Lymphosarcoma, cancer of the lymph nodes and lymphatic system

Lymph node cancer is popularly called lymphoma - malignant tumors of the lymphatic system.

• Causes of lymph node cancer
• Symptoms of lymph node cancer
• Classification of lymph node cancer
• Stages of lymph node cancer
• Diagnosis of lymph node cancer
• Treatment of cancer of the lymphatic system
• Possible complications
• Forecast
• Prevention

Further in the article, under the term “lymph node cancer” we will consider lymphomas. Despite their malignancy, they are not actually cancer, and it is this group of diseases that is characterized by primary damage to the lymph nodes.

General information

Malignant lymphomas (cancer of the lymphatic system) are a large group of tumor diseases that originate from lymphoid tissue and belong to hematological malignancies .
Malignant lymphomas are more common in young people. Lymphoid organs, which include the lymph nodes, spleen, appendix, Peyer's patches of the intestine, tonsils and thymus, contain cells of lymphoid tissue. If lymphoma develops in lymphatic structures, then this is a nodal manifestation of the disease . If lymphomas originate from the lymphoid tissue of other organs (liver, stomach, brain), skin, then these are extranodal tumors .

The lymphatic system consists of lymph capillaries, lymph vessels and lymph nodes. Lymphatic capillaries collect lymph (interstitial fluid) with microorganisms, various cells, electrolytes and carry it to the lymph nodes for filtration. This is how the drainage function of this system occurs - the lymph nodes neutralize microorganisms, providing protection against infection. Lymphatic vessels have valves that prevent the reverse flow of lymph, so it flows in one direction into the venous bed. A primary tumor can develop in the lymph nodes (in the case of hemoblastoses, which will be discussed today), or there can be a secondary metastatic lesion when malignant cells spread from tumors, when there is oncology of various organs. Most often, malignant lymphomas affect the lymph nodes, which is why in everyday vocabulary it is called lymph node cancer.

Malignant lesions of the lymph nodes occur when:

• Hodgkin's lymphoma is a common variant that affects the lymph nodes. In terms of cure, it is a more favorable disease.
• Non-Hodgkin's lymphomas (the term lymphosarcoma , which was used earlier, is considered obsolete). This is a large group of malignant lymphoproliferative tumors. The identification of various variants is based on the morphological and immunophenotypic characteristics of tumors. Depending on this, there are differences in the clinical course and prognosis.

The starting point for diagnosing all these diseases is enlarged lymph nodes, which is the first and main symptom. Most often, malignant lesions of the lymph nodes occur in the groin area, neck and axillary region. An enlarged lymph node of more than 1 cm and lasting more than a month is an indication for a biopsy .

Pulmonary lymphoma - what is it?

The lymphatic system of the lungs resembles a branched tree - its vessels penetrate the entire length of the chest and are responsible for lymph flow. There are 13 types of lymph nodes, classified into 5 groups:

1.Supraclavicular lymph nodes;

2.Upper medial lymph nodes (paratracheal, prevascular, prevertebral);

3.Aortic lymph nodes;

4.Lower mediastinal lymph nodes;

5.Root, lobar, (sub)segmental lymph nodes.

In the nodes, lymph is filtered and lymphocytes mature. Lymphomas arise in the lymph nodes.

Affected lymph nodes are often not visible or palpable. Pathological changes - enlarged lymph nodes, tissue compaction - are clearly visible on a high-resolution multi-slice CT scan or MRI. To determine the specifics of the neoplasm (normal or malignant process), the attending physician may refer the patient for histological examination. In some situations, an increase in nodes is a relative norm (after infectious and inflammatory diseases, injuries, allergic reactions), in others it indicates an oncological process. In the latter case, we can talk about lymphoma.

Since the lymphatic system is a vast network of vessels, capillaries and cavities, malignant cells can spread throughout the body, forming multiple disseminated metastases.

