What To Do To Patients With Lymphoma Cancer

The term lymphoma refers to a primary tumor of lymphatic tissue caused by the neoplastic overgrowth of one of its cellular components.

Lymphomas generally originate in lymph nodes where the majority of the "lymphatic tissue" is located and, as they grow and spread, they show a definite preference for other lymph nodes. Thus, the most characteristic clinical feature of lymphoma is "lymph node enlargement".

However, lymphomas can also be found elsewhere. They can also be found in the lungs, spleen, skin, and bone marrow. These organ tissues, as well as lymph nodes occasionally become primary sites of malignant lymphomas and can be expected ultimately to participate in most lymphomatous processes, including those of lymph node origin.

Basically, lymphoma cancer is categorized as Hodgkin's disease. The name came from its discoverer, Thomas Hodgkin. This particular type of lymphoma, which was revealed in 1832, is the common type of lymphoma cancer, while the other types of lymphomas are called "non-Hodgkin's lymphoma".

Hodgkin's Disease

Hodgkin's disease, like other lymphomas, is a malignant or cancerous disease of unknown etiology that originates in the lymphatic system and involves predominantly the lymph nodes. It occurs at all ages and in both sexes equally.

The malignant cell of Hodgkin's lymphoma, its pathologic hallmark, and its essential diagnostic criterion is the "Reed-Sternberg cell". This is a gigantic, atypical tumor cell, morphologically unique and of uncertain lineage, which many regard as an aberrant histiocyte.

Patients with Hodgkin's disease are customarily classified into subgroups based on pathologic criteria that reflect the grade of malignancy and suggest the forecast.

Hodgkin's disease usually begins as a painless enlargement of the lymph nodes on one side of the neck, which becomes increasingly conspicuous.

However, for months generalized pruritus may be the first and only symptom and later is often a most distressing one. The individual nodes remain firm and discrete. That is, they do not soften and do not fuse, and they are seldom tender and painful.

Soon, the lymph nodes of other regions, usually the other side of the neck, also enlarge in the same manner. The mediastinal and retroperitoneal lymph nodes may also enlarge, causing sever pressure symptoms. These are pressure against the trachea causing dyspnea; the esophagus, dysphagia; the nerves, laryngeal paralysis, etc.

On a later stage, the spleen may become palpable, and the liver may enlarge. In some patients, the first nodes to enlarge are those of one groin. Occasionally, the disease starts in mediastinal or peritoneal nodes and may remain limited to them. In still other cases, the enlargement of the spleen is the only conspicuous lesion.

Diagnosis

The diagnosis of Hodgkin's disease hinges on the identification of its characteristic histologic features in an excised lymph node. A diagnosis having been firmly established based on the requisite criteria; it becomes necessary to assess as accurately as possible the total extent of tumor involvement and to define the manner in which it is distributed.

In other words, one attempts to pinpoint the location of every tumor lesion inside and outside the lymphatic region system and to exclude the presence of a tumor in organs and tissues that are not yet involved. This is a difficult, expensive, and uncertain undertaking but an extremely important one, since these are the very considerations on which treatment is to be based.

Caring Management of Patients with Lymphomas

Supportive and protective measures are very important in the treatment of patients with lymphoma cancer including the correction of anemia and the control of infection, to which these patients are peculiarly subject.

The only effective antianemic therapy in these patients is the transfusion of whole blood or red cell concentrates. Infections are treated by chemotherapy and other auxiliary measures according to their type and location.

Indeed, the hope of cure in malignant disease such as lymphoma cancer depends on treatment of the malignancy before it is spread beyond the possibility of removal. This means that treatment should be given as soon as possible after the malignancy is recognized, but it must also be understood that in some patients even by that time there may have been a spread of tumor, which would make it impossible to cure by the present methods of therapy.