer drugs.

• Combined method ( combination of chemotherapy and radiation therapy) - performed in patients with stage II lymphoma. It is also recommended for patients with massive lesions of the lymph nodes and severe symptoms intoxication. At the first stage, chemotherapy is carried out, which can include from 4 to 6 courses.

Radiation therapy for lymphoma

Radiation therapy is a method that uses gamma radiation ( x-rays). The purpose of this method, as well as others used in the treatment of malignant neoplasms, is the destruction cancer cells. With Hodgkin's lymphoma ( given that it is a primary common disease) is undergoing a radical program of radiotherapy. This means that not only the affected lymph nodes and organs are exposed to radiation, but also adjacent lymphatic areas. This is carried out with a preventive goal to maximize the prevention of relapses ( recurrence of the disease).

Chemotherapy for lymphoma

Chemotherapy is a cancer treatment method based on the use of anticancer drugs. medicines. This is the category of drugs that has a detrimental effect on rapidly dividing cells ( i.e. cancer cells). Anticancer drugs are also called cytostatics. The main goal of chemotherapy ( like other methods used in oncology) is the achievement of maximum remission ( subsidence of symptoms).

The choice of method depends entirely on the type and degree of malignancy of the lymphoma. With Hodgkin's lymphoma, it is always polychemotherapy, that is, the use of several drugs at once. There are two main treatment regimens for Hodgkin's lymphoma.

Treatment regimens for Hodgkin's lymphoma

Method name	When is it applied?	What drugs are included?
Scheme ABVD	It is used for sluggish ( indolent) forms with a relatively favorable prognosis.	doxorubicin on days 1 and 14; bleomycin on days 1 and 14; vinblastine on days 1 and 14; dacarbazine on days 1 and 14.
Scheme BEACOPP	It is prescribed for aggressive forms with an unfavorable prognosis.	cyclophosphamide for 1 day; doxorubicin for 1 day; etoposide on days 1, 2 and 3; procarbazine from 1 to 7 days; prednisolone from 1 to 14 days; vincristine on day 8; bleomycin on day 8.

Treatment for non-Hodgkin's lymphomas depends on morphological type tumors and grades. The most commonly used treatment regimen is ACOP, which includes cyclophosphamide, doxorubicin, oncovin, prednisolone. Courses of drugs are carried out every three weeks.

drugs for lymphoma

Drugs used in the treatment of lymphoma are called cytostatics. These drugs permanently damage the tumor tissue and prevent the formation of new cancer cells. Cytostatics can be classified according to several principles - according to the mechanism of action, according to chemical structure, by nature. So, in origin anticancer drugs divided into natural and synthetic.

The main cytostatics used in the treatment of lymphoma include:

• antibiotics- doxorubicin, amsacrine, idarubicin;
• alkylating drugs- cyclophosphamide, chlorambucil;
• antimetabolites- methotrexate, mercaptopurine;
• hormones- prednisolone.

Where is lymphoma treated?

Lymphoma is treated in any health facility that has an oncologist on staff. It is this specialist who puts the patient on record, if he has lesions of the lymphatic tissue. As a rule, an oncologist works in a hospital or oncology clinic, which may be public or private. During periods of remission subsidence of symptoms) Patients with lymphoma are encouraged to visit sanatorium-resort-type institutions, where they receive supportive treatment.

Folk remedies for lymphoma

Folk remedies for lymphoma do not bring a positive result, and in some cases can adversely affect the patient's condition. Of the non-traditional treatments, various oral tinctures based on toxic products such as wormwood or fly agaric are popular. It is believed that these products contain cells that stop tumor growth. There is no scientific evidence for this assumption, but the likelihood of side effects is quite high, because both wormwood and fly agaric contain many toxic substances.

Another popular remedy for lymphoma is celandine. This plant is an active stimulant of the immune system thanks to the vitamins it contains. Celandine, as well as other drugs of this kind, can also negatively affect the patient's well-being, because the factors that stimulate the growth and reproduction of cancer cells are not fully understood. So, until recently, there was an opinion that cancer patients need to take a lot of vitamins. To date, tests are being conducted that prove the opposite. Therefore, when diagnosing lymphoma, traditional medicine is not recommended, since it is impossible to predict the reaction of the tumor to such drugs.

Some patients may benefit from folk remedies after removal of the tumor to restore the energy and other resources of the body. The expediency of taking such drugs, their composition and dosage is determined only by a doctor who focuses on tests and other data about the patient. It is strictly forbidden to take any funds on your own.

Nutrition for lymphoma

To date, there is no diet designed specifically for patients with lymphoma or cancer in general. There are many theories about how a patient with an oncological tumor should eat, but each of them has significant contraindications. The only thing experts insist on is that the nutrition of a patient with lymphoma should be varied and complete and consist of high quality products. It also emphasizes the need for an individual approach when compiling a menu for each individual patient.

Theories about nutrition for cancer patients
One of the popular theories is based on the fact that the products consumed by the patient feed, first of all, not him, but the oncological neoplasm. Based on this, with lymphoma and other forms of cancer, patients are encouraged to follow strict diets, and in some cases resort to partial or even complete fasting. And in especially severe cases, supporters of this theory propose to exclude not only food, but also drinking water. Refusal of a balanced diet is a quick way to deplete an organism that is already weakened. pathological process and ongoing treatment. Therefore, independently ( without medical supervision) patients with lymphoma are not recommended to switch to this diet.

Another theory is based on the opinion that lymphoma uses the energy it receives from the breakdown of glucose. Focusing on this, the authors recommend excluding all sources of carbohydrates from the patient's menu ( sugar, honey, flour products ). But with a lack of glucose, the body begins to extract it from non-carbohydrate substances, which can subsequently adversely affect the patient's condition.

There is also an opinion that a patient with lymphoma needs to receive loading doses of vitamins by ingesting various vitamin complexes. More modern research refute this theory. The recommendations of leading experts boil down to the fact that cancer patients should receive all vitamins with food. In cases where the patient has poor appetite, vitamin preparations may be prescribed, but in small, doctor-controlled doses.

The importance of an individual approach
A flexible menu approach is a fundamental factor in dietary therapy for lymphoma. Since there are a large number of such tumors, dietary recommendations cannot be the same. For example, with an increase in tumor size, an excess of salt in the body is often detected, which provokes fluid stagnation and swelling. Therefore, one of the criteria for a diet for lymphoma is to reduce the amount of salt consumed. But in some patients, the disease is accompanied by frequent vomiting and / or diarrhea, which provokes a lack of salt in the body. In this case, recommendations to reduce salt in the diet will be inappropriate. Based on all this, it is obvious that only a doctor who knows the nuances of the patient's history can provide useful nutritional advice.

