Lymphomas always occur in the body's lymphatic system. The lymphatic system includes the tonsils, spleen, bone marrow, lymph vessels, lymph nodes, thymus and appendix.
Benign lymphomas are usually caused by an infectious disease. These include harmless colds as well as more serious viral or bacterial diseases such as
Parasitic diseases such as toxoplasmosis can also lead to an enlargement of the lymph nodes.
The malignant neoplasms are caused by an increased growth of lymphatic cells. Depending on which type of cells are affected by the degeneration, different types of lymphoma develop.
The number of new cases is 10 to 15 per 100,000 people per year. Although malignant lymphomas can develop at any age, the probability increases significantly from the age of 60. Older age is therefore a risk factor for the malignant formation of new lymphatic cells.
Presumably, gene mutations increase with age . As a result of these changes, genes that inhibit cell growth (tumor suppressor genes) are missing.
Increased activation of cell growth-stimulating genes is also being discussed as a cause.
Another risk factor for the development of malignant lymphomas is a weakened immune system. More people fall ill after immunosuppressive therapy. The risk of lymphoma is also increased in patients with autoimmune diseases.
Other risk factors include increased exposure to herbicides and insecticides and exposure to UV radiation. In rare cases, lymphoma is based on a genetic predisposition.
Whether one's own lifestyle increases the risk has not yet been clearly proven. However, obesity in particular appears to play a role, especially in aggressive lymphomas.
Benign lymphomas usually only appear in the form of an enlargement of the lymph nodes. The affected lymph nodes are sensitive to pressure and can be easily moved on palpation.
Experts differentiate between malignant lymphomas:
- Hodgkin's lymphomas and
- non-Hodgkin's lymphomas
Hodgkin's disease is characterized by the presence of Sternberg-Reed cells or mononuclear Hodgkin cells. Around 25 percent of all lymphomas are classified as Hodgkin's disease.
Hodgkin's lymphoma begins with a painless swelling of the lymph nodes. As the lymph nodes are fused together, they cannot be moved on palpation.
The swelling is typically localized on the neck, under the armpits or in the groin region. Patients also suffer from general symptoms such as fever, unwanted weight loss and reduced performance.
Itching and night sweats are also part of these so-called B-symptoms. In some patients, the swollen lymph nodes hurt after drinking alcohol. Although this symptom rarely occurs, it is sufficient for a diagnosis, as it does not occur with any other disease.
Lymphoma usually causes swollen lymph nodes, which can occur anywhere in the body @ Dan Race /AdobeStock
In later stages of the disease, organs are affected. This can affect the nervous system as well as the urogenital tract and the hormone balance.
Due to a weakening of the immune system, patients increasingly suffer from infections. Serious fungal or viral infections and tuberculosis are also possible.
The term non-Hodgkin's lymphoma covers all lymphomas that do not meet the diagnostic criteria for Hodgkin's disease.
These include
- Chronic lymphocytic leukemia
- Plasmocytoma and
- NK-cell leukemia
Non-Hodgkin's lymphomas initially cause symptoms such as
- Swelling of the lymph nodes
- loss of appetite
- weight loss
- pallor
- tiredness and fatigue
- depressive moods
- increased susceptibility to infections
- headaches and/or back pain
Depending on the degree of the disease, the symptoms can develop gradually or rapidly. As with Hodgkin's disease, the swollen lymph nodes do not cause any pain. They also cannot be moved.
If lymph nodes in the chest or abdomen are affected, organ compression may occur depending on the extent of the swelling.
Symptoms are
- shortness of breath
- coughing or
- Digestive problems
If the central nervous system is affected, patients suffer from visual disturbances, dizziness or vomiting.
Benign lymphomas generally require no treatment. They usually disappear on their own after the underlying disease has healed.
Treatment for Hodgkin's disease consists of chemotherapy and radiotherapy. As a rule, doctors first carry out chemotherapy and then radiotherapy.
Various cell-damaging and growth-inhibiting drugs (cytostatics) are used during chemotherapy. In order to prevent further progression of the lymphoma, treatment should begin immediately after diagnosis.
Chemotherapy can be used alone or in combination with radiotherapy for non-Hodgkin's lymphoma @ Seventyfour /AdobeStock
It is not uncommon for a relapse to occur during or in the months following therapy . In this case, high-dose chemotherapy followed by autologous stem cell transplantation makes sense.
In this form of stem cell transplantation, the patient 's own blood stem cells are removed and transplanted after chemotherapy. If the patient does not respond to the therapy, an allogeneic stem cell transplant may be necessary. In this case, the patient receives bone marrow or blood stem cells from another donor.
The treatment of non-Hodgkin's lymphoma depends on the form of the disease. If the disease progresses slowly and causes few or no symptoms, doctors often do not treat it.
However, regular check-ups should be carried out so that treatment can be administered in good time if necessary. Treatment involves a combination of several therapy methods.
Here too, the combinations differ depending on the lymphoma. To kill the malignant cells and minimize the growths, doctors administer cytostatic drugs in tablet form or as an infusion.
High-dose X-rays are often used to help shrink the tumor. Doctors often treat so-called indolent, i.e. painless, lymphomas in early stages with radiotherapy alone .
Another treatment option is antibody therapy. Antibodies are often used in combination with chemotherapeutic agents.