Lymphomas, malignant

Lymphomas are a group of cancers in which cells of the lymphatic system become abnormal and start to grow uncontrollably. Because there is lymph tissue in many parts of the body, lymphomas can start in almost any organ of the body.

The lymphatic system is made up of ducts or tubules that carry a milky fluid(lymph) to all parts of the body. Lymph contains the lymphocytes or white blood cells, which are the infection- fighting cells of the body. Small pea-shaped organs are found along the network of lymph vessels. These are called thelymph nodes, and their main function is to make and store the lymphocytes. Clusters of lymph nodes are found in the pelvis region, underarm, neck, chest,and abdomen. The spleen (an organ in the upper abdomen), the tonsils, and thethymus (a small organ found beneath the breastbone) are part of the lymphatic system.

The lymphocyte is the main cell of the lymphoid tissue. There are two main types of lymphocytes: the T lymphocyte and the B lymphocyte. These two types ofcells perform different jobs within the immune system. B cell lymphomas aremore common among adults, while among children, the incidence of T and B celllymphomas are almost equal.

Lymphomas can be divided into two main types: Hodgkin's lymphoma and non-Hodgkin's lymphomas. A majority of non-Hodgkin's lymphomas begin in the lymph nodes. Malignant lymphocytes multiply uncontrollably and do not perform their normal functions. Hence, the body's ability to fight infections is affected. Inaddition, these malignant cells may crowd the bone marrow, and, prevent theproduction of normal blood cells.

The exact cause of non-Hodgkin's lymphomas is not known. However, the incidence has increased significantly in the recent years. Part of the increase is due to the AIDS epidemic. Individuals infected with the AIDS virus have a higher likelihood of developing non-Hodgkin's lymphomas. In general, males are ata higher risk for having non-Hodgkin's lymphomas than are females. The riskincreases with age.

The symptoms of lymphomas are often vague and non-specific. Patients may experience loss of appetite, weight loss, nausea, vomiting, abdominal discomfort,and indigestion. The patient may complain of a feeling of fullness, which isa result of enlarged lymph nodes in the abdomen. Pressure or pain in the lower back is another symptom. In the advanced stages, the patient may have bonepain, headaches, constant coughing, and abnormal pressure and congestion inthe face, neck, and upper chest. Some may have fevers and night sweats. In most cases, patients go to the doctor because of the presence of swollen glandsin the neck, armpits, or groin area.

Like all cancers, lymphomas are best treated when found early. However, it isoften difficult to diagnose lymphomas. There are no screening tests available, and, since the symptoms are non-specific, lymphomas are rarely recognizedin their early stages. Detection often occurs by chance during a routine physical examination.

When the doctor suspects lymphoma, a complete medical history is taken, and athorough physical examination is performed. Enlargement of the lymph nodes,liver, or spleen may suggest lymphomas. Blood tests will determine the cell counts and obtain information on how well the organs, such as the kidney and liver, are functioning. A biopsy of the enlarged lymph node is the most definitive diagnostic tool for staging purposes.

Conventional imaging tests, such as x rays, computed tomography scans (CT scans), magnetic resonance imaging, and abdominal sonograms, are used to determine the extent of spread of the disease.

Treatment options for lymphomas depend on the type of lymphoma and its present stage. In most cases, treatment consists of chemotherapy, radiotherapy, ora combination of the two methods.

Chemotherapy is the use of anti cancer drugs to kill cancer cells. Innon-Hodgkin's lymphomas, combination therapy, which involves the use of multiple drugs, has been found more effective than single drug use. The treatmentmay last about six months, but in some cases may last as long as a year. Thedrugs may either be administered intravenously (through a vein) in the arm orgiven orally in the form of pills. Radiation therapy, where high-energy ionizing rays are directed at specific portions of the body, such as the upper chest, abdomen, pelvis, or neck, is often used for treatment of lymphomas.

Like all cancers, the prognosis for lymphoma depends on the stage of the cancer, and the patient's age and general health. The survival rate among children is definitely better than among older people. About 90% of the children diagnosed with early stage disease survive 5 years or more.

Although many cancers may be prevented by making diet and life style changeswhich reduce risk factors, there is currently no known way to prevent lymphomas. Protecting oneself from developing AIDS, which may be a risk factor for lymphomas, is the only preventive measure that can be practiced.

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