Pathogenesis

Oncogenes are of primary importance in the pathogenesis of lymphomas. B-cell tumors are characterized by changes in the c-myc proto-oncogene in the cell, which promotes the transition of lymphocytes to the phase of division and constant reproduction. Chromosome abnormalities are also important in the development of lymphomas, as a result of which control over cell division is lost. Subsequently, the tumor tissue grows and has a separate metabolism. Tumor cells suppress the development of normal cells, often cause immunosuppression and susceptibility to various infections: pneumonia , urinary tract infections, herpesvirus infection . An increase in tumor mass causes exhaustion of the body.

Symptoms of lymphatic system diseases: watch out for cancer

Most cancers of the lymphatic system are age-associated. However, in recent decades there has been a tendency to increase the percentage of cases among young and even childhood patients.

Early symptoms of cancer of the lymphatic system are nonspecific, and the basis for diagnosing diseases of a lymphoproliferative nature has been and remains morphological and immunohistochemical studies of biopsy material.

But the key to successful treatment of any pathology is early detection (which, unfortunately, statistics for the management of patients with cancer of the lymphatic system cannot boast of).

In what cases should a general practitioner and the patient suspect something is wrong? First of all, let's define the risk groups. Susceptibility to cancer of the lymphatic system is higher under the following criteria.

• Age over 50 years.
• Belonging to the Caucasian race.
• Immune system disorders.
• Male gender.
• Women have late and/or difficult labor.
• Family history of lymphatic oncopathologies.
• Other cancer pathologies among close relatives.
• Established genetic predisposition.
• Exposure to radiation and carcinogens.

The first nonspecific symptoms of cancer in the lymph nodes are:

• enlarged lymph nodes (usually without pain),
• a feeling of pressure on organs and squeezing of the blood vascular system,
• dilation of veins, growth of new blood vessels,
• increased swelling of the face, neck, arms, chest,
• shortness of breath, difficulty breathing and swallowing.

The reason for the increase is the uncontrolled growth of tumor cells. Trying to cope with it, the body, as best it can, increases blood flow to the tumor site; This causes the growth of blood vessels, which is not normal for an adult body.

A common target for cancer of the lymphatic system is the cervical and submandibular lymph nodes. The reason is frequent respiratory diseases, eye and ENT infections, as well as advanced dental problems.

The mouth and throat are an area of ​​extensive contact with the aggressive external environment through the mucous membranes. If the patient is known to be careless, this increases the load on the lymphatic system, provokes a long-term enlarged state of the lymph nodes and can catalyze the oncological process.

When this happens and a tumor forms in the face or neck, as it grows it begins to put pressure on the respiratory tract and esophagus, and in addition impairs the circulation of fluid, causing its accumulation in the tissues (pasty, edema).

Also, in almost all forms of cancer of the lymphatic system in the initial stages, there is an increase in temperature in the evening and at night for no apparent reason to the patient, rapid fatigue, frequent weakness, increased sweating, loss of body weight and appetite, and, less commonly, itching of the skin.

Additional symptoms that may indirectly indicate the early development of cancer of the lymphatic system:

• clouding of consciousness (disorientation, hallucinations, psychomotor hyperactivity, etc.),
• drowsiness with regular daily sleep of 7-8 hours,
• frequent dizziness,
• chronic internal swelling of the nose, nosebleeds,
• bluish tint of facial skin or rosacea.

Cancer of the lymphatic system cannot be diagnosed by the patient independently. Most likely, it is not immediately diagnosed by a general practitioner. But attention to primary symptoms, the ability to observe and draw conclusions based on the dynamics of the clinical picture allows a competent specialist to suspect a problem in time and prescribe an examination, and the patient to ask the attending physician the right questions.

When should you ask them?

• When antiviral therapy or antibiotic therapy does not improve the enlarged lymph nodes, it means that the enlargement may be caused not by infection, but by cancer.
• When not only neighboring lymph nodes enlarge, but also those distant from the initially enlarged ones → it means that the problem is spreading.
• When the enlargement of the lymph node was not preceded by infectious diseases → perhaps the process was not provoked by the appearance of pathogens.
• When, upon palpation, the edges of the enlarged lymph nodes are uneven or the enlarged lymph node becomes noticeable to the eye as a protruding tubercle without changing the color of the skin → this is a very alarming symptom, which is rarely the only one and means one thing: see a doctor immediately!