General provisions for the nutrition of the patient with lymphoma
Modern dietetics believes that there are no such foods that should be explicitly prohibited from being consumed by patients with lymphoma. Most patients with this disease have a deterioration in appetite, so their diet should be as diverse as possible and consist of fresh food that makes them want to eat.

Food products that should be reduced in lymphoma include products that are in principle not recommended even healthy people. These are semi-finished frozen breaded cutlets, dumplings, pizza), fast food ( hot dogs, hamburgers), fast food ( soups, mashed potatoes and other dishes, for the readiness of which it is enough to pour boiling water over them). All of these products contain a lot of trans fats ( margarine, palm oil), preservatives, chemical additives that provoke various diseases. There are few vitamins in such food, and there are plenty of calories, which is also a factor in favor of reducing its consumption to a minimum.

Before use, you should consult with a specialist.

To give a brief definition, then lymphoma is. It belongs to a group of cancers that affect the cells that support the immune system and form the body's lymphatic system - a network of blood vessels through which lymph circulates.

Lymphoma is a group of hematological diseases of the lymphatic tissue, characterized by an increase in lymph nodes and damage to various internal organs, in which there is an uncontrolled accumulation of "tumor" lymphocytes. The first symptoms of lymphoma include an increase in the size of the lymph nodes of the cervical, axillary or inguinal groups.

Lymphoma, what is this disease? When the lymph nodes and various internal organs begin to increase in size, "tumor" lymphocytes accumulate in them uncontrollably. These are the white blood cells that support the immune system. When lymphocytes accumulate in nodes and organs, they disrupt them normal work. In this case, cell division is out of control of the body, and the accumulation of tumor lymphocytes will continue. This indicates the development oncological tumor This is what lymphoma is.

The term "malignant lymphoma" combines two large groups of diseases. The first group of diseases was given the name - lymphogranulomatosis (Hodgkin's disease), the other group included. Each lymphoma disease in both groups belongs to a specific type. It differs significantly in its manifestations and approaches to treatment.

Most of the population does not know lymphoma - is it cancer or not!? In order not to face it personally, you need to learn about this disease from our article, and apply preventive measures. If there are reasons to suspect lymphoma from these two groups of diseases, then early recognition of the symptoms will help to begin treatment at an early stage.

When tumor formations arise from lymphocytes, their maturation goes through several stages. In any of the stages, lymphoma can develop, which is why the disease has many forms. Most organs have lymphoid tissue, so the primary tumor can form in any organ and lymph node. Blood and lymph moves abnormal lymphocytes throughout the body. If there is no treatment, then as a result of the progression of oncology, a sick person may die.

Lymphomas are simple, high-quality and malignant

Malignant lymphomas are true neoplasms of the lymphoid tissue of a systemic order. The occurrence of simple lymphoma is influenced by reactive processes. Simple lymphoma consists of a limited infiltrate with lymphoid cells. They have pronounced bright centers of reproduction, like lymphatic follicles.

Simple lymphoma occurs due to:

• chronic inflammatory process in tissues and organs;
• regenerative processes of lymphoid tissue;
• phenomena such as lymphatic congestion.

A simple lymphoma is formed when a high degree of immunological tension of the body occurs. Benign lymphoma is an intermediate form between lymphomas: simple and onco.

Qualitative lymphoma, what kind of disease? It is characterized by slow and asymptomatic growth of neoplasms in the lymph nodes:

Knotty neoplasms to the touch have a dense texture. Chronic inflammation can be the impetus for the growth of high-quality lymphoma. Histological examination characterizes it as a simple lymphoma in the lung area against the background of nonspecific chronic pneumonia. It is impossible to distinguish the sinuses of the lymph nodes, since their place is occupied by hyperplastic lymphoid tissue, therefore this lymphoma is mistaken for a tumor.

Oncological lymphoma develops against the background of systemic disease hematopoietic apparatus, it is limited or widespread.

Lymphomas in children under 3 years of age practically do not develop. Adults get sick more often. Among the most common 5 forms of the disease in children - 4 forms are classic Hodgkin's disease.

These are lymphomas.

• non-classical, enriched with lymphocytes;
• mixed cell forms;
• nodular forms;
• with an excess of lymphocytes;
• with a lack of lymphocytes.

The main complications of childhood lymphoma are manifested:

• oncology of the brain: brain and spinal;
• compression of the respiratory tract;
• superior vena cava syndrome;
• sepsis.

heavy negative effects radiotherapy is manifested, the child:

• confused consciousness;
• treatment is accompanied by skin burns;
• limbs weaken and head hurts;
• due to frequent nausea and vomiting, loss of appetite, weight loss;
• rashes and tumors appear.

The child's body will intensively get rid of carcinogens and radiotherapy products, so active hair loss occurs. In the future, the hair will grow back, but will have a different structure.

After chemotherapy, the following negative effects are possible:

• anorexia, nausea, vomiting, diarrhea and constipation;
• ulcers on the mucous membrane in the oral cavity;
• with fatigue and general weakness, there is a risk of an infectious disease;
• bone marrow is damaged;
• hair fall out.

Classification of lymphoma

Hodgkin's lymphoma and non-Hodgkin's lymphomas are two large groups that include malignant lymphomas that present differently clinically. Their course, response to therapy, the nature of oncocells and treatment are different. At the same time, all types of lymphomas can affect the lymphatic system, the main functional work of which is to protect the body from infectious diseases.

The structure of the lymphatic system is complex. In the lymph nodes, the lymph is cleaned of all vital organs. The lymphatic system includes the thymus gland, tonsils, spleen, bone marrow with a large network of lymphatic vessels and lymph nodes. Large and major clusters of lymph nodes are located in the axillary fossa, a couple and the neck. The number of clusters is different, only the axillary fossa has up to 50 lymph nodes.

In addition to numerous types of lymphoma, the classification also includes subspecies, by examining which doctors determined how quickly lymphoma develops and developed certain schemes for treating oncology and eliminating its causes. For example, the one that affected the mucous membranes arose against the background of an infectious agent of the bacterium Helicobacter pylori, which can cause an ulcer or gastritis.

However, some types of lymphoma appear for unknown reasons, and develop oncological pathologies in the lymphatic system. The state of the immune system is of great importance.

Lymphoma can be caused by:

• against the background of the immunodeficiency virus (HIV) with long-term use of drugs that suppress the immune system;
• in tissue and organ transplantation;
• autoimmune diseases, hepatitis C virus.

Hodgkin's lymphoma affects people under 30 years of age and after 60 years of age and gives a more favorable prognosis. Survival for 5 years is approximately 90%. The prognosis of survival of non-Hodgkin's lymphomas depends on the type, there are about 60 of them. The average survival rate for 5 years is 60%, at stages 1-2 - 70-80%, at stages 3-4 - 20-30%. Non-Hodgkin's lymphomas are more common and often occur after age 60.

