Symptoms such as fever, cough, general weakness, and night sweats ┑(￣Д ￣)┍ that are similar to the common cold, if they persist for a long time without improvement and are accompanied by painless lumps in areas such as the neck and armpits, may be a silent alarm from the immune system that lymphoma is approaching.
As a malignant tumor originating from the lymphatic system, the early manifestations of lymphoma are often similar to those of common respiratory diseases such as colds and bronchitis, which can easily be overlooked or misdiagnosed. Therefore, only by having a correct understanding of lymphoma can it be detected, diagnosed and treated early.
How to correctly identify and diagnose lymphoma? We have specially invited Tian Yuyang, the director of the Department of Hematology at Hainan Provincial Cancer Hospital, to provide a professional interpretation.
I. Could the "main force" of the immune system also turn traitor?
Lymphocytes are the "main force" of the human immune system, mainly including B cells, T cells and NK cells, and they shoulder the important responsibility of resisting pathogens and safeguarding health. However, when the immune system is disrupted due to certain factors - whether it is weakened or overactive - it may cause lymphocytes to undergo malignant transformation, thereby triggering lymphoma.
Director Tian Yuyang reminds us that the lymphatic system is like a fine network covering the entire body, which gives lymphoma the characteristic of being "systemic": except for hair and nails, any part of the body can be affected by it. This feature makes the manifestation of lymphoma more complex and requires us to be more vigilant.
II. Lymphoma is mainly divided into two major categories.
Lymphoma is divided into Hodgkins lymphoma and non-Hodgkins lymphoma.
Non-Hodgkins lymphoma is generally classified into B-cell lymphoma and T-cell lymphoma based on cell origin; Hodgkins lymphoma is pathologically divided into four major types: lymphocyte-predominant type, nodular sclerosis type, mixed cellularity type, and lymphocyte depletion type.
In China, there are 80,000 to 100,000 new cases of lymphoma each year, with about 10% being Hodgkins lymphoma and the rest being non-Hodgkins lymphoma. Both are malignant tumors, and their malignancy degrees are classified as low, intermediate and high.
III. Atypical Symptoms of Lymphoma
Director Tian Yuyang introduced that lymphoma usually does not have particularly typical or specific symptoms. Common manifestations include:
General symptoms:
About one-third of patients will experience fever, night sweats, fatigue, weight loss, and itching is often seen in Hodgkins lymphoma and angioimmunoblastic T-cell lymphoma.
Local manifestations:
Lymph nodes show progressive enlargement. When the lesion develops to a certain extent, it may compress the airway, gastrointestinal tract or even large blood vessels, causing obstruction, bleeding, perforation and other problems. If it invades important organs such as the pericardium, pleura and peritoneum, pericardial effusion, pleural effusion or ascites may occur. If it involves the skin, rashes, skin nodules or ulcers may appear.
IV. Diagnosis of lymphoma is divided into three steps.
Lymphoma patients often seek medical attention because they have felt a lump themselves, and the doctors palpation is a crucial step in the diagnosis.
1. If the lymph nodes are soft like the lips and have a flat shape, they are mostly caused by inflammation.
2. If the texture is as smooth as a ping-pong ball and as tough as the tip of the nose, one should be alert to the possibility of a malignant tumor in the lymphatic system.
3. If the lymph nodes are significantly enlarged, fixed in position and as hard as the forehead, it may be metastatic lymph node cancer from a tumor in another part of the body.
Lymph node malignancy or benignity can be initially judged by palpation. Further examination is needed afterwards: ultrasound or CT can be used to assist in differentiating between inflammation and tumor-induced enlargement. If the results of palpation and imaging tests are not satisfactory, the third step - taking a biopsy for pathological examination - should be carried out to determine whether it is lymphoma, the specific type and the cell origin.
Therefore, the diagnosis of lymphoma requires going through three steps: "palpation → ultrasound/CT examination → pathological examination".
V. Lymphoma has a wide range of prognoses. How to choose the treatment plan?
Director Tian Yuyang stated that the prognosis of different types of lymphoma varies greatly: some are indolent lymphomas, and after diagnosis, treatment may not be needed for 10 or 20 years; while lymphomas that grow rapidly and have obvious symptoms are often highly malignant, and once diagnosed, treatment should be initiated immediately.
Experts warn
The treatment of lymphoma mainly relies on chemotherapy, which can be combined with local radiotherapy. In some cases, surgical intervention is also necessary. Besides the traditional chemotherapy and combined chemoradiotherapy regimens, the clinical field is also actively exploring new treatment methods, including immunotherapy, targeted therapy, and autologous hematopoietic stem cell transplantation.
The specific treatment plan to be chosen depends on a comprehensive assessment of the type of lymphoma, the location of the disease, and other relevant factors.
Science popularization expert
Tian Yuyang, Director of the Department of Hematology
Deputy Chief Physician
Other types of high-level talents in Hainan Province
Medical expertise
Individualized cellular immunotherapy for malignant tumors, treatment of malignant tumors leading to immune and hematopoietic function failure, diagnosis and treatment of hematological malignancies mainly focus on lymphoma and multiple myeloma, with the dominant technology being hematopoietic stem cell microtransplantation combined with the treatment of various refractory and high-risk hematological malignancies. There is rich research and clinical experience in cutting-edge treatment technologies such as CAR-T cells and TRuC-T cells.
Outpatient visit time
Hematology Outpatient Clinic: Monday all day
Lymphoma Specialty Clinic: Monday all day, Wednesday all day
Editor | Chen Lin