Definition and causes
Non-Hodgkin lymphoma (NHL) is a group of malignant diseases, which together with Hodgkin's lymphoma is the categorylymfekræftormalignant lymphoma. The diseases has therefore been deleted from lymfevævet, especially lymph nodes, and includes the white blood cells.
All blood cells develop from stamcellen in the bone marrow, and this share in 2 lines and is represented by themyeloidandlymphoidstem cell. The myeloid stem cell develops roughly in 3 different lines, resulting in the formation of red blood cells, some of the white blood cells and platelets (see the blood in general ). Apart from the lymphoid stem cell developed B-lymphocytes and T-lymphocytes (both fall under the white blood cells), both of which play an important role in the immune system.
Non-Hodgkin lymphoma is a group of cancer, of which about. 90% from B-lymphocytes and 10% from T-lymphocytes. The diseased cell (kræftcellen) share is uncontrolled and spreading in the body. Although white blood cells called lymphocytes, are the most in the lymphatic system disorders (described below).
The vast majority of NHL from lymphocytes in a lymph node, which magnified (called a lymphoma) but can also be deleted from lymphocytes, which makes a knot in the mucous membranes (called maltomer). It is a characteristic of the NHL to develop a specific malignant (malignant) cells of each type of NHL, so that we can distinguish between them by taking special tests. NHL could spread to all bodies (metastasering).
The specific reason for the development of NHL is unknown, but it can probably caused by several factors such as viral infection (NHL seen in the context of HIV ) Or the influence of the environment. from insecticides.
NHL can be divided into 2 divisions:
- There are types of which consists of småcellede, langsomvoksende lymphoma (for example.follicular lymphoma). These types are typically scattered in other tissues in diagnosetidspunktet and are difficult to cure.
- These types consists of storcellede fast-growing lymphoma (for example.diffuse storcellede lymphoma), Which is more aggressive but it is easier to cure.
NHL is relatively frequent, and there seems to some. 900 new cases in Denmark a year. The increase of new cases each year around. 4%.
This is a system which consists of lymfekar and lymph nodes. Lymfekarrene drain the body of the excess fluid that out of the tissue, and lead it back to the bloodstream. On the way back to the bloodstream through lymfekarrene lymph nodes, continues in major lymfekar order to finally run out in the large veins in the neck, leading the blood back to the heart (halsvenerne). In this way, nutrients, proteins, etc. recycled in the body, while not accumulate fluid in the tissue. Lymf
Lymfeknuder found in greatest numbers in the neck, in armhulen, in the stomach and in lysken. They form a kind of filter and development of the immune system, as infectious substances from the tissue runs through them. B lymphocytes develop in the lymph nodes, while the formation of antibodies against a bug. infection in the body. So you can feel sore and swollen lymph nodes by an infection. In the event that cancer cells spread by lymfekarrene, these will be detained in a lymph node, which will be affected
Symptoms of NHL
Most forms of NHL is reflected by:
- Raised and uømme lymph nodes, which are often more than 1 cm in diameter. Typical are the swollen lymph nodes in armhulen, neck or in lysken. Ømme lymph nodes indicates more on an infection in the body.
- Sits lymfomet in depth. in the chest or the abdomen, discovered the swollen knot usually not, and the disease can be expressed by the classic signs of lymphoma (the so-called B-like symptoms): fever, weight loss, fatigue and night sweats.
- Has the disease spread to the bone marrow, can be seen as signs of bleeding (see thrombocytopenia ) anaemia and infections.
- There may, in some cases felt a bump on the left and / or right side of the abdomen just below the ribs by, respectively. enlarged spleen and liver.
Precautions and diagnosis by NHL
If you have swollen lymph nodes, it may be referred due to an infection in the body, and enforcement may disappear in a couple of weeks. Is enforcement renewable and lymfeknuden uøm, one should consult a doctor as soon as possible. Similarly, we must seek out a doctor if you have any of the above symptoms. HIV-infected persons should be extra alert to the symptoms.
At the doctor to get blood tests, and from these we can, inter alia, see if the NHL has spread to, for example. liver or bone marrow. If there is any doubt about whether the bone marrow is involved, can be complemented with a knoglemarvsundersøgelse . There is also a biopsy (vævsprøve) from the swollen lymph node, which you can see the subgroup of NHL is concerned.
In addition, you can take an X-ray of the chest, do a CT or MRI scan , A low PET scanning of the chest and stomach to look at the size of the deep lymph nodes and look at the internal organs. When we have to define the severity of the disease, looks on how many lymph nodes in various fields, which are involved, and whether there is organpåvirkning, for example. liver and spleen.
Treatment and progress of NHL
By the småcellede slow-growing lymphoma attempt with local radiotherapy of the swollen lymph node. This is often a good effect, and it is disease-free for years, if the malignant cells have not spread to diagnosetidspunktet. In the case of the spread of cancercellerne, it is not possible to cure the disease.
It will, however, try to deal with a small quantity chemotherapy (cellegifte) and binyrebarkhormon (prednisolone) possibly. in combination with radiation therapy, to allow the longest possible survival with the best quality of life.
Recent research has contributed to the formation of an antibody which can be given without side effects, and the effect is promising. However, the substance is so new that you can not say something about long-term effects.
The storcellede fast-growing lymphoma is a good chance of cure with a so-called 4-stofsbehandling. It gives 6-8 slither of 3 weeks, and also well tolerated by the elderly, so as to be home between treatments. As with the slow-growing lymphoma think the new antibody to have a good effect. Young people can tolerate high doses of chemotherapy, and we can try to create a bone marrow subsequently. The forecast is good, if lymfomet is small, if one is young (which can tolerate high doses of chemotherapy) and if the chemotherapy works best on the sick cells. The forecast is bad, if the cells have spread. to the nervous system.
In general, given supportive care with blood, antibiotics and medicines kvalmestillende during intensive kemoterapibehandling.