Informative video: Hodgkin's lymphoma, diagnosis at the bottom of a glass

Primary lymphoma can occur in any organ, such as the brain.

Then patients will complain about:

• headache due to increased intracranial pressure, drowsiness, nausea and vomiting - signs of intracranial hypertension;
• epileptic seizures;
• symptoms of meningitis;
• cognitive impairment;
• cranial nerve injury.

Primary lymphoma can also affect the serous cavities, central nervous system, liver, heart, brain when HIV infection.

Secondary lymphoma manifests itself as a result of metastasis in any organ where the bloodstream or lymph flow delivers the cancer cell.

The classification of non-Hodgkin's lymphomas includes more than 60 names of lymphomas. In non-Hodgkin's lymphomas, 2 types of tumors are noted: B and T - cellular.

Treatment for them is chosen differently, since they come in the following forms:

1. aggressive - rapidly growing and progressing with the presence of many symptoms. They should be treated immediately, which gives a chance to completely get rid of oncology;
2. indolent - a benign chronic course of lymphomas with a low degree of malignancy. Permanent treatment not required, but constant monitoring is required.

Causes of Lymphoma

The initial causes of lymphoma are not known to science. When researching a large number toxins, there is no convincing evidence of their association with this type of disease.

Some researchers believe that in the diagnosis of "lymphoma" the causes should be sought in long-term exposure to insecticides or pesticides. Most scientists are sure that when lymphoma is diagnosed, the causes of the disease are manifested in a sharp decrease in immunity with viral infections and long-term medication.

Other factors that adversely affect immunity are also possible: autoimmune diseases, organ and tissue transplantation with prolonged activation of the immune system create favorable conditions for the development of lymphoma. When transplanting organs such as the liver, kidneys, lungs and heart, a conflict between the transplant and the patient's body is possible - that is, a rejection reaction is possible. Long-term medications to prevent conflict can aggravate the immune system.

AIDS reduces immunity due to the defeat of lymphocytes by the virus, so patients with the presence of the virus are more likely to get cancer of the lymph nodes. If a person is infected with a lymphotropic T-cell virus (type 1), then an aggressive T-cell lymphoma develops. Recent studies have shown that the hepatitis C virus increases the risk of developing lymphoma.

Lymphoma - the first symptoms and signs in the early stages

The initial signs of lymphoma in adults are characterized by swollen lymph nodes in the neck, groin, and armpits.

But there may be other symptoms of lymphoma:

• lung tissues are affected - there are manifestations of shortness of breath, cough and compression syndrome of the superior vena cava: the upper part of the body swells and breathing becomes difficult;
• lymphoma develops in the peritoneum, symptoms are manifested by a feeling of heaviness in the abdomen, bloating and pain;
• enlarged inguinal lymph nodes, then these first signs of lymphoma are accompanied by swelling of the legs.

The symptoms of lymphoma are characterized by persistent headaches and strong weakness indicating damage to the brain and spinal cord.

Symptoms of lymphoma are manifested by general intoxication, characteristic excessive night sweats, sudden weight loss, and indigestion. For no reason, the temperature will rise with lymphoma to 38ºС and above.

If cutaneous lymphoma is suspected, the symptoms are as follows:

• the blood formula changes;
• regional lymph nodes increase;
• internal organs are involved in the process of germination of secondary tumors during metastasis at stages 2-4;
• the skin constantly itches up to scratching and abscesses when an infection enters;
• the skin suffers from polymorphic rashes.

Diagnosis of lymphoma

It is much more difficult to develop general principles for the treatment of T-cell lymphomas with indolence and aggressiveness than B-cell lymphomas, since they have a variety of morphological, clinical, and incl. extranodal variants and heterogeneity within the same localization in the organ. For example, T-cell primary cutaneous lymphomas are indolent. Their treatment, apart from the rare T-cell chronic lymphocytic leukemia/T-cell prolymphocytic leukemia (TCLL/PLL), is limited to the treatment of primary cutaneous NHL, including mycosis fungoides or its variant, Sazari's syndrome.

Lymphoma treatment of mycosis fungoides at different stages is different:

• At stage IA (T1N0M0), local methods are used:

1. PUVA - therapy - long-wave ultraviolet irradiation with the presence of a photosensitizer and intratumoral administration aqueous solution with a low concentration of embihin (mustargen, chlormethine);
2. BCNU (Carmustine);
3. electron irradiation.

• At stages IB and IIA (T2N0M0 and T1-2N1M0) and in IIB (T3N0-1M0) and later, therapy is supplemented with long-term administration of Alfainterferon. Or the treatment is carried out with a selective activator of retinoid X-receptors - Bexarotene or a recombinant diphtheria toxin preparation (with CD25 expression) and Interleukin, 2 (IL,2) Denileukin diphytox, as an agent that has a turomocidal effect.
• At stages III and IV, cytostatic therapy is carried out and Prospidin, purine antimetabolites - Fludara, Pentostatin (for Cesari's syndrome), or combined chemistry according to the CHOP program are used.

If possible, high-dose chemotherapy with allogeneic bone marrow transplantation is used.

The principles of treatment for major aggressive forms of T-cell NHL may not be identical. Peripheral T-cell lymphoma, the course of which is even more malignant than B-cell lymphoma, is treated at stages I-III with standard combined chemotherapy according to the CHOP program or Natulan is added to CHOP, which gives good result. At stage IV, this approach or the VASOR program is less effective, the response is worse.

Angioimmunoblastic T-cell lymphoma (angioimmunoblastic lymphadenopathy) can give a good response - 30% complete remissions after the use of one corticosteroid therapy, sometimes with the addition of alpha interferon. But combined chemotherapy gives a response twice as high, so the COPBLAM program in combination with will be preferable.

In extranodal forms, these 2 subtypes of T-cell lymphomas are treated with high-dose chemotherapy and transplanted stem cells or bone marrow. This is the first line of treatment for them and for anaplastic large T-cell NHL, as it is highly sensitive to standard chemotherapy, steroids, as are aggressive B-cell lymphomas.

The use of the cytokine Alfainterferon as monotherapy for aggressive T-cell NHL has no effect even when combined with chemotherapy.

Irradiation for aggressive T-cell lymphomas, as an adjuvant treatment, is used on localized lesions if:

• foci of large volume and are not completely irradiated;
• primary extranodal foci in the skin, stomach, testicle, central nervous system.

