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Hodgkin's lymphoma - symptoms and treatment, extent, prognosis of life

Hodgkin's lymphoma is one of the forms of a malignant lesion of the main element of the human body - the lymphatic system. The initial process is characterized by a local, limited process of nodal lesions followed by the migration of tumor cells through the organs and systems of the body.

A distinctive feature of the pathological process is the presence in the affected lymph nodes of special modified cells (Hodgkin cells - the name of the discoverer of the disease) and rare multi-core Sternberg cells (his colleagues).

The disease is slow, but without specialized treatment provokes functional failure of many organs, leading to death.

Hodgkin's disease affects people of all ages. However, the peak of the greatest manifestation falls on transitional (20-30) and elderly (after 50) age.

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Hodgkin's lymphoma - what is this disease?

Hodgkin's lymphoma

Inside our body, every moment there is a huge number of mutations caused by improper interaction of nucleic complexes (acids) in the molecular structure of deoxyribonucleic acid (DNA). This provokes the development of many differentiated tumor cells.

In a healthy organism, with such a process, a genetically programmed program of cellular self-destruction works, preventing their further growth and reproduction.

The immune system, in the form of a phagocytic reaction, represents the second protective level, quickly identifying and destroying “mutants”. As a result, the tumor process is blocked in the embryo itself.

For any violations of the mechanism of protective functions, not currently identified, the cell clone is not destroyed and its uncontrolled cloning of similar copies of itself continues. This process is the basis for the development of Hodgkin's lymphoma.

As soon as a tumor begins to develop in any node of the system, it attracts many components of immune defenders to it. Macrophages, neutrophils, eosinophils and lymphocytes, preoccupied with the destruction of "newcomers" begin to form around the cells of the tumor, a kind of protective barrier of cells and dense fibrous cords (scars).

The growth of cords on the surface of the node contributes to the formation of granulomas and inflammation reactions, which causes a significant growth of the lymph node.

The progression of pathology causes the migration of tumor clones to all nearby lymph nodes and organ tissues. Gradually expanding, granulomatous masses replace healthy tissue, causing functional and structural changes in the affected organ.

Likely causes of lymphoma

Today, the question of the causative factor of granuloma development remains for medicine open. There are only presumptive versions, based on indirect facts, but nothing concrete is not confirmed.

Most scientists support the version of infectious effects and the failure of immunity. There is a version of genetic predisposition, due to the frequent identification of Hodgkin's pathology in twins, but it was not possible to identify specific genes that influence its development.

causes of lymphoma

The only confirmed version of this infection is the Enstein-Barr virus, which was found in multi-core tumor cells. It violates B-lymphocyte cells leads to their enhanced cloning and tumor degeneration.

As for the immune factor, everything is clear here - violations of the second immune level of protection, is one of the reasons that triggers the development of Hodgkin's disease.

Hodgkim's lymphoma forms

The manifestations of Hodgkin's lymphoma are due to the histological structure of the tumor and have four options for development, manifesting itself:

  • Lymphohistational form (classical) - lymphocytic cells dominate in the lymph node.
  • A form of nodular sclerosis caused by a structural disorder of a lymph node by fibrous cords penetrating the knot.
  • Mixed cell variant characterized by the presence of all leukocyte cells in the tumor and the presence of signs of tissue necrosis of the lymph node.
  • A variant of lymphoid depletion, manifested by contraction, or the complete absence of healthy lymphocytes in the nodes, a large number of tumor cells, and healthy tissue of the node being replaced with fibrous tissue.

The determination of the histological structure of the tumor is a very important criterion for the preparation of an effective therapeutic protocol.

Hodgkin lymphomas stages 1, 2, 3 and 4 - what is it?

The stages of Hodgkin's lymphoma are classified according to the severity and extent of the tumor lesion.