If the lymph nodes are bothering you, under no circumstances should you warm them, cool them, knead them, or perform other manipulations: this is dangerous. Seeing a therapist is mandatory if you do not want lymphadenitis to develop into a malignant process.

After the doctor has helped you eliminate the cause of the enlarged lymph nodes, to be completely sure, you can carry out a competent, gentle detoxification of the body, thereby destroying the lymphatic system, making its work easier. This will not be superfluous for healthy patients - for the purpose of general immunoprophylaxis.

It can be carried out systematically and safely within the framework of the practical phytomathon “Dietetics Light”, which is conducted by immunodietologist™, nutritionist with 30 years of experience Marina Nikolaevna Vnukova. Follow the link to find out the detailed program, indications, contraindications and results after completing the marathon.

Classification

All malignant lymphomas are usually divided into two large groups: Hodgkin and non-Hodgkin.

Classifications of lymphomas have constantly changed and been supplemented by histological and molecular genetic studies. Currently, neoplasms of lymphoid tissue include more than 20 types and are divided into 3 large groups:

• B cell.
• T cell.
• Hodgkin's disease.
• B-cell and T-cell lymphomas constitute “non-Hodgkin lymphomas.” In turn, they can originate from precursors of B and T lymphocytes and mature B and T lymphocytes.

Nodular lymphomas are divided into stages:

• Stage I - one lymphatic zone is affected.
• Stage II - two or more areas of lymph nodes are affected, but on one side of the diaphragm. One extranodular organ with regional lymph nodes may also be affected.
• Stage III - lymph nodes on both sides of the diaphragm and one extranodular organ are affected.
• Stage IV is widespread involvement of multiple extranodular organs with lymph node involvement.

Separately, it is worth mentioning secondary damage to the lymph nodes - these are metastases in the lymph nodes. In this case, tumor cells from the primary tumor travel through the lymph to the lymph nodes. Metastasis cells correspond to the cells of the primary tumor. The tumor embolus begins to grow in the node. In most cases, the lymph node cortex is involved in the metastatic process. As the tumor mass grows, the node's own tissue is replaced, the size of the metastasis increases and the unevenness of its contours increases. Subsequently, the tumor process progresses and extends beyond the capsule of the node. Very often, the affected lymph nodes are combined into a conglomerate. The growth of the metastasis beyond the node then involves surrounding tissue. Vessels are often involved in the tumor process - they are displaced and compressed. The less normal tissue of the lymph node and the greater the tumor mass, the more homogeneous the structure of the node and the less echogenic it is.

The main “target” is the lymph nodes of the neck, since lymph flow occurs here from the upper part of the body and from the lower half of the body. Metastases to the neck area occur in 40–70% of cases and are most often caused by oncology of the thyroid gland, nasopharynx, salivary glands, sweat glands, oral cavity and breast.

Lymphoma of the lungs on CT

Signs of pulmonary lymphoma are especially pronounced in the fourth stage of the disease, when the disease affects the respiratory organ. On a CT scan, enlarged lymph nodes will be visible, forming chains and conglomerates. In this case, the patient may also experience pulmonary edema. However, the high resolution of CT makes it possible to detect lymphoma at an early, first stage.

On CT scans, lymphomas, like any lumps, are visualized in a relatively lighter color. Normally, the airy pulmonary parenchyma is almost uniformly dark in color. Sometimes there are several such compactions and they are disseminated. The contours of the lymphoma are clear and even. Areas of “frosted glass” are found around pathological lesions.