Highly aggressive B cell NHL is treated as Burkitt's lymphoma, T-cell NHL as lymphoblastic lymphoma, using the therapy used for acute lymphoblastic leukemia, standard combined chemotherapy according to the CHOP or CHOP + asparaginase program, and prevention of CNS damage (intrathecally administered Methotrexate and Cytarabine). At the same time, induction is first carried out, then consolidation of remission and long-term maintenance therapy.

Burkitt's lymphoma of any stage and localization is treated with combined chemotherapy, carried out according to the algorithms of acute lymphocytic leukemia with simultaneous prevention of CNS lesions (the brain is not irradiated). Or carry out such treatment as for lymphoblastic T-cell lymphoma.

Combined chemistry (for children and adults) includes:

• Cyclophosphamide or Cyclophosphamide + (alternating mode);
• Cyclophosphamide + high-dose Methotrexate;
• Cyclophosphamide + anthracyclines;
• Cyclophosphamide + Vincristine;
• Cyclophosphamide + drugs - epipodophyllotoxins (VM,26) and Cytarabine.

Sometimes therapeutic tactics are limited to chemotherapy with high doses - 1-3-8 g / m² and Methotrexate in moderate doses (systemically or intrathecally with Cytarabine).

It makes no sense to support high-dose chemotherapy with bone marrow autotransplantation or colony-stimulating factor preparations due to low results. In intracerebral lesions and testicular involvement, it is highly questionable to prescribe radiotherapy in addition to optimal combination chemotherapy in the hope of improving treatment outcomes. The same thing happens when performing palliative resections of large tumor masses, which also prevents urgent chemotherapy.

Relapses also occur when complete remission is achieved after chemotherapy in all types of NHL: indolent, aggressive, and highly aggressive.

The relapse-free period can last several months to several years, depending on the degree of malignancy of NHL and adverse prognostic factors, including MPI rates.

Complications after chemotherapy

The consequences of chemotherapy in lymphoma arise due to the fact that anticancer therapy destroys normal cells along with tumor cells. Cells are damaged especially quickly, those that divide rapidly in the bone marrow, oral mucosa and gastrointestinal tract, hair follicles in the scalp.

The total and total doses of drugs and the duration of chemotherapy affect the severity of side effects. When this appears:

• ulcers on mucous membranes;
• baldness;
• increased susceptibility to infections with a reduced level of leukocytes;
• bleeding occurs with a lack of platelets;
• fatigue - with a lack of red blood cells;
• loss of appetite.

With large lymphomas, due to the rapid effects of chemistry, lysis syndrome may occur. The decay products of cancer cells through the bloodstream enter the kidneys, heart and central nervous system and disrupt their function. In this case, the patient is prescribed a large volume of fluid and treatment of lymphoma with soda and Allopurinol.

So that antitumor chemistry does not directly damage the main vital organs, and oncological leukemia does not occur, modern means of prevention are used:

• antiemetic drugs;
• antibiotics;
• growth factors that stimulate the production of leukocytes;
• drugs against viruses and fungi

Until the immune system gains its strength, it is necessary to avoid infectious complications by following simple preventive measures:

• patients, visitors should wear gauze masks, and hospital staff should wear masks and sterile gloves;
• wash hands thoroughly, as well as fruits and vegetables brought to the patient;
• avoid contact with children who are carriers of infections.

Lymphoma - treatment after relapses

Early recurrence of lymphomas begins 6 months after the end of treatment. This requires a change in the chemotherapy program. If the degree of malignancy is low, they switch to treatment programs for aggressive lymphomas, for example, changing the COP program, or Cyclophosphamide to CHOP, or anthracycline regimens. If there is no answer, they switch to combination chemistry schemes with, Fludara, Etoposide, Cytarabine and.

If lymphoma recurrence is late, occurring one year or more after initial treatment, then treatment regimens may be repeated for indolent and aggressive lymphomas. If recurrence occurs in large B-cell lymphoma after an anthracycline-containing first-line program, any regimen of "rescue" chemotherapy is carried out, then high-dose chemotherapy and hematopoietic support with peripheral hematopoietic stem cells are prescribed, including irradiation of the original lesion or use the "iceberg" type.

If only partial remission is achieved after first-line chemotherapy and there is no positive dynamics of lesions after the first courses of standard therapy, the program is changed. Intensive "rescue" therapy is connected, including bone marrow transplantation, immunotherapy with monoclonal antilymphocyte antibodies: Rituximab, Mabther. They induce long-term remissions in monotherapy in 50% of patients, but do not prevent repeated relapses.

First-line NHL without the risk of complications can be treated with a combination of Rituximab and combined chemotherapy with CHOP or Fludara and Mitoxantrone.
It is important to know. In local relapses and primary refractory forms of NHL, radiation may be more promising for treatment than search effective regime chemotherapy.

Lymphoma - treatment with immunotherapy (biotherapy)

With a decrease in immunity, the body can no longer produce protective substances, so they are used in immunotherapy. They destroy lymphoma cells and slow their growth, activate the immune system to fight lymphoma.

White blood cells produce hormones to fight infection. Hormone-like substance - Interferon of various types stops cell growth and reduces lymphoma. It is used in combination with chemotherapy drugs.

Side effects during treatment with Interferon are manifested:

• increased fatigue;
• an increase in body temperature;
• chills, headache;
• pain attacks in the joints and muscles;
• mood change.

Monoclonal antibodies are produced by the immune system to fight infectious diseases. Such monoclonal antibodies are produced in laboratories and used to kill lymphoma cells.

Surgical treatment of lymphoma

Certain types of lymphomas, such as the gastrointestinal tract, require partial surgical treatment. But now operations are replaced or supplemented by other methods of treatment.

Use of laparotomy surgical operation, in which the abdominal wall is cut to gain access to the organs of the peritoneum. The purpose of the laparotomy affects the size of the incision. To conduct a microscopic examination for oncology of tissues, samples of organs and tissues are taken through the incision.

Treatment with bone marrow and peripheral stem cell transplantation

If standard therapy does not give the expected effect, then bone marrow or peripheral stem cell transplantation is used for lymphoma. In this case, high doses of chemicals are used to destroy resistant tumor cells.

Transplantation is performed with autologous (from the patient) and allogeneic (from a donor) bone marrow or peripheral blood cells. Autologous transplantation is not performed in case of damage to the bone marrow or peripheral blood by lymphoma cells.

Peripheral stem cells or bone marrow are removed from the patient before intensive chemotherapy or radiation is started. Then, after treatment, they are returned to the patient so that the blood counts are restored. Leukocytes increase after 2-3 weeks, later - platelets and red blood cells.

After bone marrow or peripheral stem cell transplantation, early or late complications or side effects. The early effects are the same as when prescribing high doses of chemotherapy. The later ones are:

• shortness of breath when radiation injury lungs;
• female infertility due to damaged ovaries;
• damage to the thyroid gland;
• the development of cataracts;
• bone damage, which causes aseptic (without inflammation) necrosis;
• development of leukemia.

