Non-Hodgkin's Lymphoma

定义

淋巴瘤是淋巴系统的癌症. The lymphatic system drains excess fluid from tissues. 它还有助于防止感染.

Non-Hodgkin lymphoma is a name that applies to many types of lymphomas. These types are based on the cell that is involved 和 the patterns of growth.

一般来说，这些类型可以分为:

• Slow growing lymphomas, also known as indolent lymphomas
• Aggressive lymphomas
• 高度侵袭性淋巴瘤

这些癌症不同于 Hodgkin lymphoma .

The Lymphatic System

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原因

Cancer occurs when cells in the body divide out of control or order. 如果细胞不断分裂，就会形成大量的组织. 这些被称为生长或肿瘤. 如果肿瘤是癌症，就称为恶性肿瘤. It can invade nearby tissue 和 spread to other parts of the body.

非霍奇金淋巴瘤的病因尚不清楚. DNA mutations that occur after birth may be related to this 癌症. These mutations can occur as a result of exposure to radiation or 癌症-causing chemicals. They may also occur with age or for no apparent reason.

风险因素

Most people who develop non-Hodgkin lymphoma have no known 风险因素. Men 和 people age 60 to 70 years old are at increased risk. The following factors may also increase your chance of developing this condition:

• Frequent 和 accumulating exposure to certain types of chemicals, such as herbicides, 农药, 苯, 氯化有机溶剂
• 感染涉及免疫系统，如 艾滋病毒/艾滋病 和 Epstein-Barr virus
• 的历史 化疗 , 放射疗法，或者免疫抑制疗法
• 染色体易位, which occur when DNA breaks off one chromosome 和 becomes attached to another
• A parent who has had non-Hodgkin lymphoma, especially if it occurred at an early age
• Celiac disease -麸质肠病或麸质不耐症
• Chronic issues, such as systemic lupus erythematosus, rheumatoid arthritis , Sjogren syndrome
• 肥胖

症状

症状 include:

• Painless swelling of the neck, underarm, groin, or any other lymph node-bearing regions of the body
• Unexplained fever
• Profuse sweating
• Constant fatigue
• Unexplained weight loss
• 皮肤发痒，尤其在腿和脚上
• Red patches on the skin
• 胸痛或呼吸短促
• 瘀伤

诊断

You will be asked about your symptoms 和 medical history. A physical exam 将会完成. 包括检查你的淋巴结.

你的体液和组织可能会被检测. This can be done with:

• Excisional or incisional 活组织检查
• Fine needle aspiration (FNA)
• 骨髓 活组织检查
• Lumbar puncture
• Immunohistochemistry
• Flow cytometry
• 细胞遗传学和/或分子遗传学研究
• 血液测试

Imaging tests are used to view internal structures. Some may use contrast material to make structures easier to see. 影像学检查可能包括:

• 胸部x光片
• CT扫描
• 核磁共振成像扫描
• FDG PET/CT扫描
• 骨扫描
• 超声波

治疗

治疗 这取决于癌症的阶段和类型. The type is determined in part by a microscopic exam 和 other studies. Talk with your doctor about the best plan for you. 治疗方案包括:

Watchful Waiting

For some indolent lymphomas, no 治疗 may be needed for some time. 治疗 is needed if the tumor begins to cause symptoms. 治疗 may also be needed if the tumor becomes too large to tolerate, 或者表现出攻击性的迹象.

化疗

化疗 包括使用药物杀死癌细胞. It may be given by pill, injection, or via a catheter (tube). The drugs enter the bloodstream 和 travel through the body. 它们杀死的主要是癌细胞. 一些健康细胞也可能被杀死.

外部放射治疗

辐射 is directed at the tumor from a source outside the body to kill the 癌症 cells.

骨 Marrow Transplant

你也许可以用你自己的骨髓. 骨髓 被移除，处理和冷冻. Large doses of 化疗 和/or radiation therapy are then applied to kill the 癌症 cells. After 治疗, the bone marrow is replaced via a vein.

骨髓也可以由健康的人捐献.

外周干细胞移植

Stem cells are immature cells that produce blood cells. They are removed from circulating blood before 化疗 or radiation 治疗. 这些细胞在治疗后被替换. 然后这些细胞可以发育出新的健康细胞.

Biological Therapy

These medications or substances are made by the body. They increase or restore the body’s natural defenses against 癌症.

干扰素是一种生物疗法. They interfere with the division of 癌症 cells 和 can slow tumor growth. 干扰素由身体产生. They can also be made in a lab to treat 癌症 和 other diseases.

Sometimes, a drug or antibody that is directed at the lymphoma is linked to a radioactive substance. It will deliver a focused dose of radiation to the tumor.

预防

There are no guidelines for preventing non-Hodgkin lymphoma. To reduce your risk, 避免接触化学物质，如除草剂, 农药, 苯, 氯化有机溶剂. 如果你有 celiac disease 保持无谷蛋白饮食. This diet will minimize stimulation of your immune system from exposure to gluten.

参考文献

• Adult non-Hodgkin lymphoma 治疗 (PDQ)-patient version. 国家癌症研究所网站. Available at: http://www.癌症.gov/types/lymphoma/patient/adult-nhl-治疗-pdq. Accessed January 28, 2021.
• 非霍奇金淋巴瘤(成人). 美国癌症协会网站. Available at: http://www.癌症.org/癌症/non-hodgkin-lymphoma.html. Accessed January 28, 2021.
• 7/7/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116014/Non-Hodgkin-lymphoma-NHL [1]梁毅，杨志，秦波，钟锐. Primary Sjogren's syndrome 和 malignancy risk: a systematic review 和 meta-analysis. Ann Rheum Dis. 2014;73(6):1151-1156.