Causes

Considering the causes of lymphomas, we can highlight the main ones:

• Infectious causes. Epstein-Barr virus causes Burkitt's lymphoma , Hodgkin's lymphoma , NK-T-cell lymphoma . T-cell leukemia virus has an association with T-cell lymphoma. Hepatitis C virus has been associated with splenic lymphoma and large cell lymphoma. The bacterium Helicobacter pylori has an association with MALT lymphoma.
• Exposure to carcinogens. The development of these diseases is facilitated by chemical carcinogens: polychlorinated biphenyls , phenytoin , dioxin , phenoxy herbicides . In addition, it has been noted that taking cytostatics (alkylating drugs cyclophosphamide, melphalan and others) also contributes to the development of lymphomas.
• Exposure to ionizing radiation (radiation therapy for medical purposes).
• Immunosuppression. This refers to long-term use of immunosuppressants ( cyclosporine , glucocorticoids ).
• Autoimmune diseases, among which are Sjögren's syndrome , systemic lupus erythematosus and rheumatoid arthritis .
• Some genetic diseases that predispose to the appearance of lymphomas are Chediak-Higashi and Klinefelter .

Causes and mechanism of development of non-Hodgkin lymphomas

The causes of most lymphomas remain unknown. There are a number of etiological factors common to all tumors that can contribute to the occurrence of NHL:

• Ionizing radiation.
• Chemicals with carcinogenic properties.
• Unfavorable environmental factors.

The viral nature of some forms of lymphomas has been proven, in particular, Burkitt's lymphoma (Epstein-Barr virus), some T-cell lymphomas (retrovirus HTLV-1).

Approximately 90% of cases of gastric MALT lymphoma (extronodal B-cell lymphoma) are associated with H. pylori infection.

The risk of developing lymphomas is increased in immunodeficiency conditions of various natures (HIV infection, autoimmune and hereditary diseases, etc.).

An immune cell, under the influence of causative factors, stops at some stage of maturation, transforms into a malignant one and begins to divide uncontrollably, which leads to the formation of a tumor. Non-Hodgkin's lymphomas begin with a single tumor focus, which is most often localized in a lymph node (nodal lesion), less often in other organs and tissues (extranodal lesion).

Over time, hematogenous (with blood flow) or lymphogenous (with lymph flow) spread of the tumor occurs, involving the bone marrow and central nervous system in the process.

Symptoms of lymph node cancer

If we consider cancer of the lymphatic system using the example of lymphogranulomatosis, then patients may experience the following symptoms:

• enlarged lymph nodes above the neck and collarbone;
• enlargement of the mediastinal nodes, which is accompanied by cough and shortness of breath, and due to impaired venous outflow - swelling of the veins of the neck;
• lower back pain at night;
• pronounced weakness.

The first manifestations of lymphatic system tumors may vary, but most often the disease begins with enlarged lymph nodes that grow quickly. In addition, characteristic of malignant lymphomas are signs of intoxication, which can be used to suspect that there is oncology:

• heavy sweats at night;
• weight loss;
• temperature rise above 38;
• skin itching.

The appearance of one of these symptoms may precede the appearance of the primary tumor.

Symptoms of cancer of the lymph nodes in the neck

Almost half of lymphomas primarily develop in the lymph nodes. With local damage, the lymph nodes of the neck are most often involved in the process. They are dense, but painless, not fused with tissues and merge into conglomerates, forming a single tumor of the lymph nodes.

Photo of lymph node damage in Hodgkin's disease

A tumor in the neck (regardless of which side it is on the left or right) causes cosmetic discomfort, makes movement difficult, and, if large, makes breathing difficult.

Mediastinal lymphoma

This tumor is located in the anterior mediastinum and affects the intrathoracic lymph nodes and thymus nodes. At first, lymphoma does not manifest itself and is discovered accidentally during a chest x-ray. Then symptoms appear that are associated with compression of the mediastinal organs or tumor growth into these organs: hoarseness, cough, difficulty breathing, difficulty swallowing, heart pain, chest pain, shortness of breath, fainting, drooping eyelids and constriction of the pupil (this is associated with compression of the cervical sympathetic ganglion).