Treatment of chronic lymphocytic leukemia

Chronic lymphocytic leukemia and small lymphocyte lymphoma are considered different manifestations of the same disease; treatment is required for specific lesions of the skin. Lymphoma from small lymphocytes - leukocyte lymphoma (LML) or chronic lymphocytic leukemia (CLL) is contained in the structure of all lymphomas, then when manifested, the disease can compete with the most common B-large cell lymphoma.

CLL and LML cells do not differ, arise from the same type of lymphocytes and develop almost the same way. However, CLL cells are found in the blood, while LML cells are found first in the lymph nodes. CLL cells originate in the bone marrow, while LML becomes generalized and then only involves the bone marrow in the process.

With long-term development, LML is treatable. For the first 1-2 years, patients do not need therapy, then cytostatic treatment is used. LML can then be histologically transformed into aggressive large B-cell lymphoma (Richter's syndrome) or Hodgkin's lymphoma. Like follicular lymphoma, it is poorly treatable. The median remission-free survival is 8-10 years.

Symptoms can be manifested by a monthly increase in lymphatic leukocytosis. Cervical, then axillary LU and other groups increase first. The spleen will be normal or slightly enlarged. Leukocytosis will be less than 20x109/l for many years. Nodular lymphatic proliferation in the bone marrow will be negligible. Then, on the skin in patients with B-CLL, manifestations of staphylococcal and viral lesions are possible.

The generalization of the tumor process is completed by secondary specific skin lesions: infiltrated spots, plaques and nodes, more often on the trunk, proximal extremities and face.

Treatment regimens for malignant lymphomas

Blocks 1-4 reveal treatment regimens in accordance with the stage of the disease and the functional status of the patient.

Lymphoma, treatment with folk remedies is included in general therapy and used as a prophylaxis. To reduce the side effects of radiation and chemistry, decoctions, infusions and tinctures are prepared from antitumor foods. Widely used: goji berries, mushrooms: chaga, reishi, meitake, shiitake and cordyceps. They are sold in fresh people who grow them at home. In dried form, they are sold in pharmacies and company stores, in the markets.

Since it can be unpredictable, like lymphoma, treatment with folk remedies must be agreed with an oncologist. For example, treating lymphoma with soda to facilitate complex therapy, replenishing blood with alkali to make it more liquid and less acidic, expelling fungi from the body is recommended by chemists and researchers: Professor Neumyvakin, Otto Warburg, Tulio Simoncini. German and Chinese doctors agree with them, who have conducted numerous studies to identify the effect of bicarbonate on cancer patients.

Important! Despite the opinion of scientists, it is impossible to treat lymphoma on your own, at your own discretion.

Lymphoma treatment with folk remedies includes before and after chemotherapy or radiation. The use of herbs and plants is well described on the site in the article ““, as well as interesting and useful material on the treatment of cancer with folk remedies, you will find in the heading, To reduce intoxication of the body and increase immunity, you can use the recipes from these articles in agreement with the oncologist.

Nutrition and diet for lymphoma

An important role is played by nutrition in chemotherapy of lymphoma. It should be high-calorie in order to compensate for the energy spent by the body on fighting cancer and recovering from chemo and radiation.

The diet for lymphoma chemotherapy should improve the quality of life with low immunity, eliminate sudden weight loss and infectious diseases.

Namely:

• will resume the loss of appetite with chemo diet.

Every 2-3 hours you should eat food without overeating and without an annoying feeling of hunger. At the same time, dry snacks “on the run” with sandwiches are excluded;

• food must be freshly prepared.

To eliminate nausea and for better absorption of food, you need to abandon fatty and fried foods, smoked, salted, peppered, preservatives, marinades, blue cheeses, fast foods, shawarma, hot dogs, pasties, etc.

You can boiled, baked or steamed meat and fish dishes, pasteurized milk, goat, cottage cheese casseroles, dumplings, mousses, etc.;

• sugar is replaced with honey.

In the absence of allergies to honey and honey products, it is recommended to drink a glass of water with honey in the morning and flower pollen(1 tsp each). Tea, juices, compotes, jelly are recommended to be consumed with honey (to taste). If there is an allergy, then limit the amount of sugar.

Oncological tumors actively develop in a carbohydrate (sweet) environment. But it is not recommended to completely exclude carbohydrates, since oncocells will replenish energy from muscles and other soft tissues, weakening the body;

• flush out toxins with water.

Water (without gas) in the amount of 1.5-2 liters per day reduces the toxic load on the urinary system. Compotes, teas with milk, broths, soups, kissels - this is considered food. Drinking green tea is not recommended - it levels the properties of chemicals;

• alcoholic drinks are excluded.

Alcohol: beer, vodka, sweet fortified wines add toxins to a weakened body. However, doctors recommend drinking 50 ml of natural red wine between treatments;

• vitamins for immunity.

Vitamins for lymphoma support the immune system and remove infectious diseases. Most vitamins can be found in fresh vegetables, berries and fruits. In winter, dried fruits are preferable, but they must be thoroughly washed and compotes insisted on them;

• flour products give strength.

Boiled durum pasta always excites the appetite if you add boiled low-fat poultry or baked fish, vegetable salad with lemon juice instead of butter to them. Bread must be fresh. It is better to refuse rolls, cakes, cakes with the presence of cream, icing, fatty fillings.

Nutrition after chemotherapy for lymphoma should also be fresh. You cannot increase or decrease calories. If nausea interferes with appetite, the body may go into saving mode. Hence - weight loss and reduced immunity.

To exclude this, you need:

• “work up an appetite” in the fresh air and replenish calories with nuts, honey, chocolate or fresh sour cream;
• eat warm food, excluding hot and cold;
• water and other liquid food: compote, jelly, fruit cocktail, juice drink 30-60 minutes before meals, or 1.5 hours after it;
• chew food thoroughly, since the absorption of juices begins in the oral cavity (under the tongue);
• delimit rough food from raw vegetables and fruits;
• in the presence of diarrhea, consume more cereals, especially rice, shabby soups, eggs;
• cook food in a double boiler, chop and wipe as much as possible to reduce the impact on the walls of the digestive system.

Informative video: Lymphoma, what is it, what are the symptoms and treatment

The term "lymphoma" is the collective name for many cancers that affect the lymphatic system. This is accompanied by an increase in lymph nodes and damage to some somatic organs, which are capable of accumulating a huge number of lymphocytes. A tumor can form in any part of the body, as lymph circulates throughout the body.

What is lymphoma?

