lymphoma | What are the causes of lymphoma?

What are the causes of lymphoma?

A lymphoma is a form of cancer that affects the immune system, specifically, is a cancer in defensive immune cells called lymphocytes, a type of Leukocyte (white blood cell). There are two main types of lymphoma and several subtypes.
On this page you will find tools to understand easily information related to lymphomas, both Hodgkin and non-Hodgkin's.

This is to Spanish-language translation of the following article: What is lymphoma? Lymphoma causes, symptoms and treatments

What is Lymphoma?
A lymphoma is a cancer of the lymphatic tissue (lymphatic system), which plays a major role in our immune system activation. He is characterized by the formation of solid tumors in the system inmune.1 this type of cancer affects immune cells called lymphocytes, which are a type of white blood cell.

Statistics from the National Institute of Cancer in the United States estimate that there are about 20 cases of non-Hodgkin Lymphoma per 100,000 people in the population estadounidense.2

For his part, Hodgkin's lymphoma is relatively rare, with around three cases per every 100,000 personas.3

That means that approximately 90% of lymphomas are non-Hodgkin's type, while 10% are the Hodgkin type.

Cancer is part of a group of more than 100 diseases, of which all start with the growth of abnormal cells. Instead of dying in the normal life of a cell cycle, cancer cells continue dividing in new abnormal cells and grow out control.4

Cancer of the lymphatic system is classified by the type of affected immune cells.

On the type of non Hodgkin's lymphoma, B-cell and T-cell are affected, these cells are lymphocytes that play roles in the activation of immunity. In the United States, B-cell lymphomas are much more common than the type T.5

In Hodgkin's lymphoma, the cancer cells are usually an abnormal type of lymphocytes B, known as Reed-Sternberg cells. There are several subtypes of Hodgkin's lymphoma, which have been classified by the differences observed under the lens of the microscope, however, a very high percentage of cases classified as Hodgkin's lymphoma "clásico".6

This short video on Youtube, produced by the American Society of Hematology (ASH), shows us how a lymphoma develops.

General data on lymphomas
Here are some general facts about lymphomas. More details and information in the body of this article.
A lymphoma is a cancer that develops in the lymph nodes or nodules and in the lymphatic system.
The two main types of lymphoma are: non-Hodgkin's (approximately 90% of cases) and Hodgkin (approximately 10%).
The cause of lymphoma is unknown, however some risk factors have been identified.
The main symptom is usually inflammation of the lymph nodes, which doesn't go away (such as after an infection).
The diagnostic process includes taking a medical history with the aim to rule out other problems, feel the body of the patient looking for masses, and biopsies of the area.
Results from biopsies, along with other kinds of tests and scans will indicate us the type of lymphoma and stage in which it is located.
Lymphomas are not preventable, however, rates of survival after treatment are highly positive.
Treatments are similar to those used in other types of cancer. Include chemotherapy, radiotherapy and consumption of specialty drugs.
Some cases are treated with stem cell transplantation in combination with a high dose of standard therapy.
Types of lymphomas
There are different types of lymphomas depending on the affected lymphatic cell.

Type Hodgkin lymphoma can occur at any age, affects more men than women, and most will completely cure themselves

Type Hodgkin lymphoma is diagnosed when a special type of cell, the Reed-Sternberg cell, seen with the microscopio.5

Non-Hodgkin's type Lymphoma represents the other types of lymphoma. These may be high or low grade and their treatment and prognosis varian.6

Causes of lymphoma

In the majority of cases of cancer, researchers are still trying to understand what causes them, which originates them. This truth also applies to lymphomas, and although doctors do not know what is your cause, they point out that it is more likely to occur in certain types of trafficking.5, 7, 8

Medical researchers have identified certain risk factors that make more likely a lymphoma develops, but at the same time you do not understand the why: 5, 8