Lymphosarcoma

Non-Hodgkin's lymphoma begins with a single tumor node, which then spreads through metastasis. The tumor focus may be in the lymph node or in other organs. In non-Hodgkin's lymphomas, mediastinal lymph nodes are affected less frequently than in Hodgkin's disease, the spleen and bone marrow are affected in 30-40%, and the liver in 20-50% of cases, and damage to the gastrointestinal tract is also typical.

Just as with lymphogranulomatosis, patients are concerned about fever, night sweats and rapid weight loss. Moreover, elevated temperature can bother you for more than 2 months. Then, in half of the patients, the lymph nodes of the neck are affected one after another, merging into large groups. A primary tumor can also develop in the tonsils, which is accompanied by a sore throat and a change in voice. If the tumor develops in the chest cavity, which is much less common, coughing and shortness of breath appear. Possible damage to the gastrointestinal tract. B-large cell lymphoma is the most aggressive and accounts for 40% of all non-Hodgkin lymphomas.

Spleen cancer

Malignant tumors of the spleen are primary (marginal zone lymphoma) and secondary (metastatic spleen cancer). Splenic lymphoma is very rare and accounts for 1% of all non-Hodgkin lymphomas. The disease has a benign course and occurs in older people. Usually the disease is asymptomatic for a long time and the main manifestation is an enlargement of the organ, detected by chance, and mild itching. Sometimes the disease begins with a severe infection, for which patients are hospitalized and examined. With significant enlargement of the organ, patients experience abdominal pain on the left, weakness, sweating, and hemorrhages on the skin. Damage to the spleen develops in the third stage of Hodgkin's disease , when in addition to damage to the lymph nodes, organs are also affected - most often the liver and spleen.

Is lung lymphoma cancer?

Not always. However, lymphomas primarily include malignant neoplasms of the lymphatic system, which are formed due to the uncontrolled accumulation of pathologically altered lymphocytes. An exception may be indolent lymphomas. They do not require treatment, but monitoring them is also important. If the patient exhibits the symptoms described above (temperature, fever, chest pain), then examination and treatment of such lymphomas must be carried out.

Malignant lymphocyte cells have a different shape from “regular” cells and represent a fatal “failure” in the functioning of the body. Such cells have completely different functions - they produce a huge amount of proteins and toxins, but are not destroyed by cells of the immune system as hostile.

Lymphomas are not always the primary site of cancer. A pathologically enlarged node or a group of nodes (disseminated or localized in one place) is often a consequence of metastatic processes. This occurs due to the fact that the lymph node acts as a filter and accumulates malignant cells that have separated from the primary affected organ. In this case, it is important not only to identify the lymphoma, but also the primary focus. Enlarged lymph nodes of the lungs may indicate cancer of the lungs, breast, mediastinum, stomach, that is, organs located in close proximity.

The diagnosis of a benign or malignant neoplasm can be clarified based on the results of a biopsy (histological examination of a tissue sample). The patient also undergoes clinical and biochemical blood tests. On a CT scan of the lungs, doctors identify a tumor, can assess its size, the extent of enlarged lymph nodes, but it is not possible to make an accurate conclusion about the type of tumor without tests.

Tests and diagnostics

Before a lymph node biopsy, a blood test is performed with a mandatory leukocyte count. The following blood test indicators for lymphosarcoma are characteristic:

• The number of red blood cells, and therefore hemoglobin .
• of platelets decreases .
• of leukocytes decreases . At the same time, in the leukocyte formula there is an increase/decrease in lymphocytes and a mandatory increase in neutrophils and eosinophils.
• Increased ESR.

Microscopy of a lymph node in Hodgkin's disease reveals characteristic Berezovsky-Sternberg cells. Currently, a morphological and immunohistochemical study of the material obtained from a biopsy is mandatory, and on the basis of this a diagnosis is established. A PET/CT or magnetic resonance imaging scan of three areas (chest, abdomen and pelvis) is performed.