In short, lymphoma (Lymphoma) is. The disease affects cells that perform a protective function in the body and form the entire lymphatic system.

So what is lymphoma? How does it manifest itself?

With an increase in lymph nodes and other internal organs, the process of accumulation of lymphocytes responsible for the immune system of the body begins in them. Accumulating in nodes and organs, lymphocytes disrupt them normal functioning. There is a failure in the division of normal cells, and the accumulation of tumor lymphocytes does not stop, resulting in a tumor - lymphoma.

Like all malignant tumors, lymphoma is manifested by the formation of the primary focus of the disease. In addition, it can not only metastasize to other structures, but also spread throughout the body, accompanied by a condition similar to lymphocytic leukemia. There is a type of lymphoma that occurs without enlargement of the lymph nodes and initially develops in the structures of the brain, lungs, stomach and intestines.

Many people wonder if lymphoma is cancer or not? The emergence of tumors from lymphocytes and the process of their maturation takes place in several stages. At any stage, the disease can become malignant, so lymphoma has many forms. Since lymphatic tissue affects almost all structures of the body, a tumor can form in any lymph node or organ. In addition to the lymph, blood also contributes to the spread of abnormal lymphocytes. If left untreated, the disease acquires the character of oncology, as a result of which the patient may die.

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Causes

The exact reasons for which the development of lymphoma occurs are not known to science to this day.

There is an assumption that lymphoma occurs due to the influence of many toxic substances on the body, but there is no confirmation of this theory. The list of factors that can provoke the disease includes:

• Hepatitis C virus;
• HIV infection;
• T-cell leukemia virus;
• mutagenic substances.

The people whose professional activity associated with close contact with heavy chemical compounds are at risk. People who come into contact with pesticides and those who eat processed foods are also at risk.

According to doctors, the following can also affect the development of lymphoma:

• Hereditary diseases (including lymphogenesis);
• autoimmune diseases;
• Drugs that suppress the immune system;
• herpes virus;
• Helicobacter pylori bacteria;
• Weakened immunity.

Types of lymphomas

Lymphomas are divided into 2 groups. The first group of diseases was called, the second included the so-called,. Each type of disease is characterized by individual signs, manifestations, and methods of their treatment are different. All types of lymphomas affect the lymphatic system, which performs a protective function of the body against infections.

The lymphatic system is complex. In the lymph nodes, the lymph circulating throughout the body is cleansed. The main components of the lymphatic system are the tonsils, thymus gland, spleen, bone marrow with a large number lymphatic vessels and nodes. The main accumulation of lymph nodes is concentrated in the armpits, on the neck and in the groin on the leg. Their number is not the same, in the axillary fossa there are more than 50 lymph nodes.

Today in medical practice, the following types of lymphomas are more common:

Symptoms of the disease

The manifestation of the disease depends primarily on the form of the disease, the size and location of the tumor. Hodgkin's lymphoma covers 5 types of malignant tumors. The number includes over 30 types of diseases.

The first group of diseases is different various symptoms, including lymph nodes and organs are affected. The symptomatology of the disease is characterized by both local symptoms and common manifestations diseases. The most common signs of lymphoma disease are fever, sweating, joint pain, general malaise, headaches, fatigue, weight loss, itchy skin.

Elevated body temperature is the first sign of lymphoma! An increase in body temperature is mainly observed in the evening and can reach 40 degrees. This is accompanied by chilliness, causing the patient to sweat profusely.

It is possible to determine skin lymphoma by the appearance of skin itching, and itching can appear long before the defeat of the lymph nodes. It can spread both throughout the body and appear in a certain area (more often on the limbs, including the palms and feet, on the head, in the breast area, etc.).

It is possible to diagnose lesions of the lymph nodes and organs after examination by a doctor. In 90% of cases, oncological foci are located at a level above the diaphragm, the remaining 10% are found below.

In 70% of cases, Hodgkin's lymphoma can be detected by enlarged lymph nodes in the neck, which are elastic and not soldered to each other and neighboring tissues. Lymphoproliferative lesions of the cervical lymph nodes are not accompanied by special symptoms, the nodes do not hurt, the skin around them is not red. Sometimes lymphoplasmosis affects small lymph nodes above the collarbone, and may affect the armpits. From them, in turn, the tumor is transmitted to the mammary glands.

Mediastinal lymphoma affects the lymph nodes in 20% of cases. The disease is characterized by compression and germination of lymph nodes in neighboring tissues. At the very beginning, the disease accompanies a dry cough, pain in the thoracic region, which is dull in nature and aggravated by deep inspiration and coughing. There may be pain in the heart and a bursting feeling in the chest due to enlarged lymph nodes. This may be accompanied by metastases to the pericardium, lungs and bronchi. As the tumor grows, patients develop shortness of breath during physical exertion. When the tumor reaches an impressive size, the "vena cava" syndrome may occur, but there are cases when the disease proceeds without symptoms and is detected randomly during x-ray examination.

Lymphoma in the abdominal cavity and retroperitoneal space is rare and accounts for no more than 8% of cases. For the most part, gastric lymphoma occurs, characterized by an asymptomatic course of the disease on. As the tumor grows, you may experience back pain, constipation, or gas.

Another rare type of lymphoma is inguinal and iliac lymphoma, accounting for only 3% of all cases of the disease. The tumor carries a poor prognosis due to its malignancy. The manifestation of the disease is as follows: it causes permanent and cramping pains in the lower abdomen, heaviness or swelling appears in the limbs, the sensitivity of the skin in the affected area decreases.

In addition to malignant forms of lymphoma, there are also benign ones.

Lymphoma of the spleen is very rare. This benign tumor is characterized by a high level of survival of patients, compared with other forms of the disease. The only sign of a lymphoblastic tumor is an increase in the size of the organ as a result of the accumulation of lymphatic fluid, which is detected by ultrasound or radionuclide research.

Lung lymphosis occurs in 30% of cases. Abnormal lymphocytes enter the organ with the flow of blood and lymph. The disease is accompanied by pain in the thoracic region, shortness of breath and cough. The tumor covers the lung and pleural tissue.

30% of cases are due to bone lymphoma. There are primary and secondary tumors depending on the type of lesion (tumor germination from neighboring foci or its transfer with blood and lymph). The tumor can affect areas of the spinal system (parts of the spine), ribs, sternum, and pelvic bones. Less commonly observed lesions of the bones of the skull and tubular bones. With lesions of the vertebrae, pain appears when pressed, there is also a feeling of numbness and twitching of the limbs. Progressing, the tumor can cause paresis and paralysis of the lower extremities and disrupt the functioning of the pelvic organs (uterus, ovary).

In 10% of cases, lymphoma affects the liver. The disease proceeds with symptoms such as nausea, vomiting, heartburn, pain in the right hypochondrium, and an unpleasant taste in the mouth. The disease can be confused with jaundice.

