Lymphoma is a disease in which lymphatic tissue is affected. At the same time, the affected lymphocytes begin to intensively divide and provoke malfunctions in the normal functioning of the internal organs of the human body. There are such groups of the disease: lymphogranulomatosis (or the so-called Hodgkin's disease) and non-Hodgkin's lymphomas (including follicular non-Hodgkin's lymphoma).
Lymphatic system. What is it
Part of the immune system of our body is the lymphatic, the main function of which is protection from all kinds of infections and other diseases. It is a network of channels through which a special fluid moves - lymph. Along the capillaries, lymph nodes are observed, in which the lymph is enriched with special cells - lymphocytes. There are several subspecies. B-lymphocytes are responsible for acquired immunity to infectious diseases. Contacting with a pathogenic microorganism, they eliminate its action and store it in their memory. B-lymphocytes are very important agents in the formation of a positive effect of vaccination. Most (80%) of the lymph are T-lymphocytes. They are responsible for destroyingall kinds of viruses and bacteria. NK-lymphocytes are found in the lymph in a small amount (up to 10%). Their main function is the destruction of their own affected cells (including in such a disease as follicular lymphoma).
How a malignant process develops in the lymphatic system
The tumor process begins to develop from the cells of the lymphatic system (B-lymphocytes). The disease is diagnosed mainly in the elderly, in children it occurs in isolated cases. Follicular lymphoma gets its name from the fact that the hair follicle is the first to be affected. Very often, neoplasms are observed in the neck, armpits, groin. A feature of such lymphoma is that patients seek help very late. Affected lymphocytes penetrate into all internal organs, disrupting their work. Although follicular lymphoma iiiia responds well enough to therapy, late diagnosis does not make it possible to completely get rid of the disease.
Possible causes of disease
Experts cannot name the exact reasons that contribute to the development of oncological diseases. However, there are a number of factors that increase the possibility of malignant tumors. One of them is mutations of genes, chromosomes. Working in adverse conditions, constant contact with harmful chemicals can also be a catalyst for the development of a condition such as follicular lymphoma. The causes of the disease can be as follows:radiation, immunodeficiency weakening of the body, autoimmune diseases. Some experts also identify factors such as smoking, taking certain medications, and even obesity.
Symptoms of lymphoma
Follicular lymphoma has rather mild symptoms, especially the initial stages. First of all, some enlargement of the lymph nodes can be noted. However, they remain painless. It is characteristic that a small swelling periodically disappears, then reappears. This fact should be especially alarming. The nodes inside the sternum also increase. Outwardly, this can manifest itself as coughing, shortness of breath. There may be slight swelling of the face. In some cases, the spleen also suffers. Follicular lymphoma symptoms can be quite common: weight loss, general fatigue, weakness of the body. However, these signs are the exception rather than the rule, they are observed in only one patient out of ten. More severe stages of the disease are characterized by damage to the nervous system, in particular the bone marrow. At the same time, dizziness, nausea are noted, and loss of consciousness is possible.
Classification and stages of the course of cancer
There are several types of lymphomas. The first is follicular. The content of follicles in this case is 75%. If it is in the range of 25-75%, then this is a follicular-diffuse subspecies. With diffuse type, less than 25% of follicles are noted. Follicular lymphoma (iiiia) occurs in several stages. At the initial stage, only one area of the lymph nodes is affected. Secondthe stage is characterized by the involvement of two or more sites in the pathological process (but on one side of the diaphragm). In the third degree, areas on both sides of the diaphragm are affected. The most difficult fourth stage. Changes also occur in internal organs and systems (bone marrow, liver, etc.). Sometimes letters are added to the numerical designation of the stage of lymphoma: A or B. This indicates whether the follicular lymphoma has signs of the following kind: “B” - there is a change in body temperature (periodic increase), weight loss, sweating at night. Lymphoma with the prefix "A" - these symptoms are absent.
Method of diagnosing lymphoma
First of all, a specialist (onco-hematologist) conducts a visual examination of the patient. Histological examination of the sample is mandatory. For this, a biopsy is performed. A piece of the affected lymph node is removed and examined under a microscope. It is worth noting three cytological types of the disease that require different treatment. The first type is characterized by the presence of up to five centroblasts in the field of view of the microscope, the second - up to 15 units. The second cytological type requires shock chemotherapy, as it is quite aggressive. Follicular lymphoma 3a cytological type has the most unfavorable prognosis. Extensive neoplasms can be seen in the field of view of the microscope. Additionally, the patient needs to donate blood (tumor markers, general analysis), undergo an ultrasound examination of internal organs, CT or MRI. To determine if the affectedthe central nervous system, the spinal cord is being taken for further examination for the presence of cancer cells.
Follicular lymphoma. Treatment
Recently, the number of patients with this diagnosis has increased significantly. As a rule, the sooner it was possible to notice neoplasms, the more chances the patient has to save his he alth and life. Lymphoma is characterized by a rather sluggish course, therefore, in certain cases, doctors choose a wait-and-see attitude, observing all the changes in the human body. This is due to the fact that both chemotherapy and surgery do not pass without a trace and have their negative sides. Remission of follicular lymphoma can last several years. If the oncological disease begins to progress, then therapy should be carried out immediately. Among the main methods of treatment, radiation, chemotherapy, and medications should be distinguished. Depending on the type of lymphoma, regional irradiation can prevent possible relapses. At the first stage of the disease, long-term remissions were recorded in most patients.
Administration of chemotherapy
Aggressive chemotherapy (predominantly using multiple drugs) in the early stages of lymphoma can significantly reduce the likelihood of recurrences. For a long time, this method was considered the main one in the treatment of cancer. Chemotherapy aims to kill tumor cells as they multiply. Combined drugs are able to influence the division process at different stages, so their use is more effective. However, chemotherapy has a destructive effect on other organs (skin, hair, etc.). The bone marrow also suffers from these drugs. During the period of therapy, a person becomes more susceptible to infectious diseases, multiple bruises may appear, as well as bleeding. Often, drug treatment causes an increased production of uric acid, which leads to the formation of kidney stones. However, all side effects disappear a few weeks after the end of the course. It is worth noting that some chemotherapy drugs can lead to a decrease in the number of sperm in men, provoke infertility in women.
Treatment with monoclonal antibodies
Follicular lymphoma is also treated with new drugs such as monoclonal antibodies. They purposefully destroy only lymphoma cells. This technique is especially effective in combination with chemotherapy. Monoclonal antibodies somewhat reduce the toxicity of chemicals. Patients experience prolonged remission of follicular lymphoma. In some cases, an allergic reaction is possible, so the first administration of antibodies takes a rather long time. Before starting treatment, the patient needs a course of antiallergic drugs.
Relapses of disease
This disease is characterized by slow progression in the early stages, the period of remission can last up to 20 years. More oftenIn total, recurrence of follicular lymphoma is observed with 3a cytological type. In this case, a stem cell transplant may be needed. Both a brother (sister) and a non-blood relative can become a donor. The procedure is performed on patients under the age of 70 who respond fairly well to chemotherapy and are in a satisfactory state of he alth. After transplantation, improvements are observed in about half of the patients. Patient survival depends on many factors. First of all, the stage of the disease, the morphology of changes matters (the prognosis of follicular lymphoma in the fourth stage is rather unfavorable). It should be noted that young people cope better with the disease. It is very important to recognize lymphoma in time, so do not refuse preventive examinations from specialists.
