lymphoma

What is lymphoma?

Lymphoma is a primary neoplasm of lymphoid cells. More precisely, by "lymphoma" we mean a heterogeneous group of malignant tumors that involve the lymph nodes and the lympho-glandular apparatus in general, including also B lymphocytes, T lymphocytes and relative precursors.

Erroneously, due to the presence of some similar cellular and phenotypic expressions, lymphoma tends to be confused with leukemia; in reality, while leukemia is a tumor of the bone marrow in which the malignant cells do not localize in a particular locus, the lymphoma foresees the localization of the tumor mass in a precise lymphoid area (generally it appears in a given peripheral lymphatic tissue).

Incidence and causes

Lymphomas register a very high incidence, so much so that they are among the most frequent malignant tumors on a global scale; lymphomas not only account for 5% of malignant neoplasms, but are also the fifth cause of death from cancer.

Unfortunately, for 70% of lymphomas the cause is unknown; for the remaining 30%, lymphomas can be favored by immunodeficiency (eg associated with HIV or following an organ transplant), autoimmune diseases (eg rheumatoid arthritis) and bacterial infections ( Helicobacter pilory ) and viral (virus of Epstein-Barr that causes Burkitt's lymphoma). Other cancers can also trigger lymphomas, as well as radiation and chemicals in general (related to cancer only in 1% of cases).

Spleen lymphoma

Lymphoma in the spleen, a tumor that occurs mainly in the elderly, is very difficult to diagnose and most of the times it is underestimated; as a rule, lymphoma in the spleen is related to thrombocytopenia (quantity of circulating platelets less than 150, 000 / mm3), lymphocytosis anemia (lymphocytosis associated with anemia) and splenomegaly (excessive increase in the volume of the spleen). Genetic predisposition also affects the etiopathology of lymphomas.

Classification of Lymphomas

In WHO Classification, the WHO (World Health Organization) refines the work previously performed by REAL (an acronym for Revised European-American Lymphoma ), and classifies lymphomas into five broad categories, each of which is made up of several sub-classes:

• lymphoma of T-cell precursors;
• lymphoma of T lymphocytes and mature natural killer cells (eg leukemia with large granular T lymphocytes, lymphomatoid papulosis, Sèzaty's syndrome );
• lymphoma of B-cell precursors (eg leukemia of B-cell precursors);
• lymphoma of mature B lymphocytes (eg follicular lymphoma, cutaneous lymphoma, mantle cell lymphoma, Burkit lymphoma );
• Hodgkin's lymphoma to which they belong: nodular sclerosis, lymphocyte depletion, cellular heterogeneity;
• non-Hodgkin's lymphomas (eg lymphoma in the spleen).

This classification of lymphomas is the last one, updated in 2008. Before that, lymphomas were subdivided according to their dangerousness, a complex division because it made use of relatively subjective principles: a lymphoma could explode in its manifestations in a more or less aggressive way in based on the subject. The previous catalogs were therefore not clear, and caused confusion because the criteria for recognizing the different neoplasms were doubtful and not defined den. The current classification of lymphomas, on the other hand, based on cellular, morphological, anatomical and histological parameters, appears to be indisputable.

Aggressive and indolent lymphomas

A further classification of the lymphomas is carried out based on the clinical course: the painful and aggressive lymphomas are distinguished from the indolent ones. The former have a rapid course with an almost immediate weakening of the health of the affected person. If they are not treated promptly they lead to death. Fortunately, if diagnosed early, aggressive lymphoma can heal definitively (eg most lymphomas involving T lymphocytes). Indolent lymphomas, on the other hand, occur without causing serious injury to the organism, so that affected individuals may not notice the neoplasm even for a few years (eg neoplasms of B lymphocytes). Non-aggressive neoplasms, although such, present a difficult and complex solution to therapy, and the patient is unlikely to completely heal.

Course

The clinical and pathological picture of lymphoma presents an almost standardized course: first the tumor involves a specific area, such as a single organ, an area rich in lymph nodes or an extra-nodal region. Subsequently, the neoplasm affects multiple areas, usually located on the same side of the diaphragm; in the next stage, the lymphoma progresses by affecting localized regions on both sides of the diaphragm and / or spleen. The maximum evolution of the lymphoma occurs when the tumor spreads to the other organs, metastasizing.

Symptoms

To learn more: Symptoms Lymphoma

The symptoms that act as a wake-up call for the affected person can be multiple based on the lymphoma; given the multiplicity of lymphomas and the variability of clinical aspects, the symptoms may also be different: consistent and inexplicable decrease in body weight in a few months, excessive and overabundant sweating during the night, fever above 38 ° C.

Therapy

Lymphomas can be treated by radiotherapy, chemotherapy or both: thanks to these treatments, refined in recent years, the chances of survival have definitely increased. However, the side effects that derive from the aforementioned therapies can also be very unpleasant and determine, for example, sterility.

However, medicine is studying new, even more precise, innovative methods designed to defeat only malignant cells, without affecting healthy ones, in order to create as few side effects as possible. Some research to defeat lymphomas are perfecting immunotherapy methods: these are biological substances that can stimulate the body's immune system for the sole destruction of lymphoma-affected cells.

To know more:

Drugs for the treatment of non-Hodgkin's lymphoma

Hodgkin's lymphoma treatment medications

Summary

To fix the concepts ...