Non-Hodgkin's

Age: most of the non-Hodgkin's lymphomas occur in people older than 60 years

Sex: the rates of non-Hodgkin Lymphomas are varied within the sexes

Ethnicity and location: in the United States, African American and the Asian-American is less likely that the U.S. Caucasian to develop this disease, at the same time this disease is more common in developed countries

Chemicals and radiation: some chemicals used in agriculture, as in the nuclear radiation exposure have been identified as risk factors

Immunodeficiency: for example caused by HIV infection or acquired in organ transplantation

Autoimmune disease: in which the immune system attacks the body's own cells

Infection: certain viral and bacterial infections increase the risk of developing Lymphoma

Visit the page of the American Cancer Society for more detail about the risk factors for non-Hodgkin's lymphoma.

Hodgkin

Infectious Mononucleosis: infection caused by the Epstein-Barr virus

Age: two groups are the most affected, on the one hand the people in 20 years and the other over the age of 55

Sex: slightly more common in males

Location: most common in the United States, Canada and Northern Europe, less common in Asia

Family: the risk of developing this disease is slightly higher if a brother has suffered from it, this risk can increase even more in the case of being an identical twin

Economic level: people of higher socioeconomic status have increased risk of developing the disease

HIV infection

Visit the page of the American Cancer Society for more detail about the risk factors for Hodgkin's lymphoma.

Signs and symptoms

Lymphomas can trigger a number of symptoms, many of which can be caused by other diseases. For this reason, it is important to tell your doctor all the symptoms that present.

The signs and symptoms of lymphoma are very similar to the common illnesses such as colds, and this may cause a delay in diagnosis.

The difference is that, when it comes to a lymphoma, these symptoms persist for longer than the normal course of a viral infection

Lymph nodes

Lymph nodes in the neck may swell during a cold or a flu. We have many other lymph nodes throughout the body.

The most common symptom of lymphoma is usually painless swelling of the lymph nodes, however it may be painful for some people, and even, this pain may increase after alcohol consumption. This inflammation are frequently noticed in the neck and the armpit, where nodes are concentrated. Also they can be noted in the groin and abdomen, although some people will be no lymph node inflammation that is detectable. 9

Perhaps you already familiar with this symptom to the lymph nodes of the neck (commonly called as "glándulas" ") can ignite during some infections, for example in a cold, where later the swelling decreases, which is not the case when it comes to a cancer.6

The increase in the size of the nodes can press organs, bones and other structures causing pain, but this will be similar to that caused by other less serious diseases (such as back pain). This contributes to that the lymphoma is difficult to diagnose.

Anyone that has swollen glands, and does not improve after some time, see your doctor.

Lymph nodes are part of the immune, lymphatic system and they are throughout our body, however the inflammation of a lymphoma may be more notable and common in the following area:7, 9, 10

Other symptoms that people can experience with lymphomas are as follows: 9, 11

Swelling in legs and ankles

Excessive sweating, especially at night, even to let the sweat soaked sheets

High body temperature / recurrent fevers

Sudden loss of weight without obvious explanation

Itching, which may be worse after alcohol consumption

Cough or shortness of breath

Abdominal pain or vomiting after drinking alcohol

Loss of weight and appetite

Fatigue.

Pain and altered sensation

Unexplained tiredness and loss of energy

Persistent cough

Shortness of breath

Increase of the tonsils

Headache.

The pain usually does not appear in the early stages of lymphoma. In fact, the presence of painful lymph nodes accompanied by other signs of infection, are usually a sign of active infection.

Lymphoma is more common the presence of painless and inflamed lymph nodes. Pain, weakness, paralysis and other sensory symptoms typically occur when the increase in size of lymph nodes pressing on spinal nerves or spinal cord.

Anyone who experience any of these symptoms should seek medical attention urgently.

Lymphoma is a type of cancer that originates in the lymph nodes, but can spread quickly to other parts of the body through the lymphatic system. The spread of cancerous cells to other tissues, may decrease the ability of the body to fight infections

Lymphoma can cause a variety of symptoms, many of which are also present in other illnesses. It is worth commenting to their physician any symptoms.

