Lymphoma is a malignant tumor originating from tissue lymph and lymph nodes, and can also originate from lymphoid hematopoietic system. Its incidence is the third in children’s malignant tumors. Lymphoma is mainly divided into two categories: Hodgkin lymphoma (HD) and non-Hodgkin lymphoma (NHL), of which in China, non-Hodgkin lymphoma and Hodgkin lymphoma are the main types. In addition, there are classifications such as Burkitt’s lymphoma, other miscellaneous lymphoreticular tumors, and indeterminate lymphomas.
2. Symptoms The symptoms of lymphoma usually include: 1. Painless lymph node enlargement: This is a common symptom of lymphoma. It is usually manifested as lymph node enlargement in the neck, supraclavicular, axillary, inguinal and other parts. The lymph nodes are hard, movable or adherent. There is no pain at first, but pain may occur as the disease progresses. Sixty percent of children have enlarged anterior mediastinal, paratracheal and hilar lymph nodes, which compress the bronchi and cause cough and asthma. 2. Fever: It is usually manifested as persistent or intermittent low fever, and high fever may also occur, with body temperature above 39 ℃. 3. Night sweats: Sweat heavily at night or after falling asleep, soaking clothes and bedding. 4. Weight loss: In the absence of deliberate dieting or increased exercise, weight loss is significant in a short period of time. 5. Skin pruritus: Intractable pruritus occurs in the whole body or local skin, and the effect of conventional antipruritic drugs is not good. In addition, lymphoma patients may also have anemia, easy bleeding and other symptoms. If the symptoms persist and can not be alleviated, it is recommended to seek medical treatment in time.
3. Examination and diagnosis The examination and diagnosis of lymphoma usually include the following aspects: 1. Blood examination: including blood routine, erythrocyte sedimentation rate, liver and kidney function, etc. 2. Imaging examination, such as ultrasound, chest X-ray or chest and abdominal CT scan, to find out whether the tumor invades the mediastinum, abdominal lymph nodes, lungs, liver and spleen. 3. Pathological examination of lymph node tissue: lymph node biopsy was taken to make a definite diagnosis, and histopathological typing was carried out at the same time. 4. Bone marrow puncture: to find out whether the tumor cells have invaded the bone marrow.
4. Treatment methods The treatment methods of lymphoma include chemotherapy, radiotherapy, immunotherapy, hematopoietic stem cell transplantation and surgery, etc. The specific treatment plan should be individualized according to the specific conditions of patients: 1. Chemotherapy: Commonly used drugs include cyclophosphamide, vincristine, prednisone, etc. Drugs are used to kill tumor cells. This is the primary treatment for lymphoma, usually with a combination of drugs. 2. Radiotherapy: Radiation is used to kill tumor cells, which is suitable for local lesions. Radiotherapy was performed on the residual tumor site or the original huge mass site after chemotherapy. 3. Immunotherapy, such as rituximab, can enhance the recognition and attack of the immune system on tumor cells. 4. Hematopoietic stem cell transplantation: including bone marrow transplantation and peripheral blood hematopoietic stem cell transplantation to reconstruct the hematopoietic and immune functions of patients. 5. Surgery: It is mainly used for diagnosis and treatment of complications.
5. The preventive measure of preventive measure lymphoma include: 1. Take strict precautions against virus invasion: through vaccination (such as hepatitis vaccine), promoting sleep, frequent exercise and other measures, enhance physical fitness, improve the body’s immunity and disease resistance. 2. Strengthen the immune system in the body: reasonable diet, adequate intake of nutrients related to immunity, prevent malnutrition; rational use of drugs, try to avoid antibiotics, glucocorticoids and other drugs that damage the immune system. Avoid and control long-term chronic infection, radiation and other long-term stimulation. 3. Pay attention to food hygiene: live and eat regularly, do not drink alcohol, do not eat moldy food, eat less pickled, fried and high-fat food, quit smoking (including second-hand smoke). 4. Purify the environment: strive for environmental protection in room decoration, use mobile phones and computers correctly, and control ionizing radiation within the allowable range. 5. Avoid harmful chemicals: for example, do not use or use less hair dyes, and remove pesticides and other anti-pollution treatments for fruits and vegetables. 6. Moderate sunbathing: Sunbathing has an obvious preventive effect on lymphoma, but it can not be excessively exposed to the sun, otherwise it will cause the possibility of skin cancer. If high-risk groups have genetic factors or are elderly and infirm, they should eat some anti-malignant lymphoma foods and alkaline foods with high alkali content, such as frog, taro, Water chestnut, walnut, litchi, snail, sheep stomach, oyster, etc. At the same time, pay close attention to the changes of superficial enlarged lymph nodes, and for patients with similar diseases in family members, we should be more vigilant and have regular physical examinations. Actively treat other chronic diseases that may be related to the occurrence of this disease, such as chronic lymphadenitis, autoimmune diseases, etc. Generally speaking, lymphoma is a serious malignant tumor, which needs early detection and treatment. Reasonable preventive measure and active treatment can effectively improve the survival rates of lymphoma and the quality of life of patients.
