Lymphoma

Lymphoma is also known by the name lymphatic cancer. Lymphomas are malignant neoplasms that originate in the bone marrow and in the lymphatic structures, which results in the proliferation of lymphocytes. Lymphoma is derived from two words: “lymph”, which indicates the change of a lymphocyte, and “-oma” which indicates the term which induces tumour. 

Causes of Lymphoma-  Scientists are not aware of the exact causes of what actually leads to lymphoma. They are only able to notify the risk factors. 

We can classify the causes of lymphoma on the basis of:

Age: Lymphoma varies according to age, but most of the time, in severe cases, it occurs in people aged above 60. 

Gender: The exact cause is not known, but it may be due to smoking, which is seen higher in men than women. 

Family history: Chances of the development of cancer increase if any of our ancestors, parents, siblings suffered from lymphoma. Genetic factors lead to severe cases of lymphoma. 

Exposure to radiation, chemicals, and drugs: Hair dye, solvents like benzene, phenoxy herbicides, certain insecticides that are used for the killing of invasive insects can lead to severe cases of lymphoma. Certain drugs like methotrexate that are used for the treatment of rheumatoid arthritis might lead to an increase in cases of lymphoma. Radiation here is the term related to survivors of accidents like atomic bomb blasts, nuclear reactors, etc. 

Autoimmune diseases: Autoimmune diseases such as rheumatoid arthritis have a positive correlation with lymphoma as these patients already have a weakened immune system response towards foreign particles such as germ and mutagens. There are various infections like the human immunodeficiency virus and AIDS, which weaken the immune system. Bacteria such as Helicobacter pylori, linked to mucosa-associated lymphoid tissue, cause stomach ulcers. Campylobacter jejuni is related to immunoproliferative small intestinal disease sometimes known as Mediterranean abdominal lymphoma. It occurs in adults of a younger age. Chlamydophiola psittaci causes lung infection and is linked to mucosa-associated lymphoid tissue lymphoma. 

Bodyweight: Overweight and obesity may lead to lymphoma.

Breast implants: Women have anaplastic large cell lymphoma in their breasts after implantation which may lead to lymphoma. 

Stages of lymphoma: 

There are four main stages for lymphoma cancer in adults which are numbered as stage I, stage II, stage III, and stage IV. 

Stage I: Involvement of single lymph node region or extra sites for lymphatic tissues. In stage I, the lymphoma can occur anywhere in the body lying far, near, upper, the bottom of the diaphragm. Most commonly it is found near the neck. This lymphoma can be termed extranodal lymphoma. 

Stage II: Involvement of two or more lymph nodes regions or origination of extra lymphatic sites and lymph nodes on the diaphragm same side. Stage II meant that the lymphoma started with one single organ of the body, but in recent times, it has been spread down in more than one group of lymph nodes. 

Stage III: On both sides of the diaphragm, there is the involvement of lymph nodes, extra lymphatic tissues, and there is also an involvement of the spleen. In stage III, it can be found in the neck (cervical lymph nodes), armpit (axillary lymph nodes), and groyne (inguinal lymph nodes). 

Stage IV: Outside the lymph nodes there is an involvement of the liver, solid bones, and bone marrow. It is considered the advanced stage of lymphoma as it has been spread outside the lymphatic tissue system. Spleen and Thymus are not considered in stage IV as these are the parts of the lymphatic system. 

Stages: Early and Advanced: Stage I and II are considered as the early stages, Stage III and IV are considered as advanced stages of lymphoma cancer. 

Categories of lymphoma stages: 

Categories of lymphoma stages have been made on the basis of symptoms, their presence or absence, or it is a kind of indication that tells about the distance means how far the tumour has been spread from the lymph nodes. 

Stage A. No symptoms have been developed inside the host body.

Stage B. Symptoms like weight loss, fever, and drenching night sweats are developed inside the host body. 

Stage X. It is a bulky stage of lymphoma cancer meaning the tumour is greater than 10 cm in size in the chest. 

Stage E. It is an indication of extranodal cancer which has spread out from lymph nodes to other tissues and organs of the body. 

Stage S. It is a stage related to splenomegaly. It is a condition related to an enlarged spleen. 

Types of Lymphoma-

• Hodgkin’s Lymphoma: Hodgkin’s lymphoma can be described as the neoplastic transformed lymphocytes of lymph nodes. It is a B-cell disease whose course is variable but the treatments are available. The clinical features include fatigue, night sweats, weight loss, loss of appetite, chills, stomach pain, severe itching, swelling in the armpits and groyne. Hodgkin lymphoma was first described by Dr. Thomas Hodgkin in 1832. He was one of the most prominent pathologists from British culture known for Hodgkin’s disease. Pathology of Hodgkin’s lymphoma affects the lymph nodes majorly the polyclonal reactive lymphoid cells but not the neoplastic cells,.The treatment of Hodgkin’s lymphoma depends on the stage and can be treated by chemotherapy, immunotherapy, radiotherapy, targeted therapy, and stem cell transplant. 

• Non-Hodgkin’s Lymphoma: It can be defined as the highly heterogeneous malignant disease of the lymphoid system. The treatment of Non-Hodgkin’s lymphoma depends upon the behaviour of disease stages. The stages include Indolent which are incurable and their growth is very slow inside the host body. Aggressive, this stage follows the rapid growth pattern inside the host body and is considered as the second most common stage which can be treated by chemotherapy. Very aggressive, these lymphomas are considered as life-threatening cancer to the host as they grow very rapidly and can be cured by chemotherapy. 

• Chronic lymphocytic leukaemia and small lymphocytic lymphoma: CLL and SLL lymphomas are classified as B-cell Non-Hodgkin’s lymphoma. And can be treated by chemotherapy. 

Conclusion:

There are a lot of multiple malignancies that occur in the host body like breast cancer, Hodgkin’s lymphoma, lung cancer. These malignancies lead to metachronous cancer whose occurrence lies inside the inherited factors by the patient, lifestyle inside the environmental factors, exposure to the radiations of the survivors, age. Based on the article it can be concluded that we have to develop treatments for the patient populations who are developing the risk factors at an adult stage, especially for those who are having a history of smoking as they carry lymphomas in higher frequency. Secondly, we have to develop anticancer drugs for rheumatoid arthritis as it also plays a significant role in causing lymphoma. There are genetic testing labs with a wide variety of gene panels in these labs that diagnose various multiple malignancies that are inherited by the ancestors. Various drugs can be developed by using in silico approaches for the disease-causing drugs in the form of their alternatives.