Lymphoma of the brain is characterized by damage to the lymphatic tissues of the brain, does not give metastases. It occurs more often in adults over 60 years of age. Symptoms of the disease are impaired speech and vision, drowsiness, headaches and memory lapses. Treating brain lymphoma is much more difficult due to its inaccessible location. Chemotherapy for brain lymphoma is the best treatment option, sometimes surgery is used.

In addition to those listed, there are other types of lymphomas (lymphofibroma, lymphoma, immunoblastic lymphoma, lymphocytic leukemia from small lymphocytes, lymphadenoma, etc.).

With lymphoma, both an indolent course of the disease and an aggressive one can be observed. Aggressive non-Hodgkin's lymphomas are characterized by a high degree of malignancy. They are easier to treat, as they make themselves felt in the early stages. Indolent Hodgkin's lymphoma is asymptomatic and incurable. It is treated with chemotherapy and surgery. Radiation therapy for Hodgkin's lymphoma is also relevant. Non-aggressive lymphomas are prone to recurrence, which can be fatal.

Stages of the disease

There are 4 stages of progression:

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Therefore, the earlier the disease was diagnosed, the greater the chance of recovery. If timely assistance is not provided, the prognosis for the patient will be sad.

Diagnostics

Lymphoma can be diagnosed by doing the following tests:

• CT (computed tomography) and PET (positron emission tomography);
• Ultrasound of the abdominal organs;
• X-ray of the chest;
• Biopsy when removing the affected lymph node to establish the form of the disease;
• Radionuclide diagnostics to detect bone lymphoma;
• Trepanobiopsy - allows you to identify lymphoma of the bone marrow;
• Fibrolaryngoscopy - a biopsy of the tissues of the tonsils, oropharynx, larynx is performed if they are often affected.

If Hodgkin's lymphoma is suspected, procedures such as:

• Make up a picture of the disease, specifying the symptoms (sweating, fever, weight loss);
• Palpation of all peripheral lymph nodes (elbow, subclavian, popliteal), abdominal and retroperitoneal cavities, iliac lymph nodes.
• Puncture and cytological analysis to identify the affected nodes and select the required type of therapy;
• Biopsy of affected lymph nodes.

Treatment

Treatment of lymphosis is carried out both by traditional methods and by traditional medicine. Of the traditional methods, chemotherapy and radiation therapy, or a combination of both, are widely used. When choosing a method of therapy, the stage of the disease and risk factors are taken into account. Lymphoma treatment begins with the use of chemotherapy drugs. Radiation therapy treats only the initial stage of the disease. With lesions of the lymph nodes, the procedures of lymphectomy and lymphomodulation are performed. Both soft tissue lymphoma is surgically removed and carried out.

Another important question Which doctor treats lymphoma? Treatment of oncology of the lymph nodes is carried out under the supervision of an oncologist, hematologist, in some cases, the help of a surgeon is necessary.

With a favorable prognosis, ABVD chemotherapy is prescribed. Prescribed drugs for the treatment of the disease, such as Bleomycin, Dacarbazine, Vinblastine and Doxorubicin. The drugs are administered intravenously. With an unfavorable prognosis, a VEACORR scheme is prescribed with the drugs Prednisolone, Bleomycin, Cyclophosphamide, Etoposide, Doxorubicin, Vincristine, Procarbazine. Diet after therapy plays an important role in restoring the body's strength.

Monoclonal antibodies, which have a low degree of toxicity, are also prescribed for the treatment of lymphoma.

Nodular lymphoma is difficult to treat in the elderly. Complete remission is observed before the age of 40 and is about 65%, after sixty years - 37%. Toxic mortality with the collapse of the lymph node is observed in 30% of cases.

Treatment for recurrent generalized, aggressive lymphoma depends on many factors. This is the age of the patient general well-being, sensitivity to drugs used during previous therapy. Re-treatment should include additional drugs to achieve a positive result. What drugs should be used, the doctor will specify.

Lymphoma is not treatable and the patient is given to improve the quality of life. This includes spiritual, psychological and social support.

Treatment with folk remedies

Many people ask the question - is it possible to cure lymphoma with folk methods? Facilities traditional medicine can help speedy recovery if they are used in combination with the main type of therapy. We should not forget that folk remedies can be used only after the establishment accurate diagnosis and with the approval of the attending physician. It is unacceptable to make a diagnosis without an examination by a doctor, by reading the symptoms of the disease on the Internet.

For the treatment of lymphoma, decoctions of plants such as:

Before starting treatment, you should consult your doctor, as certain components may have contraindications, allergic reactions and other complications may occur after taking decoctions.

Nutrition and diet

Proper nutrition plays a big role after tumor treatment with chemotherapy. The diet should be balanced, high-calorie in order to compensate for the energy expended by the body to fight the tumor and restore its former strength.

The diet should improve the quality of life, the patient's condition, prevent a sharp decrease in body weight and infection with infectious diseases. To restore the body after chemotherapy, you should:

• Take vitamins to restore immune forces;
• Exclude alcohol;
• Replace sugar with honey;
• Eat freshly prepared food;
• Drink more fluids;
• Include flour in the diet.

You should eat after 2-3 hours, while it is not recommended to overeat and eat food that does not give pleasure. It is also not recommended to starve. Walking in the fresh air before eating will be beneficial.

Video: Lymphoma - what is it, symptoms and treatment

How long do people live with lymphoma? Forecast

With the use of modern methods of treatment, the prospect of a 5-year survival is observed in 95% of cases with a favorable prognosis. With an intermediate prognosis, this survival rate is about 75%, and with a poor prognosis, no more than 60%. Patients who neglect the symptoms of the disease and take no action die of lymphoma.

From the above, we learned that lymphoma can be benign and malignant, its signs and how it is treated. Each variety has a specific symptomatology. Lymphoma is not contagious, so there is no prevention of it, like any other oncological disease. If you adhere to the right lifestyle, monitor your health and consult a doctor in a timely manner for help, you can significantly reduce the risk of developing oncology. If you have symptoms or if you still get sick with lymphoma, it was confirmed during the examination, then you should immediately begin treatment.

- malignant lymphoproliferative tumor of extranodal localization, originating from lymphoid formations bronchopulmonary system. The clinic of lung lymphoma consists of non-specific symptoms (unsharp weakness, periodic subfebrile condition) and signs of damage to the respiratory tract (unproductive cough, shortness of breath, chest pain, etc.). The diagnosis is made on the basis of x-ray data (radiography, CT, MSCT of the lungs), confirmed by the study of biopsy material. The choice of tactics for the treatment of lung lymphoma (surgery, radiation therapy, polychemotherapy) is carried out taking into account the degree of malignancy and the prevalence of the lesion.