Spread of lymphoma

Hodgkin's lymphoma is a cancer of the lymphocytes, a type of white blood cell. This type of cancer affects the lymph nodes and lymphatic tissue is connected along the body, this facilitates travel from their location of origin spreading to other tissues, including outside the linfatico.10 system

In Hodgkin's lymphoma, this spread is usually in sequence, affecting a one nodule after another in a row.

In non-Hodgkin's lymphoma, the tumor may appear in lymph disparate, skipping any of the nodules.

Tests and diagnosis

Currently there is no program of screening for lymphoma, this only is diagnosed when the person goes to the doctor for something that you concerned. Due to the inespecificidad of the symptoms, sometimes the doctor reassures the patient with an early stage of lymphoma, thinking that you it's a simple infeccion.12

If your symptoms persist, you must return to the doctor.

A lymphoma is not the kind of cancer that is expected to appear in individuals of the population saludable.5, 6

Ultrasound scan neck

Through an ultrasound images of a tumor may occur in the lymph nodes.

Doctors can investigate thoroughly a lymphoma when a patient has signs and symptoms mentioned above.

This research will begin by taking a medical history for which will be questions that help to rule out other explanations for the symptoms. So will limit: 5, 6

Possible risk factors

Family history

Other medical conditions.

A physical examination will be the next step in all cases where there is a suspicion of lymphoma, you will feel in the areas of the body that feel swollen lymph nodes. The doctor will also feel around the abdomen to examine the spleen and higado.5, 6

During the physical examination, the doctor will look for signs of infection near the lymph nodes, since the majority of the cases of inflammation are the result of an infeccion.5, 6

The doctor will look for the swollen lymph nodes in several areas, including:

Chin

Neck

Tonsils

English

Armpits

Shoulders

Elbows.

Classifying lymphomas

Classify is a complicated process but it helps the surgeon and specialist to determine the best treatment (or no treatment) Lymphoma.

Different classifications have been proposed in recent years, though the most widely used is that of the World Health Organization (who). This classification helps the specialists to standardize how they analyze the lymphoma.

Classifying Lymphoma

After the classification, clinical Lymphoma grade has to be determined. This describes how aggressive a tumor is and predicts what will be its comportamiento.7-9

Pathologists take into account:

The type of cells in the biopsy

The activity and rate of growth of these cells

Unique characteristics observed in the cells, and other factors

A low grade lymphoma is one that grows slowly (occasionally called indolent), while intermediate-grade, or high-grade lymphomas grow faster and are more aggressive.

Indolent lymphomas include:

Follicular Lymphoma

Small Lymphocytic Lymphoma

MALT Lymphoma

Lymph node marginal zone B-cell lymphoma

Lymphoma linfoplasmocitico

Lymphoma anaplastic large cell, primary cutaneous type (may also occur as an aggressive lymphoma).

The most common type of aggressive lymphoma is (DLBC) diffuse large B cell lymphoma. Other forms of aggressive lymphoma include:

Burkitt Lymphoma

Lymphoblastic Lymphoma

Hepatosplenic gamma/delta T-cell lymphoma

T cell lymphoma type subcutaneous Panniculitis

T cell lymphoma associated with enteropathy

Adult T-cell lymphoma/leukemia (T-cell Lymphotropic virus human type I positive, HTLV 1 +)

Lymphoma anaplastic large cell, systemic type

Aggressive NK-cell leukemia.

Laboratory tests - biopsy

If there is a suspicion of lymphoma, because, for example, inflammation has been maintained after having ruled out an infection, the biopsy definitely help us to confirm or dismiss it through a laboratory test which will examine a sample of fabric lymphatic with a microscopio.5, 6

The biopsy will also help identify the particular type of lymphoma and, in this way, a guide to prognosis and tratamiento.5, 6

The most common types of biopsy son:5, 6

Excisional biopsy: the surgeon completely removes a lymph node for analysis

Incisional biopsy: the surgeon removes only part of the suspected lymph tumor.

