Lymphosarcoma: Symptoms and Treatment
Lymphosarcoma is a malignant tumor for which the cellular elements belonging to the lymphoid series act as a morphological substrate. Lymphosarcoma, the symptoms of which appear in such clinical signs as the damage of lymph nodes and various organs, is also characterized by hematogenous and lymphogenic metastasis occurring with leukemia in about 20% of patients.
When considering lymphosarcoma, a significant secondary group is formed, which is formed from lymphocytes and lymphocytic leukemia. In those situations in which a benign tumor that precedes a given condition is unknown, the primary lymphosarcoma is noted. Primarily lymphosarcoma of B-cell origin, T-cell lymphosarcomas are much less common.
Lymphosarcoma is formed in the lymphatic tissues, while its course, like the growth rate, equals it predicted to acute leukemia, rather than to similar lymphogranulomatosis.
There are no special age categories for lymphosarcoma. It is noted that boys are more prone to disease than girls. Symptomatology with lymphosarcoma, primarily in its primary manifestations depends on the primary location of tumor formation. Let’s consider the basic variants of localization of primary lymphosarcoma depending on cellular (B- or T-) variants of the given disease.
Lymphosarcoma: symptoms of the B-cell primary mediastinal tumor
This concentration is more likely to affect young women. For a long time the tumor does not leave the limits of its main focus, which is located in the anterior mediastinum. Such a manifestation as intoxication is not characteristic, and even with a significant tumor size. In some cases, this type of lymphosarcoma is manifested as a concomitant compression syndrome that appears in the superior vena cava, which can act as the only symptom that indicates it.
The scantiness of the symptoms leads to the accidental determination of the tumor, which is mainly detected by X-ray studies. Among the primary signs are those that accompany inflammatory and viral diseases: temperature, malaise, cough. Puffiness of the face, dyspnoea, venous expansion in the thoracic wall — these symptoms are identified, as a rule, when the tumor process is far gone. Often the tumor grows into tissues and organs surrounding it (pericardium, lungs).
This type of lymphosarcoma can metastasize to the brain, pleura, kidneys and adrenal glands, as well as to other organs located in the region of the retroperitoneal space. Significantly, there are metastases in the spleen, bone marrow and lymph nodes. To make a diagnosis, a biopsy is mandatory. Sclerosis (including nodular type) is common among the manifestations of symptomatology.
Lymphosarcoma: symptoms of a B-cell primary tumor of peripheral lymph nodes
This type of tumor is extremely common, and it has a variety of clinical manifestations, which allows you to determine the forecast of its subsequent development. Mainly symptomatology is expressed in general intoxication, lymph nodes increase. The localized tumor is predominantly secreted by an increase in supraclavicular lymph nodes. As a rule, they become dense, often forming conglomerates. Due to the sprouting of lymphosarcoma in surrounding tissues, a «bulged tumor» is formed, characterized by the woodiness and immobility of conglomerate density, the boundaries of which can not be determined. Metastasis can be performed both in the spleen and in any other extranodal organs (including the bone marrow, CNS).
In some cases, this group of tumors can debut as a syndrome, manifested in blockage of lymph drainage and compression of venous trunks. It is also possible that the tumor grows into the kidneys when it squeezes the ureter, which leads to the development of hydronephrosis. Germination and compression of the nerve trunks often occurs with severe pain. It is noteworthy that the compression syndrome along with the existing «injected tumor» — all this is evidence of a progression that has gone too far, which, accordingly, determines bad forecasts for it.
Lymphosarcoma: symptoms of a B-cell primary tumor of mesenteric lymph nodes
Symptomatic of this type of disease is characterized by the emergence of profuse (profuse) diarrhea, and, as a result, rapid exhaustion of the body. An additional symptom may also be ascites (or abdominal dropsy, characterized, respectively, by accumulation in the abdominal cavity of excess fluid). The enlargement of the lymph nodes is often determined by palpation. In addition, the accompanying symptom here may be an increase in the spleen.