An ultrasound of the lymph nodes is also indicated, which reveals a round shape and multiple nodes with a tendency to merge. They have an uneven contour, hypoechoic masses and the presence of blood vessels. A chest x-ray is also ordered.

Diagnosis of lymphoma

So, if a doctor, during an examination, notices an increase in the growth of lymph nodes, he can refer the patient to a comprehensive series of examinations aimed at identifying the problem and the reasons that led to such changes.

First of all, this is a general blood test, where deviations from the norm can give the doctor a signal about the likelihood of developing lymphoma.

A chest x-ray is also considered an effective method, allowing one to determine whether there is mediastinal lymph nodes in a given area.

MRI is an examination that allows the doctor to identify any changes occurring at this stage in the body. If there is lymphoma, the disease will definitely be detected.

In children

In children, any tumor of lymphoid tissue is manifested by general symptoms: fever, weakness, fatigue, pain in bones and joints. In the early stages, the malignant process is hidden under the “masks” of various diseases. Often, malignant tumors of the nose and nasopharynx occur under the guise of ARVI, and ENT doctors have to deal with this. Very often, when lymph nodes are enlarged, reactive lymphadenitis and a full examination is not carried out. And only if the treatment is ineffective, the patient is sent for examination to a specialized medical center. This approach leads to the fact that an accurate diagnosis is established late - 75-80% of patients with lymphosarcoma are detected at stage III-IV.

Among all diseases, Hodgkin's lymphoma in children accounts for 45%. Mostly boys under the age of 12 are affected. In most cases, the disease begins with an enlargement of the cervical-supraclavicular nodes, and it is not accompanied by a deterioration in well-being. Then from the lymph nodes the process spreads to all organs (most often the lungs and bones are affected). If we consider non-Hodgkin lymphomas, then in children the cervical nodes, intestines, nasopharyngeal ring and mediastinum are most often affected. Somewhat less frequently, the process involves the bone marrow, testicles, central nervous system, ovaries, soft tissues and skin. Of the large organs, the kidneys, liver, lungs and spleen are affected.

Before the age of 18, B-cell non-Hodgkin lymphomas and T-cell progenitor lymphomas are often detected. T-cell lymphosarcoma is found in the mediastinum, and B-cell lymphosarcoma is found in the nasopharynx and abdominal cavity.

When nodes in the abdominal cavity are affected, abdominal pain appears and intussusception often occurs. If the mediastinum is affected - cough, difficulty in breathing, stagnation of blood in the neck veins, compression of the trachea, pericardial tamponade . Damage to the central nervous system is manifested by cranial nerve palsy. Enlarged liver and spleen appear in the final stages, and in peripheral T-cell lymphomas - in the early stages.

Chemotherapy treatment

An effective treatment for non-Hodgkin's lymphoma is chemotherapy, which is performed in three stages: induction, consolidation and maintenance. For T-cell lymphomas, treatment is carried out as for acute lymphocytic leukemia: continuous courses of treatment for two years. For B-cell - short courses with a total duration of 6 months. Vincristine , Cyclophosphamide , Doxorubicin , Cytosar , Prednisolone , Methotrexate , Holoxan , Mesna , Rubomycin , L-asparaginase , interferon preparations , Etoposide are used in treatment .

Accompanying therapy

• A set of measures has been developed that can reduce the severity of adverse reactions during chemotherapy treatment.
• Prevention of toxic reactions associated with lysis of tumor mass. For this purpose, massive infusion therapy is carried out ( Glucose , Sodium chloride 0.9% , Sodium bicarbonate ).
• Diuresis is stimulated by Furosemide .
• To prevent uric acid nephropathy, Allopurinol for the first 3-5 days of treatment.
• When using Holoxan (ifosfamide), an antidote with a uroprotective effect, Mesna, .
• The greatest risk of relapse for B-lymphomas in children is 1.5 years from the start of treatment, and for lymphoblastic lymphomas - three years.