Lymphoma of the lung is a tumor lesion of the lymphoid apparatus of the lower respiratory tract. May occur as Hodgkin's disease and malignant non-Hodgkin's lymphomas. Lymphomas of the lungs occupy a leading place in the structure of extranodal lesions (i.e., lesions of organs that are not related to the lymphatic system). In lymphoproliferative diseases, the interest of the lung tissue is found in 0.5-40% of cases. Pulmonary lymphomas are an urgent interdisciplinary problem that combines knowledge and efforts in the field of pulmonology, hematology and oncology.

In Hodgkin's disease, lung involvement usually serves as a local manifestation of a systemic process; much less often an independent local form of lung lymphogranulomatosis is diagnosed. In most cases, isolated primary pulmonary lymphomas belong to B-cell non-Hodgkin's lymphomas - the so-called MALT-lymphomas, originating from the lymphoid formations of the mucous membrane. Secondary pulmonary lymphomas are metastatic formations that spread directly or hematogenously from other foci.

Causes of lung lymphoma

Lung lymphoma has common etiological roots with other lymphoid tumors, however, to date, knowledge about their causes cannot be considered exhaustive. In recent years, data have been obtained on the viral origin of some malignant lymphomas. At the same time, a more frequent association of lymphoid tumors with Epstein-Barr viruses, herpes type 8, hepatitis C, human T-lymphotropic virus, HIV was noted.

Other likely risk factors include contact with chemical carcinogens (fertilizers, insecticides, herbicides, solvents, etc.), autoimmune diseases, and long-term immunosuppressive therapy. The latter circumstance determines the fact that malignant lymphomas occur somewhat more often in persons who have undergone organ or bone marrow transplantation. Quite often at patients with a lymphoma various structural chromosomal anomalies come to light. Contrary to popular belief, smoking does not affect the incidence of lung lymphoma.

Classification of lung lymphoma

Among the malignant lymphomas of the lung are:

1. Primary non-Hodgkin's lymphomas (lymphosarcomas)

• B-cell (MALT-lymphoma, mantle lymphoma, etc.)
• T-cell

2. Lymphogranulomatosis (Hodgkin's disease)

3. Plasmacytoma.

4. Secondary lymphoproliferative lesions of the lungs in malignant lymphomas of other localizations.

MALT lymphoma is the most common type of extranodal lymphoma. MALT-lymphoma of the lungs can have a limited localization for many years; bone marrow damage is observed in no more than 5% of cases. Usually develops against the background of chronic broncho-pulmonary infections and autoimmune diseases(systemic lupus erythematosus, multiple sclerosis, Sjögren's disease, etc.). In some cases, a low-grade MALT lung lymphoma can transform into a highly aggressive tumor (the reasons for and the likelihood of such transformation are unknown).

Pulmonary lymphogranulomatosis can occur in the following clinical and morphological forms:

• knotty- with the formation in the lungs (more often in the lower lobe) of a single or multiple nodes (up to 3-5 pieces). In case of compression of the bronchi, a clinic of purulent bronchitis or abscessing pneumonia develops.
• peribronchial- with the formation of strands, stretching along the bronchi. If granulomatous growths spread to the alveolar septa, interstitial pneumonia occurs, which can capture from one lobe to the whole lung.
• exudative- with the development of granulomatous lobular or lobar pneumonia.
• miliary (submiliary)- with a disseminated scattering of millet-like granulomatous nodules over the lung tissue.

Symptoms of lung lymphoma

Primary lung lymphomas have a latent course for a long time. They equally often affect men and women and are usually detected in people of the older age group (50-60 years). The asymptomatic period can vary from several months to several years, so lymphomas are often incidentally detected during a routine x-ray examination. Most often, lymphoma affects the bronchi or lung parenchyma, while in 60-70% of cases bilateral localization of the tumor is detected.

Clinical symptoms usually develop against the background of bronchial obstruction or partial atelectasis of the lung, accompanied by cough, chest pain, hemoptysis, recurrent bronchopulmonary infections. Systemic signs of intoxication (unsharp weakness, sweating, subfebrile temperature) at first are often perceived as signs of SARS. In advanced stages, pulmonary lymphoma can cause metastatic lesions of the mediastinum, gastrointestinal tract, thyroid gland, mammary glands, testicles, and bone marrow.

With lymphogranulomatosis, there is an increase and soreness of the lymph nodes (usually cervical, supraclavicular, axillary), unproductive cough, chest pain, shortness of breath. With the interest of the pleura, pleurisy often develops.

Plasma cell malignant lymphoma of the lung (plasmocytoma) is rare, predominantly in men. Usually it is a solitary node located against the background of unchanged lung tissue. Local plasmacytomas can exist for a long time, occasionally causing poor clinical symptoms: cough, chest pain, fever. When the primary node is removed, healing may occur; when the process is generalized, there is a transition to multiple myeloma (multiple myeloma).

Diagnosis and treatment of lung lymphoma

The main methods of diagnosing pulmonary lymphoma are traditional radiation studies. First of all, the patient undergoes a chest x-ray in 2 projections. If characteristic changes are detected on radiographs (focal shadows, diffuse tumor infiltration, lymphangitis, pleural effusion, etc.), MSCT or CT of the lungs is also performed for a more detailed assessment of changes and staging of the tumor process.

According to modern requirements, x-ray data indicating lung lymphoma must be confirmed histologically. To verify changes in the lung tissue, a transbronchial (during bronchoscopy) or transthoracic lung biopsy is performed with further cytological and immunohistochemical examination of the biopsy. In some cases, to obtain the necessary material, it is advisable to resort to a biopsy of the lymph node, diagnostic thoracoscopy or exploratory thoracotomy. It is necessary to differentiate lung lymphoma from bronchoalveolar cancer, carcinomatous lymphangitis, histiocytosis X of the lungs, tuberculosis, sarcoidosis, benign lymphoid hyperplasia and etc.

Treatment of isolated lung lymphoma at a local stage is usually surgical (lobectomy, pneumonectomy), supplemented by radiation therapy. With bilateral, generalized lesions, multiple foci, a high degree of malignancy of lymphoma and other aggravating factors, polychemotherapy is indicated or combined treatment(radiotherapy + chemotherapy, polychemotherapy in combination with monoclonal antibodies to B-lymphocytes (rituximab).

Survival over the next 5 years with primary MALT-lymphomas of the lungs is more than 60%, which is regarded as good forecast. With T-cell non-Hodgkin's lymphomas, lymphomas with a high degree of malignancy, generalized lesion, metastatic process in the lungs, survival is low, the prognosis is doubtful.

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