Depending on the area of operation, the type of anesthesia used can be local, sedation or general anesthesia.

Less frequent is also performed the biopsy minimally invasive, which is guided through needles and is known as "biopsia with needle fina" or "biopsia with needle gruesa".5,6

Other tests that may be ordered is a blood test to check the number of white cells present, as also chest x-rays to observe the behavior of the lymph nodes inflamados.12

If the diagnosis of lymphoma has already been confirmed by biopsy, will require other tests that help determine the stage of cancer as well as if it has spread to other parts of the body (metastasis).

Some of the following options, depending on the caso:5, 6, 11, 12 are used to determine the stage of cancer

Blood tests: including complete blood count (CBC), count of white blood cells, levels of protein, liver function tests, tests of kidney function, uric acid, and concentration of lactate dehydrogenase (LDH)

CT (computed tomography of x-ray images): scans of the thorax, abdomen and pelvis using contrast medium sometimes for better visualization of the area

MRI (magnetic resonance imaging): for detailed images of tissues

Ultrasound (ultrasound): for scanning of tumors

PET scan (positron emission tomography): in which the radioactive substance looks for cancer

Bone marrow biopsy: to verify if there are signs of lymphoma in the sample

Lumbar puncture: assisted by local anesthesia and through a long, thin needle withdraws some cerebrospinal fluid, which is subsequently analyzed in search of lymphoma.

These types of tests allow doctors to understand what kind of cancer it is and the stage in which it is located.

Oncologists use classification systems for all types of cancer. In the lymphomas four stages have been identified (I-IV), where each corresponds to the spread of cancer.

The following are basic descriptions of each etapa:5, 6

Stage I: the tumor is localized and confined to a specific area

Stage II: there are spread limited Lymphoma, staying on one side of the diaphragm

Stage III: there is spread of the cancer to both sides of the diaphragm, or an area or organ near the primary tumor

Stage IV: Lymphoma has spread beyond the lymphatics to other parts of the body.

Each step provides an additional description according to the specific symptoms presented, either with A or B added to this description. The B denotes a type of cancer that is usually in a more advanced than A State and is characterized by the following symptoms (without these symptoms lymphoma is considered type A): 5, 6

Unjustified loss of weight, more than 10% in the last 6 months

Unexplained fever of at least 100.4 ° F (38 ° C)

Night sweats.

Treatment and prevention

Prevent a lymphoma is not possible until its causes are unknown and the risk factors that have been identified, with the exception of HIV infection or virus of Epstein, are largely inevitables.5, 6

There is a large number of options in terms of treatment for lymphomas, many of which are also used to battle it out against other types of cancer.

Although the statistics cannot predict the success of the treatment of a person in particular (which depends on many factors, including the stage of the cancer), the figures show positive rates of recovery in the battle against the linfoma:2, 3

More than two-thirds of people diagnosed with non-Hodgkin Lymphoma will survive for five years

This five-year survival rate is even higher for Hodgkin's lymphoma, in a little more than 85%.

Non-Hodgkin's lymphomas

A lymphoma indolent non-Hodgkin's often causes few or no symptoms until the disease is very developed, when already has been extended. Treatment often consists of a watchful waiting (expectant attitude), followed by medical intervention in order to reduce the tumor.

Treatment is usually effective and leads to disease-free periods.

An indolent (low-grade) Lymphoma may recur, again needing treatment. In some cases, an indolent lymphoma can become aggressive, requiring more aggressive treatment.

People with indolent lymphoma usually live many years with good quality of life.

Some patients may not require any treatment.

On the other hand, patients diagnosed with high-grade lymphomas will require immediate and intensive treatment to help slow tumor growth and eventually reduce the tumor.

Those cases in which an indolent Lymphoma becomes aggressive, can be difficult cases because the tumor may be already extended, while the aggressive lymphomas tend to be diagnosed earlier, when they are still located.

