Recently, the internet celebrity "Yili Xiaoshazi", who has tens of millions of fans, was diagnosed with Hodgkin's lymphoma (nodular sclerosis type stage III) ~~~~(>_<)~~~~. The news immediately hit the trending list, attracting widespread attention across the internet and prompting the public to gain a deeper understanding and appreciation for "Hodgkin's lymphoma", a relatively unfamiliar disease.
What are the characteristics of this disease? Which groups are at high risk? And how can we scientifically prevent, diagnose, and treat it early? Tian Yuyang, director of the Hematology Department at Hainan Cancer Hospital, will answer these questions for everyone.
Part.1
The overlooked cough turns out to be a warning sign of lymphoma
"Yili Xiaoshazi", whose real name is Xu Yisha, was born in 1995 and is a young woman who recently became a mother. Initially, she only experienced pain in her axillary lymph nodes and a persistent cough. Believing she was young and in good physical condition, she didn't take it too seriously, always thinking that she could "just bear it and get through it".
But she carried on for two months. It was only when her cough became increasingly severe and even started to cause rib pain that she went to the hospital for a check-up, and was ultimately diagnosed with classical Hodgkin's lymphoma (nodular sclerosis type, stage III).
Part.2
Does lymphoma originate from the rebellion of the immune system?
Tian Yuyang explained that lymphocytes are the "main force" of the human immune system, mainly including B cells, T cells, and NK cells, and they bear the important responsibility of resisting pathogens and safeguarding health. However, when the immune system becomes disordered due to certain factors - whether it is a decline or an enhancement in function - it may lead to malignant transformation of lymphocytes, subsequently triggering lymphoma.
Lymphoma is divided into Hodgkin lymphoma and non-Hodgkin lymphoma
Non-Hodgkin lymphoma is broadly classified into B-cell lymphoma and T-cell lymphoma based on cell origin; Hodgkin lymphoma is divided into four major categories based on pathological type: lymphocyte-predominant type, nodular sclerosis type, mixed cell type, and lymphocyte depletion type.
In China, there are 80,000 to 100,000 new cases of lymphoma each year, with about 10% being Hodgkin's lymphoma and the rest being non-Hodgkin's lymphoma. Both are malignant tumors, but there is no need to be intimidated by their names. Although Hodgkin's lymphoma is a malignant tumor, it is also one of the tumors with the highest cure rates at present.
Part.3
"Don't wait until you can't bear it anymore to go to the hospital. Be aware of the 6 major body alarms."
Tian Yuyang reminded that the lymphatic system is like a dense network spread throughout the body, which also makes lymphoma have a "systemic" characteristic: apart from hair and nails, any part of the body can be affected by it.
This characteristic makes the manifestations of lymphoma more complex and requires us to be more vigilant. The early manifestations of lymphoma are often similar to respiratory diseases such as colds and bronchitis, which are easily overlooked or misjudged. Therefore, a correct understanding of lymphoma is essential for early detection, diagnosis, and treatment.
Tian Yuyang reminded that if the following symptoms occur, especially if they persist for more than 2 weeks, one should be vigilant:
1. General symptoms:
About 1/3 of patients will experience fever, night sweats, fatigue, weight loss, and itching;
2. Local symptoms:
Lymph nodes become progressively enlarged, and when the lesion progresses to a certain extent, it may compress the airway, gastrointestinal tract, or even major blood vessels, leading to issues such as obstruction, bleeding, and perforation. If it invades important organs such as the pericardium, pleura, or peritoneum, pericardial effusion, pleural effusion, or ascites may occur. If it affects the skin, it may manifest as a rash, skin nodules, or ulceration.
Part.4
What should I do after feeling a lump?
"Three-step" process for lymphoma diagnosis
Lymphoma patients often seek medical attention due to the lump they feel. Palpation by the doctor is an important step in diagnosis:
Step 1: Palpation
1. If the lymph nodes are soft like lips and flat in shape, it is often caused by inflammation;
2. If the touch feels round and smooth like a ping-pong ball, and the texture is tough like the tip of the nose, then one should be alert to the possibility of malignant tumors in the lymphatic system;
3. If the lymph node enlargement is obvious, fixed in position, and as hard as the forehead, it may be lymph node metastatic cancer transferred from tumors in other parts.