The defeat of the intestine by the tumor is characterized by the formation of an obstruction in it, which determines the entry into the patient’s hospital based on urgent indications. With regard to the development of the tumor with its location outside the intestine, then its proliferation leads, respectively, to an increase in the volume of the stomach. For this reason, patients are often treated for serious stages of the process.
Following the examination of the disease through a survey of patients, it is determined that the development of the tumor did not occur without symptoms. Thus, there are marked signs that accompany the onset of the disease, manifested in the form of vague abdominal pains, diarrhea (when alternating with constipation), changes in appetite. Given the not very significant severity of manifestations, a doctor is not consulted for this reason, which leads to the definition of tumor formation in the late stage.
As for metastases in localized lymph nodes in other sites, in this case they are not characteristic. A distinctive feature of the lymphosarcoma of the lymph nodes under consideration is that it is characterized by a high percentage of cure, which is achieved through polychemotherapy, as well as radiotherapy. Normalization of the size of the lymph nodes is accompanied by the disappearance of diarrhea, this, in turn, leads to normalization of the weight of the patient.
Lymphosarcoma: symptoms of B-cell primary lymphosarcoma of the spleen
A lymphosarcoma of this type is characterized, mainly, by an increase in the spleen. In addition, among the symptoms can be identified severity in the left hypochondrium, pain in this area, a periodic increase in temperature. It is also possible to form a syndrome of hypersplenism. For a long time, bone marrow metastases may be absent. For the statement of this diagnosis, splenectomy is necessary, which simultaneously has not only a diagnostic but also a therapeutic effect.
Provision is made for the removal of the spleen if its size increases and there is no tendency to cure, followed by polychemotherapy, acting as a measure of prevention of neuronal leukemia.
Lymphosarcoma: symptoms of a B-cell primary brain tumor
The clinical picture of the disease does not differ from other types of tumors that arise in the localization in question. In particular, the clinic consists of the symptoms of focal (with central paresis and paralysis) and the symptoms of neurologic cerebral (expressed in the syndrome of increased intracranial pressure). Most cases of this type of lymphosarcoma are accompanied by the presence of HIV infection, against which it appears.
Localization of lymphosarcoma often centers in the region of the large hemispheres, while it can be solitary (single) or multiple. Diagnosis and treatment occurs exclusively within the conditions of special institutions. Diagnosis is established through stereotactic brain biopsy. When trying to remove a tumor, the diagnosis is heavily burdened.
Lymphosarcoma: symptoms of T-cell tumors of lymph nodes and skin
T-cell tumor of lymph nodes is less common, in contrast to the B-cell form of the disease course. The clinic and morphology of these groups are indistinguishable from each other, although the T-cell lymphosarcoma develops more rapidly in the tumor progression, which determines for it a worse prediction.
As for the lymphosarcoma of the skin, it is in itself a form of rare, and therefore less studied. The localization of the tumor centers in the deep layers of the dermis, after which it spreads almost along the area of the entire subcutaneous tissue. The tumor is characterized by the density of formation and its immobility. Affected skin does not undergo changes in color. Biopsy sites acquire non-healing and sufficiently deep ulcers.
Treatment of lymphosarcoma
Lymphosarcoma involves the use of a well-known method of treatment, which consists in chemotherapy. In some cases, irradiation is used for this, and polychemotherapy is used to generalize the process.
The surgical method is not used in the treatment of lymphosarcoma due to the rapid progression observed during the course of the disease after such intervention, and also because of the formation in the wound after this implantation process. The prognosis of life in any treatment for the disease and its form is uncertain.
The special difficulty of treatment lies in the generalization of the tumor process, regardless of the form in which lymphosarcoma flows. In this case, patients are mainly transferred to symptomatic treatment, and the life expectancy in this case is calculated in several months, or even weeks.
The preferred method of treatment, which is chemotherapy, at the beginning of its application is characterized by a positive trend due to the effect, but each subsequent course subsequently leads to a decrease. The generalization of the process, again, allows to achieve a short-term effect, which in general characterizes the use of chemotherapy in this case as an ineffective method of treatment.
Diagnosis of lymphosarcoma with the subsequent determination of treatment is performed by a hematologist.