Hodgkin's lymphoma

The treatment of Hodgkin's lymphoma also depends on the extent of the cancer.

Unlike non-Hodgkin's lymphomas, treatment of early stages of Hodgkin's lymphoma usually requires a short course of chemotherapy followed by localized radiotherapy to treat the affected lymph nodes.

This provides systematic and localized treatment of cancer, helping to minimize damage on the healthy tissues.

The treatment of the advanced stages of Hodgkin's lymphoma normally requires combinations of chemotherapy to reduce the spread of the tumor.

In addition to the watchful waiting, chemotherapy and radiotherapy, other possible options of treatment for patients with lymphoma are:: 5.6

Biological therapy

Immunological therapy with monoclonal antibodies

Splenectomy

Treatment with corticosteroids

Stem cell transplantation

Surgery in a limited number of cases.

Both type Hodgkin Lymphomas Hodgkin, a long list of medications are not available for use in chemotherapy, these can be administered orally or by injection, usually in outpatient treatment cycles that allow periods from descanso.5, 6

Unusual is the combination of medications, which are named with abbreviations from the first letters of his nombre.5, 6

Chemotherapy is often combined with other treatments, such as radiation therapy and immunotherapy.

Radiation therapy, or radiation therapy, is to carefully direct x-ray of high power on lymphomas to destroy cancer cells as well.

Immunotherapy is the use of biological therapies that help to stimulate the immune system, in some cases, also supply artificial in some parts of our immune system versions. Again, the goal is to kill or slow the growth of cells cancerosas.5, 6

Some medicines are monoclonal antibodies artificial proteins that provoke the immune response, many of which are available for persons diagnosed with lymphoma.

In non-Hodgkin's lymphoma, some biological drugs can be used in cases where other treatments have failed. These include agents immunomodulators such as thalidomide and the lenalidomida.5, 6

A small number of cases of lymphoma are treated by stem cell transplantation. This process allows to provide high doses of chemotherapy and radiation therapy for those cases that have not responded to standard treatment.

High doses of treatment usually cause side effects in the bone marrow, however administered stem cells transplantation after treatment will help us with the restoration of this. The infusion of cells mother promises that new blood cells can producirse.5, 6

Prognosis of lymphoma

When it is diagnosed a Hodgkin's lymphoma, the specialist not only classifies the type and extent of the cancer, also assigns it a letter "A" or "B" to the staging of the tumor.

"B" means that at least one of the following symptoms is present: unintentional weight loss, night sweats or fever. "

"A" means that these symptoms are not present. "

Take account of this classification, the aggressiveness and stage of lymphoma, the doctor will calculate the "Indice Hodgkin Lymphoma International Prognostic" this index also takes into account the patient's age and other information. " The patient can ask about their prognosis based on this calculation.

Leukemia and Lymphoma Association points out that Hodgkin's lymphoma is considered as one of the most curable forms of cancer.

Survival relative to five years for people with lymphoma Hodgkin has doubled, from 40% in Caucasians between 1960 and 1963 (the only data available) to the 87.7% for all races from 2004 to 2010

Concerning the five-year survival is the 93.7% for people with Hodgkin's lymphoma less than 45 years at the time of diagnosis.

Survival relative to five years for people with lymphoma Hodgkin has not increased from 31% in Caucasians between 1960 and 1963 (the only data available) to the 71.4% for all races from 2004 to 2010

Early diagnosis and adequate treatment has helped to improve the survival rate of lymphomas.

It is estimated that 20,170 members of the American population have died due to Lymphoma (18,990 Lymphoma non-Hodgkin's and Hodgkin's lymphoma 1,180) per year. In general, the rate of deaths in Hodgkin's lymphoma has been reduced since 1975.

All cancer treatments have side effects, some of which are serious. Decide the treatment always includes weighing the benefits and potential side effects of the same. The benefits should offset any risk.