Step 2: Ultrasound/CT Examination
The benign or malignant nature of lymph nodes can be preliminarily determined through palpation, followed by further examination using ultrasound or CT to assist in distinguishing between inflammation and tumor-induced enlargement.
Step 3: Pathological Examination
If the results of palpation and imaging examination are unsatisfactory, the third step is to perform biopsy for pathological examination to determine whether it is lymphoma, the specific type, and the cellular origin.
Therefore, the diagnosis of lymphoma involves three steps: palpation, ultrasound/CT examination, and pathological examination.
Part.5
Does this disease particularly "favor" young people?
Hodgkin lymphoma exhibits a distinct "bimodal distribution" in terms of age of onset:
The first peak: 20-39 years old (high incidence in young adults)
Second peak: over 65 years old
In China, the median age of onset is only around 30 years old, making it a veritable "tumor of young people".
The main high-risk factors include:
Having a history of EB virus infection (such as having previously suffered from infectious mononucleosis);
There is a history of lymphoma in the immediate family;
Abnormal immune system function, such as autoimmune diseases, long-term use of immunosuppressants, etc;
Staying up late for a long time, experiencing high stress and anxiety, and being overly exhausted, although not direct causes of disease, can weaken immunity and provide opportunities for tumors to develop.
Part.6
What should I do if I am diagnosed?
Don't panic, this is a tumor with a high cure rate
Tian Yuyang stated that the prognosis for different types of lymphoma varies greatly: some are classified as indolent lymphoma, which may not require treatment for 10 or 20 years after diagnosis; whereas lymphoma that grows rapidly and presents with obvious symptoms tends to be highly malignant, necessitating immediate treatment upon diagnosis.
Lymphoma subtypes are complex, making initial diagnosis and treatment particularly crucial. Treatment plans vary significantly depending on the type. Once suspected, it is best to seek medical attention at a hospital with a lymphoma specialty. The quality of the initial diagnosis and treatment directly impacts the prognosis.
Director Tian Yuyang (second from right) conducting a ward round (file photo)
Currently, lymphoma is a type of tumor with a relatively high overall cure rate. Some subtypes, such as Hodgkin lymphoma, have a cure rate of over 90%. Even for patients with intermediate or locally advanced stages, the long-term survival rate is very high after undergoing standardized treatment.
The research and clinical application of novel targeted drugs in the lymphoma field have made rapid progress. Currently, chemotherapy remains the mainstay of treatment, which can be combined with local radiotherapy. In some cases, surgical intervention may also be necessary.
On the basis of standardized diagnosis and treatment, implementing more precise individualized treatment plans can further enhance the treatment effect for lymphoma patients. Meanwhile, continuously optimized advanced technologies such as immunotherapy, targeted therapy, and autologous hematopoietic stem cell transplantation will also provide support for the treatment of lymphoma patients.
Popular science expert
Tian Yuyang
Director of Hematology Department
Deputy Chief Physician
Master's degree
Other high-level talents in Hainan Province
Medical expertise
Specializes in the diagnosis and treatment of hematological and lymphatic malignancies, as well as tumor immunotherapy. Particularly skilled in the diagnosis and treatment of malignant lymphoma and myeloma, as well as individualized cellular immunotherapy for malignant tumors. Experienced in treating malignant tumors that lead to immune and hematopoietic failure. Advantages in techniques mainly include hematopoietic stem cell micro-transplantation combined with various treatments for refractory and high-risk hematological tumors. Conventional techniques include various immunotherapy treatments and hematopoietic stem cell transplantation. Has extensive research and clinical experience in cutting-edge treatment technologies such as CAR-T cells and TRuC-T cells.
Clinic Hours
Monday to Friday