Lymphoma stages

The stages of lymphoma are the stages of development of tumor-like formations. Each stage has a number of specific characteristics, namely: the age of the tumor, the level of spread of the tumor process and the degree of damage to the body. That is why determining the stage is very important for choosing the most effective treatment tactics. In medical practice, there are 4 stages of lymphoma.

The first, initial stage is characterized by damage to one lymph node or several lymph nodes that are located in the same area (for example, cervical lymph nodes). Lymphoma, which has begun its development in an organ (without affecting the lymph node) is also the initial stage. All stage 1 lymphomas are local tumors, that is, they do not metastasize to other organs or tissues.

Stage 2 lymphoma is determined when the tumor affects 2 or more lymph nodes that are on the same side of the diaphragm (the muscle located between the chest and abdomen).

Lymphoma of the third stage is the involvement in the pathological process of 2 or more lymph nodes located on opposite sides of the diaphragm. Stage 3 includes lymphomas that simultaneously affect the spleen and several lymph nodes located on opposite sides of the diaphragm.

Lymphoma of the last stage refers to a disseminated (massively widespread) tumor. They speak of the final stage if the tumor process affects not one, but several organs, and at the same time they are located at a distance from the primary localization of the lymphoma.

Prevention

• On the part of physicians, there should be oncological vigilance among general practitioners for the early detection of these diseases in adults and children.
• Eliminate/reduce environmental risk factors (solar radiation, exposure to chemical agents at work).
• Eliminate bad habits (smoking, drinking alcohol).
• Stick to a balanced diet.
• Have sufficient physical activity.
• Prevention of AIDS (protected sex, avoidance of contaminated syringes) is prevention of the development of NHL.

Consequences and complications

• Secondary malignancies - acute myeloid leukemia . This complication develops several years after the end of treatment.
• Disturbance of the hematopoietic germ.
• Infectious diseases (in particular, herpes infection and fungal infections ).
• Dermatitis , including allergic origin.
• Renal amyloidosis with renal failure.
• Intestinal amyloidosis.
• Blindness due to lymphomas of the anterior chamber of the eye.
• Damage to important organs (liver, spleen, kidneys, heart and lungs).
• With mediastinal tumors, compression of the superior vena cava, invasion into the pericardium, heart, esophagus and trachea. Compression of the trachea and cardiac tamponade due to the accumulation of fluid in the pericardial cavity.

Treatment methods for lymphoma at Medscan

The medical center treats lymphoma using gentle chemotherapy and the latest radiation exposure. If necessary, a course of immunotherapy is prescribed on an individual basis.

The clinic uses drugs developed by Medscan. Treatment of lymphoma with antitumor drugs is carried out strictly according to the international ESMO or NCCN protocols and has a high level of positive results. For intravenous administration of drugs, infusion pumps are used to control the dosage of the drug.

A favorable prognosis for a malignant form of pathology depends on a number of factors. Has the meaning:

• Localization, type and size of the tumor. Neoplasms in the early stages are easier to cure.
• Forms of the disease. Aggressive cancer manifests itself with a clear clinical picture, which indicates damage to internal organs.
• Lymphoma stage. The chances of recovery in advanced stages of pathology are minimal.

After treatment, the clinic’s specialists provide the patient with the necessary information about the cancer disease. The signs of relapse and subsequent routine examinations are explained. After completing treatment for non-Hodgkin's lymphoma, the patient is required to undergo systematic monitoring by the attending physician.

Improvements in diagnostic and therapeutic methods have made it possible to achieve optimal results in most patients. Prognostic factors for lymphomas are used to guide therapy rather than to estimate survival.

Prognosis for cancer of the lymphatic system

Malignant lymphomas respond differently to treatment and will therefore have a different prognosis. The prognosis for Hodgkin's disease depends on the stage: in stages IA-IIA it is favorable, in stages IB-IIB, when there is damage not only to the lymph nodes, but also to organs (more than three areas) - the prognosis is intermediate, and in III IV (there is a massive mediastinum ) - unfavorable. However, any stage can be treated with a relatively good result: the five-year survival rate in the favorable prognosis group reaches 90%. Such results are achieved by chemotherapy (the higher the stage of the disease, the more courses are administered) and irradiation of the tumor mass.

