Lymphomas, Malignant

Causes

The cause of malignant lymphomas is unknown, although some theories suggest a viral source. Up to 35,000 new cases appear annually in the United States. Malignant lymphomas are two to three times more common in males than in females and occur in all age groups.

Signs and symptoms

The following are the most common symptoms of non-Hodgkin's lymphoma. However, each individual may experience symptoms differently. Symptoms may include:

• painless swelling of lymph nodes in neck, underarm, and groin
• fever
• night sweats
• fatigue
• weight loss
• itching of the skin
• recurring infections

The symptoms of non-Hodgkin's lymphoma may resemble other blood disorders or medical problems, such as influenza or other infections. Always consult your physician for a diagnosis.

Diagnosis

A positive diagnosis requires histologic evaluation of biopsied lymph nodes of tonsils, bone marrow, liver, bowel, or skin; or of tissue removed during exploratory laparotomy. A biopsy differentiates malignant lymphoma from Hodgkin's disease.

Other tests include bone and chest X-rays, lymphangiography, a liver and spleen scan, computed tomography scan of the abdomen, and excretory urography. Laboratory tests include a complete blood count (which may show anemia), uric acid level (elevated or normal), serum calcium level (elevated if bone lesions are present), serum protein level (normal), and liver function studies.

Treatment

Radiation therapy is used mainly in the early localized stage of the disease. Total nodal irradiation is often effective for both nodular and diffuse histologies.

Chemotherapy is most effective with multiple combinations of antineoplastic agents. For example, cyclophosphamide, doxorubicin, vincristine (Oncovin), and prednisone (CHOP) can induce a complete remission in 70% to 80% of patients with a nodular histology and in 20% to 55% of patients with a diffuse histology. Other combinations-such as methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine, and pred­nisone (M-BACOP)-induce prolonged remission and sometimes cure the diffuse form.

Prevention

Although many cancers may be prevented by making diet and life style changes which reduce risk factors, there is currently no known way to prevent lymphomas. Protecting oneself from developing AIDS, which may be a risk factor for lymphomas, is the only preventive measure that can be practiced.

At present, there are no special tests that are available for early detection of non-Hodgkin's lymphomas. Paying prompt attention to the signs and symptoms of this disease, and seeing a doctor if the symptoms persist, are the best strategies for an early diagnosis of lymphoma. Early detection affords the best chance for a cure.