  • In the first stage, in almost all cases, clinical symptoms are absent. The disease is usually detected by chance, during examination for another reason. In one group of lymph nodes, or one nearby organ, tumor overgrowth is observed.
  • In the second stage of Hodgkin's lymphoma, the tumor process spreads to several groups of lymph nodes above the abdominal septum; granulomatous lesions are found in the nearest structures.
  • The third stage is characterized by extensive formation of enlarged lymph nodes on both sides of the abdominal septum (diaphragm) with the presence of multiple granulomatous inclusions in various tissues and internal organs. In almost all patients, tumors are diagnosed in the tissues of the spleen, the structure of the liver, and the hematopoietic organ.
  • At the fourth stage of lymphoma, the development of tumor processes in many structures is noted, changing and disrupting their functional activity. In more than half of the patients, an increase in lymph nodes is observed in parallel.

Symptoms of Hodgkin's lymphoma, photo

Symptoms of Hodgkin's lymphoma photo

symptoms - Hodgkin's lymphoma, photo on the neck

Symptoms of Hodgkin's lymphoma, photo

The nature of the clinical symptoms of Hodgkin's lymphoma is very diverse, but for a long time the pathology may not manifest itself, which becomes a common cause of late diagnosis. The main signs of Hodgkin's lymphoma appear:

  1. Lymphadenopathy;
  2. Symptomatic organ lesions;
  3. Signs of a systemic nature.

Lymphadenopathy is the first and most characteristic symptom of Hodgkin's lymphoma. It is characterized by local or widespread enhanced growth of lymph nodes in a completely normal condition of the patient. In the initial period, a nodular increase in the cervical and submandibular zone is characteristic. But also, there is a probability of manifestation of pathological processes in other areas of the lymphatic system - in the inguinal or axillary.

  • increase in size (sometimes gigantic);
  • acquire a tightly elastic consistency;
  • not soldered to fabrics;
  • mobile and painless.

Further development is on the downward scenario. The nodes of the sternum, abdominal cavity, organs located in the lower pelvis, lymph nodes of the legs are affected.

As long as the lymph nodes do not cause discomfort to adjacent organs and tissues, this does not affect the patient's well-being. But their increase and squeezing of the nearest "neighbors" causes a worsening of well-being, manifested by symptomatology:

  • Dry and painful cough due to compression of the bronchi.
  • Dyspnea caused by impaired passage of air through the compression of the organs of the respiratory system. Such a state is able to manifest itself even at rest.
  • Violation of swallowing functions due to compression of the intrathoracic lymph nodes of the esophageal lumen. Initially, the passage of solid food is difficult, with a pronounced process - liquid.
  • Puffiness caused by increased venous pressure due to squeezing of the hollow superior and inferior veins, causing fluid to pass through the vascular bed and soak tissue structures. Disturbed outflow of blood in the spleen and liver provokes their increase.
  • Digestive disorders caused by the compression effect of certain intestinal areas, which causes stagnant food conditions and causes bloating constipation or diarrhea. Impaired blood circulation in the intestinal walls is a prerequisite for the development of tissue necrosis, or dysfunction of the intestinal patency.
  • Sometimes damage to the nervous system as a result of compression of the spinal structures by enlarged lymph nodes, manifesting itself as impaired motor function (more often) in the limbs.
  • Renal lesion (rarely) caused by squeezing of kidney tissues by enlarged nodes of the lumbar region. With a unilateral lesion, the clinic may not appear. When the bilateral process creates the threat of complete functional impairment of the kidneys.

Symptoms of organ damage are due to the spread of malignant clones and the development of tumors and granulomas along the entire pathway. This is most often manifested:

  • Hepatomegaly is a structural lesion and an increase in liver tissue. The proliferation of granulomas displaces healthy tissue of the body, causing the failure of its functions.
  • Splenomegaly - an increase and compaction of the tissue structures of the spleen. It manifests itself usually in the later stages of the disease.
  • Hematopoietic disorders;
  • Damage to the bone structure, manifested by a decrease in bone strength even under minor loads.
  • Tumor germination in the pulmonary structure that causes impaired respiratory functions.
  • Skin pathologies caused by cellular disintegration, or elevated blood levels of bilirubin, due to functional disorders of the liver and biliary outflow. Manifested by pain in certain areas of the skin, burning and severe itching.

The listed symptoms are the most frequent and are an important component in the diagnosis and determination of the appropriate treatment protocol.