There are indeed some similarities between the symptoms of
lymphoma and other diseases, but there are also some key differences. The following are some of the main methods of differentiation:
One of the symptoms of
lymphoma is lymph node enlargement, but it is not a specific manifestation. Therefore, it needs to be differentiated from other diseases that cause lymph node enlargement, such as tuberculous lymphadenitis, necrotizing lymphadenitis and acute lymphadenitis. These diseases are usually accompanied by their own specific symptoms, such as tuberculosis may be accompanied by low fever, night sweats and other symptoms of tuberculosis poisoning, necrotizing lymphadenitis may have high fever, rash and other manifestations. It can be further differentiated by detailed medical history, physical examination and laboratory tests, such as blood routine and lymph node biopsy.
2. To distinguish from diseases with fever as the main manifestation, lymphoma patients may have fever symptoms, but it is not a specific manifestation. Therefore, it needs to be differentiated from other febrile diseases, such as tuberculosis, sepsis and connective tissue diseases. The febrile characteristics of these diseases are different, for example, tuberculosis is usually low-grade fever, and septicemia may be accompanied by high fever and chills. The cause of fever can be identified by history, physical examination, and laboratory tests, such as blood culture and tuberculin test, so as to differentiate from lymphoma.
Lymphoma occurs not only in lymph nodes, but also in extranodal organs and tissues. Therefore, it needs to be differentiated from other malignant tumors occurring in extranodal organs and tissues, such as lung cancer, gastric cancer, liver cancer, etc. These malignant tumors have different clinical signs and imaging features, such as lung cancer may have cough, hemoptysis and other symptoms, gastric cancer may have stomach pain, weight loss and other manifestations. Through medical history, physical examination, imaging examination and pathological examination, the primary site and nature of the tumor can be identified, so as to differentiate from lymphoma.
IV. Key points
of comprehensive identification
1. Medical history inquiry: Detailed inquiry about the patient’s medical history, including the onset time, symptom changes, past disease history, etc., is helpful to preliminarily judge the patient’s condition. 2. Physical examination: observe the patient’s lymph node size, texture, activity, and other accompanying symptoms, such as fever, night sweats, weight loss, etc. 3. Laboratory examination: including blood routine, erythrocyte sedimentation rate, liver and kidney function, tumor markers, etc., is helpful to understand the patient’s physical condition and tumor condition. 4. Imaging examination, such as ultrasound, chest X-ray, CT scan, etc., can observe the size, shape, location of the tumor and whether it invades other organs and tissues. 5. Pathological examination: The nature and type of the tumor can be determined by lymph node biopsy or histopathological examination, which is the most reliable method to differentiate lymphoma from other diseases. To sum up, although the symptoms of lymphoma are similar to those of other diseases, they can be accurately differentiated and diagnosed through detailed medical history inquiry, physical examination, laboratory examination, imaging examination and pathological examination. Therefore, patients with suspected lymphoma should seek medical treatment in time and receive examination and diagnosis from professional doctors.
The treatment of
lymphoma mainly includes the following:
1. Chemotherapy is one of the main treatments for lymphoma, which kills tumor cells through chemical drugs. Commonly used drugs are cyclophosphamide, doxorubicin, vincristine, prednisone and so on. These drugs can be used alone or in combination to enhance efficacy. Chemotherapy regimens will be selected according to the patient’s specific condition and the type of lymphoma.
2. Radiotherapy Radiotherapy is a method of killing tumor cells by radiation, which is suitable for local lesions. Radiotherapy can be used in the adjuvant treatment of lymphoma, especially in the consolidation therapy after chemotherapy and in the adjuvant treatment of transplantation. Radiotherapy can maximize the local effect and reduce the damage to the surrounding tissues.
3. Immunotherapy Immunotherapy is to treat lymphoma by enhancing the ability of the immune system to recognize and attack tumor cells. Commonly used immunotherapy drugs such as rituximab and PD-1 inhibitors. These drugs can help the immune system better recognize and attack tumor cells, so as to achieve the goal of treatment.
4. Hematopoietic stem cell transplantation Hematopoietic stem cell transplantation is a therapeutic method to reconstruct the hematopoietic and immune functions of patients, which is suitable for some lymphoma patients. Including autologous hematopoietic stem cell transplantation and allogeneic hematopoietic stem cell transplantation. Autologous transplantation uses the patient’s own hematopoietic stem cells, while allogeneic transplantation uses the donor’s hematopoietic stem cells. This method can rebuild the immune system of patients and improve the survival rate of patients.
5. Surgical treatment is relatively rarely used in the treatment of lymphoma, mainly for the diagnosis and treatment of complications. For example, when lymphoma compresses adjacent organs or tissues, it can be removed by surgery. In addition, surgical treatment can also be used to obtain pathological tissue samples for pathological typing and diagnosis.
6. Comprehensive treatment of lymphoma is often comprehensive, and individualized programs need to be formulated according to the specific conditions of patients. Comprehensive treatment includes chemotherapy, radiotherapy, immunotherapy, hematopoietic stem cell transplantation and other methods to improve the efficacy and survival rate of patients. In conclusion, there are various treatments for lymphoma, which need to be selected according to the specific situation of patients and the type of lymphoma. Patients are advised to go to regular hospitals for evaluation and treatment by professional doctors. At the same time, maintaining a good attitude and a positive lifestyle are also important factors in the treatment of lymphoma.
