lymphomas cancer

The lymphomas are blood diseases characterized by the proliferation of malignant lymphoid cells and reticular which tend to infiltrate through the body.

They are mainly:

* Hodgkin's disease;
* And of non-Hodgkin's lymphoma which Burkitt's lymphoma and mycosis fungoides are attached.

Hodgkin's disease
(Lymphogranuloma malignant)
[?] What's this?

This lymphoma (blood disease characterized by the proliferation of malignant lymphoid cells and reticular which tend to infiltrate through the body) is characterized by the presence in the bodies with reticular cells dystrophic: Sternberg cells.

The disease primarily affects adults between ages 15 and 60.
[?] Causes and risk factors

The cause of the disease is unknown.

[?] Signs of the disease

The lymph node is firm, painless, which can be found in all territories ganglion.

Sometimes it is a thoracic or cervical ganglion isolated in a young adult.

In all cases, the persistence more than 3 weeks of lymph nodes increased volume without inflammatory nature, apart from one episode of infection, should result in a puncture to achieve a cytology swelling. The surgical biopsy is the next step.

Demonstrations visceral are possible: pleurisy, pneumonia, gastritis, liver injury (large liver, jaundice), spinal pain with spinal cord compression and paraplegia syndrome-Claude-Bernard Horner in the event of nerve compression in the cervical sympathetic journey Chest, paralysis in the case of laryngeal nerve compression recurring neuralgia by compression of the spinal roots, big rate;

They are accompanied by symptoms: a prolonged fever with sweating, often undulating, a generalized itching.
[?] Examinations and analysis

The blood can show a decrease in lymphocytes, an increase of eosinophils (eosinophilia), anemia.

The speed is accelerated sedimentation.

The elevation of fibrin, the increase in alpha 2 globulins, the fall of serum iron, hyperplaquettose, increased serum alkaline phophatases and leucocytaires ... Are signs scalability of the disease.

Puncture of juice can show ganglion cells typical Sternberg cells, which can only confirm the diagnosis.

The biopsy of a lymph node examination is essential: it is made by first direct surgical neck, endoscopy, laparotomy or thoracotomy depending on the location.

The study of the biopsy to differentiate on the histological four forms numbered from 1 to 4, and different prognoses.

It also practices:

* The chest radiograph;
* CT and ultrasound of the chest and upper abdomen, which specify the injuries thoracic and detect violations of mediastinal lymph node and / or invisible on the chest radiograph;
* The lymphographie abdominal imaging of the spleen and liver, skeletal radiographs complement the balance sheet.

The degree of spreading the disease can define clinical stages 4 (Ann Arbor):

* Stage I: violation of a single node group, or two contiguous territories ganglion on the same side of the diaphragm;
* Stage II: attack of two non-contiguous territories ganglion but the same side of the diaphragm;
* Stage III: Achieving lymph node addition and sub-diaphragmatic;
* Stage IV: Visceral associated: liver, heart, lungs, gastrointestinal tract, bone marrow, bone, nervous system.

For each of these stages, there is the absence (A) or presence (B) of symptoms: fever, sweats, weight loss ...

[?] Differential Diagnosis

* The infectious mononucleosis (MNI);
* The toxoplasmosis;
* A cytomegalovirus;
* A leukemia;
* A non-Hodgkin lymphoma;
* A lung cancer;
* A sarcoidosis;
*
A tuberculosis ...

[?] Prognostics

The prognosis depends on the histologic type of the disease and the clinical stage.
Under treatment, the prognosis is excellent ..
[?] Treatment

It is based in principle on radiation therapy in stage I and II and chemotherapy in stages III and IV, but in practice the two types of treatments are often linked in patients.

Multidrug MOPP combines Oncovin (vincristine), Caryolysine (chlorméthine) through IV, Solupred (prednisone) and Natulan (procarbazine) per os, administered by cycles.

Other drugs may be used.

The non-Hodgkin's lymphoma
(NHL)
[?] What's this?

The lymphomas are blood diseases characterized by the proliferation of malignant lymphoid cells and reticular which tend to infiltrate through the body.

The non-Hodgkin's lymphoma do not contain Sternberg cells.

These diseases were previously designated under the terms of lymphosarcomes.

Two forms are isolated: Burkitt's lymphoma and mycosis fungoides.

The malignant lymphomas are frequent.

A retrovirus (HTLV-1) was isolated in patients as well as the Epstein-Barr virus.

The classification of malignant lymphomas based on histology, and the degree of malignancy.
[?] Signs of the disease

The symptoms are very varied and are similar to those of Hodgkin's disease.

The disease is often painless lymph node in the neck or inguinal folds. The thoracic and retroperitoneal lymph nodes can lead to compression.

All organs can be infiltrated: gastrointestinal tract, skin, bone, etc. ...

An altered state General (weight loss, fever, fatigue, night sweats) exhibits a disease spread.

Diagnosis is based on biopsy and histology, the study historians immunological and cytogenetics.
[?] Treatment

The treatment can be conceived as specialized: radiotherapy, chemotherapy, bone marrow transplant. In some cases little evolutionary one prefers not to deal.

The Burkitt lymphoma cell lymphoma is a very undifferentiated B, which tends to locate outside of the lymph nodes and the reticulo-endothelial system. It is endemic in tropical Africa, where the Epstein-Barr virus seems to play an important role.
The disease is usually abdominal masses due to intestinal attack. The maxillary tumors are common. The biopsy allows diagnosis. The treatment is often effective.

There is a sporadic (non-endemic), which reaches more often immunocompromised adults (AIDS).

The Mycosis fungoides lymphoma is a chronic T-cell, uncommon, affecting mainly the skin. The disease usually manifests itself in a chronic itchy rash (causing itching). The treatment is based on local applications of methotrexate and corticosteroids, sometimes selective irradiation injuries ..

Dr. Lyonel Rossant, Dr Jacqueline Rossant-Lumbroso.