Symptoms of Hodgkin's disease photo

Symptoms of Hodgkin's disease, photo

Manifestations of a systemic nature , with Khojin's lymphoma, are expressed by a number of signs:

  • 1) Hours of febrile temperature accompanied by pain and chills, profuse sweating while rapidly reducing it. Such a condition can occur periodically, but with the progression of the disease, the interval of frequency is sharply reduced.
    2) Signs of neurasthenia - fatigue, drowsiness and weakening of cognitive functions (hearing, vision, movements), manifested mainly in the third and fourth stages of the disease. Symptomatology is caused by the depletion of the activation of immune protection due to the progression of the growth of tumor cells.
    3) Rapid weight loss and muscle mass due to the functional failure of many organs.
    4) Frequent development of infectious pathologies caused by depletion of reserve forces of immunity. The situation is aggravated by chemotherapeutic and radiotherapy treatments.

Survey methods

How many people live with Hodgkin's lymphoma depends on the stage of the process, timely diagnosis and the nature of the treatment. The nonspecificity of the manifestation of most of the signs of the disease is rather difficult in the diagnostic plan.

This is the reason for the onset of late treatment of granulomatosis, which is not always effective in the latter stages of the disease.
The examination involved a variety of diagnostic techniques.

  • standard studies of blood counts - KLA and biochemistry;
  • test assessment of liver function;
  • methods of review radiography, endoscopy, CT and ultrasound;
  • bronchoscopic examination, examination of the esophagus (FGDS);
  • colonoscopic examination of the intestine;
  • laparoscopy of the abdominal walls;
  • sterile bone marrow puncture;
  • histological examination of lymph nodes by puncture, aspiration and incisional biopsy;
  • lymphocytic immunophenotyping.

Treatment of Hodgkin's disease - drugs and techniques

With timely diagnosis and correctly selected therapy, today the Hodgkinsky lymphoma is successfully treated to achieve its complete remission. In the treatment of various techniques.

Radiotherapy

The effect of radiation therapy on tumor cells leads to their numerous mutational changes, which is incompatible with further reproduction and existence. In the treatment of Hodgkin's disease, various methods of radiotherapy are used, but the most radical is a mantic-like one.

It is used in the 1st and 2nd stages of the disease - it is a method of simultaneous irradiation of all affected areas of the body.

In the third and fourth stages of the disease, one manticular radiation is not enough. Connect pharmaceutical "artillery" - chemotherapy.

Chemotherapy regimens

Chemotherapeutic regimens for the treatment of Hodgkin's lymphoma have been developed with the aim of effectively stopping cell division and for defeating all dangerous mutated cells. Today, these are different combinations of anticancer drug regimens. Treatment is due to the use of:

  • "ABVD" regimen in the form of drugs "Adriamycin", "Bleomycin", "Vinblastina", "Dacarbazine".
  • "BEACOPP" scheme, due to the introduction of "Bleomycin", "Etoposid" "Adriblastina" "Cyclophosphamide" "Vincristine" "Procarbazine" "Prednisolone".

Properly written treatment course for each stage ensures the absence of exacerbations for many years. To prevent recurrence of Hodgskin's lymphoma, in certain forms of the disease that are resistant to the above mentioned schemes, the so-called “salvation” therapy - “DHAP” scheme is used.

It includes preparations of antitumor properties in the form of "Cisplatin", "Tsitarabina" and their analogues. Embedding them into cells causes their death.

But even with such a treatment regimen, the possibility of recurrence is high. In these cases, shock doses of chemotherapeutic drugs are used that destroy all cellular components of the blood, which subsequently requires their donor transplantation.

  • Surgical intervention is used very rarely - in the formation of large conglomerates in the nodes of the lymph, or irreversible changes in the affected organs.

Probable forecast

In Hodgkin's lymphoma, the prognosis depends on the staging of the disease, its histological variant, the severity of the clinical picture and the likelihood of relapse. Basically, the prognosis is good - more than 85% of patients recover.

With the first and second stages of the disease, with complex treatment with chemotherapy and radiotherapy, more than 90% of patients show complete recovery with a stable remission.

If only the last stages showed symptoms, and the treatment of Hodgkin's lymphoma begins in the third and fourth stages of the development of the disease, then 75-80% of patients can count on long-term stable remission.

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