How long do people live with cancer of the lymph nodes in the neck? The prognosis is relatively favorable, with a five-year survival rate ranging from 49 to 82% depending on the stage. High survival rate is observed at stages I-II and is 82% and 78%, respectively. Significantly lower at stage IV - 49%. The prognosis depends not only on the stage, but also on the age of the patient, the size of the tumor and damage to other groups of lymph nodes. Unfavorable factors regarding prognosis: systemic manifestations (especially itching), age over 50 years, tumors larger than 6 cm, stage II-IV, involvement of lymph nodes in 3 zones or more.

The prognosis for lymphosarcoma (meaning non-Hodgkin's lymphoma) is not so comforting. Five-year survival varies widely, depending on the morphological structure of the tumor. So, for marginal zone lymphomas, follicular and MALT lymphomas, it is more than 70%, and for T-lymphoblastic NHL, mantle zone lymphomas and peripheral T-cell lymphomas, it is below 30%. If we consider abdominal lymphomas, then gastric lesions are more common, and intestinal lesions occur only in 0.5% of cases. Non-Hodgkin's lymphoma of the stomach has varying degrees of malignancy and is most often a well-differentiated tumor.

The prognosis for gastric lymphoma is favorable, since it has limited growth for a long time. The five-year survival rate is 82%. If we consider non-Hodgkin's lymphomas by localization, then lymphomas of the gastrointestinal tract, tonsils, orbit, and lungs are considered favorable, and lymphomas of the bones, testicles and ovaries, breast, and central nervous system have a high malignancy. Low-grade tumors progress slowly, are moderately sensitive to standard chemotherapy, and therefore are often not cured with its use. Highly aggressive lymphomas are characterized by rapid progression, but are highly sensitive to standard chemotherapy, so they can be cured.

Splenic lymphoma is a sluggish lymphoma, and therefore does not require treatment in the early stages. If aggressiveness occurs, treatment is carried out. Splenectomy is the first line of treatment because it allows for stabilization of the disease. Chemotherapy regimens are also used, which achieve good results in 90% of patients.

The prognosis for metastases in the lymph nodes depends on the location and size of the primary tumor, as well as the stage of the underlying disease. In the third stage of many tumors, when metastases appear in regional lymph nodes, the five-year survival rate is about 50%. At the fourth stage and the appearance of distant metastases, the survival rate is 5-10%.

Treatment

The two main treatments for lymphoma are radiation therapy and chemotherapy. Transplantation of the patient's own stem cells or transplantation from a donor is also used. There are a lot of treatment regimens - they depend on the stage, characteristics of the disease, as well as on how the person’s immune system responds to certain actions, and whether it responds to previous therapy.

If you want to consult on the treatment of lymphoma, JSC Meditsina in Moscow has oncologists who are ready to see you and understand the problem in detail.

List of sources

• Ponomareva O. V., Yurchenko O. V. Non-Hodgkin malignant lymphomas from marginal zone cells: diagnosis and treatment // Oncology - 2013. - vol. 15, no. 3. - p. 241-253.
• Klimenko A. A., Raksha A. P., Kopelev A. A. Hodgkin’s lymphoma // General Medicine. - 2007.- No. 2. - With. 15-20.
• Gluzman D.F., Sklyarenko L.M. Principles of modern diagnosis of lymphoid neoplasms // Oncohematology. - 2012. - No. 1. - pp. 44-46.
• Demina E. A., Tumyan G.S., Moiseeva T. N., Mikhailova N. B., Myakova N.V. Hodgkin's lymphoma // Modern oncology. - 2021. - volume 22, no. 2. pp. 6-33.
• Babicheva L.G., Tumyan G.S., Osmanov E.A. Follicular lymphoma // Modern oncology. — 2021.— volume 22, no. 2. pp. 34-51.