Lymphoma

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Malignant lymphomas (colloquially lymph node cancer, formerly also lymphosarcoma) are a group of malignant diseases of the lymphatic system. These include lymph nodes, tonsils, spleen and bone marrow. But other organs can also be affected.

Causes

The disease is based on a malignant transformation of lymphoid cells of different maturation and differentiation stages. Depending on which cell type is affected, different types of lymphoma develop, which differ in manifestation, course, therapeutic influenceability and prognosis. Traditionally, a distinction is made between Hodgkin's lymphoma and the heterogeneous group of non-Hodgkin's lymphomas (NHL). Today, the classification of malignant lymphomas by the World Health Organization is common. In addition to the cell of origin (B-lymphocyte or T-lymphocyte), this distinguishes between

  1. Indolent lymphomas (dolor = lat. pain; low grade, meaning: slow-growing lymphomas that do not cause any symptoms for a long time)
  2. Aggressive lymphomas (high grade, meaning fast-growing lymphomas that cause rapid symptoms)
  3. Hodgkin's disease.

Due to their origin in the lymphatic system, some malignant lymphomas are caused by disorders of the immune system. With the increasing number of organ transplantations and the subsequent need for immunosuppression as well as immunodeficiencies in HIV, the incidence (number of new cases) of so-called post-transplant lymphoproliferative disorders has increased. Congenital immune system disorders such as Wiskott-Aldrich syndrome or severe combined immunodeficiency (SCID) have also been reported to increase the incidence of lymphoma. The age peaks in Europe and the USA (not in the rest of the world) are around 30 and 60 years of age, men are affected slightly more often than women.

In the treatment of malignant lymphomas, therapy with cytostatics (chemotherapy) plays a decisive role, sometimes supplemented by radiotherapy. This means that many lymphomas can be treated well. Some lymphomas are curable today.

Classification

Lymphomas are basically divided into Hodgkin's lymphomas, which account for about 25% of all lymphomas, and non-Hodgkin's lymphomas, which account for about 75% of all lymphomas.

Hodgkin's Lymphoma

Hodgkin's lymphoma (HL, Hodgkin's disease) is a malignant, monoclonal B-cell lymphoma. In histology, mostly Sternberg-Reed cells (multinucleated giant cells) and mononuclear Hodgkin cells are detectable.

Non-Hodgkin's Lymphoma

Non-Hodgkin's lymphomas (NHL) are a heterogeneous group of monoclonal neoplasms derived from precursor B or T lymphocytes.

B-cell lymphomas

  • Chronic lymphocytic leukemia
  • Plasmocytoma (multiple myeloma)
  • Lymphoplasmocytic lymphoma (including Waldenström's disease)
  • Follicular lymphoma
  • MALT lymphoma
  • diffuse large B-cell lymphoma (DLCBL)
  • Burkitt's Lymphoma

T-cell lymphomas

  • T-/NK-cell lymphoma
  • NK cell leukemia
  • T-cell prolymphocytic leukemia
  • mycosis fungoides
  • Sézary Syndrome

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