Lymphoma usually affects the lymph nodes. However, it can occur in other tissues. They can be classified in several ways; Hodgkin’s or non-Hodgkin’s lymphoma and indolent lymphoma or aggressive lymphoma are some of them.
What is Lymphoma
Lymphoma is the “disease of the lymph nodes”, that is, the system of the organism that conducts the lymph, which is the one that contains a large amount of antibodies. It is defined as a clonal and malignant proliferation of lymphocytes, which are the body’s defense cells. These lymphocytes are found within the lymph nodes, although it can affect other tissues, such as the liver, spleen, tonsils, etc. The medium-term consequence of this disease is a malfunction of the immune system, which can be more or less severe depending on the extent of the disease. The leukemic expression of this pathology occurs when the disease infiltrates the bone marrow and the tumor cell passes into the bloodstream.
Factors that can produce Lymphoma and what is its incidence?
Lymphoma has an incidence of 5 people per 100,000 inhabitants each year. The average age at which this disease usually appears is 60 years, with a slight male predominance. At this time it is not clear what factors may trigger the disease. In some cases it is associated with infectious processes due to certain types of bacteria such as Helicobacter Pylori or Borrelia, or viral processes such as the Epstein Baar virus. Experts have also associated this pathology to the use of certain hair dyes, ionizing radiation, insecticides and certain types of chemotherapy treatment, without conclusive evidence.
Symptoms of Lymphoma
The main sign of lymphoma is enlarged lymph nodes, called lymphadenopathies, sometimes in areas accessible to examination, such as the neck, armpits or groin. Generally these enlarged lymph nodes are not painful on palpation. When lymph nodes appear in areas less accessible to examination, such as the abdomen or mediastinum, they can go unnoticed, making diagnosis more difficult, and diagnosis is made when other symptoms appear that require more in-depth studies. Among the symptoms that may appear are
- Fever above 38 ºC
- Profuse night sweats that may even soak clothes.
- Unexplained weight loss, usually greater than 10% of total body weight in six months.
Other less common symptoms:
- Liver and spleen enlargement.
Do I have Lymphoma because of enlarged lymph nodes and fever?
Given the low incidence of this pathology, the first thing to rule out is that there is no underlying infectious process, which is usually present in most cases. Therefore, the first thing to do is to be calm and go to the general practitioner to carry out the pertinent complementary tests or refer to the relevant specialist.
Prevention of lymphoma: is it possible?
Given the little that is known about the epidemiology of this process, there is, to date, no way to prevent the development of lymphoma. Experts agree that a healthy lifestyle could reduce the risk of developing this type of disease, although a direct causal relationship has not been established. In general, specialists recommend avoiding obesity, smoking and cardiovascular risk factors, not because they prevent the development of the disease, but because, when faced with the need for intense chemotherapy or radiotherapy treatment, there is a greater chance of success by reducing the associated comorbidity as much as possible.
Classification of Lymphomas
Traditionally, and from the histological point of view, the first classification of lymphoma dates back to the end of the 19th century. It was in Hodgkin and non-Hodgkin type, depending on the presence of a type of cell that, to date, seems to belong to the B lymphocyte family, which was called Reed-Stembert cell in Hodgkin’s lymphoma or “owl’s eye cell”, because of the peculiar arrangement of the double nucleus of the cell seen under the light microscope. All others that did not belong to this category were called non-Hodgkin’s lymphomas. This classification has endured over time to the present day.
Another form of classification dating from the mid 1970’s is according to prognosis or possibility of cure in grades: low, intermediate or high grade. However, a more updated classification system from the end of the 80’s, which is the system most used by specialists according to their clinical behavior, is called REAL classification, and divides them into two main types:
- Indolent lymphoma: is one that tends to grow slowly. Even without treatment, patients live many years without presenting any complications, as a consequence of the evolution of the disease. For some of these patients, no treatment is recommended until symptoms appear.
- Aggressive lymphoma: they grow more rapidly than indolent lymphomas. Without treatment the life expectancy of these patients is weeks or a few months. Fortunately, most are chemo- and radiosensitive and many are cured.
Diagnosis of Lymphoma
The diagnosis of lymphoma must be systematized and structured in order to determine the histological type of lymphoma and the degree of extension, since it will condition the prognosis and the protocolized treatment scheme. In this way an exhaustive clinical history of the patient will be taken, with emphasis on family and personal history, habits or concomitant pathologies, followed by an adequate clinical examination, detecting adenopathies or visceromegalies, as well as their characteristics.
Once this is done, the specialist will proceed to the corresponding analytical-serological study of the patient, imaging tests such as ultrasound-CT-PET, among others, and finally a study of the biopsy of the lymph node and / or bone marrow, which will give the confirmatory diagnosis of the pathology.
Treatment and prognosis of lymphoma
The treatment of lymphoma is varied and goes from simply observing the patient on a scheduled basis, to the application of different chemo-radiotherapy treatment protocols, including hematopoietic progenitor transplantation. All treatment will depend on the type of lymphoma and the degree of extension of the disease. Therefore, it is important, at the appearance or suspicion of the first symptoms, to go to your doctor for the appropriate approach.
As for the prognosis, thanks to the great medical advances in treatment, up to 60% of cases of lymphoma are now cured, although the prognosis depends on a series of factors such as: age, the general condition of the patient, the stage of the disease at the time of diagnosis and the histological type involved, as mentioned above.