Malignant Lymphoma : Treatment, Diagnosis And Prevention

Malignant lymphoma are a group of cancers in which cells of the lymphatic system become abnormal and start to grow uncontrollably. Because there is lymph tissue in many parts of the body, lymphomas can start in almost any organ of the body.

The diagnosis of malignant lymphoma requires the presence of malignant lymphocytes in a biopsy of lymph node or extra-lymphatic tissue. An excisional lymph node biopsy is essential for complete diagnostic assessment. If a whole lymph node is not obtainable, sufficient incised tissue from an extra-lymphatic site can be diagnostic but is less desirable. Fine needle aspiration biopsy (see Appendix I: Biopsy Procedures) is not sufficient for the initial diagnosis of malignant lymphoma.

The following histologic sub-classification of the malignant lymphomas is an adaptation of the Working Formulation and the WHO/REAL classification (Jaffe E, Tumours of Hematopoietic and Lymphoid Tissues, World Health Organization Classification of Tumours, IARC Press, 2001) and is based on the light microscopic interpretation complemented by special stains, immunophenotyping, cytogenetics and other information as available. The specific lymphomas are divided into three major groups for treatment planning.

Treatment of malignant lymphoma.

Malignant lymphomas are increasing in frequency for unknown reasons. We know today that they constitute a big family of tumours of lymphoproliferative origin, which can be very different one from the other in terms of morphology, biology, and clinical behaviour. Some of them need very specific treatments and it is therefore important that a clear diagnosis is obtained and that the treatment is administered by specialised doctors. Although the new WHO classification has abolished the concepts of low-grade and high-grade lymphomas, it remains true that some lymphatic cancers exhibit indolent behaviour and cannot be cured, while other aggressive lymphomas can be cured by modern therapy. The cornerstone of treatment remains chemotherapy and, to a minor extent, radiotherapy. New treatment modalities such as the use of monoclonal antibodies, high-dose therapy or allogenic transplantation have improved the treatment results in the last decade. In this article we offer a summary of the most important concepts which are of interest for practising physicians.

Diagnosis of malignant lymphoma

An immunoperoxidase method for distinguishing lymphomas from nonlymphoid neoplasms with monoclonal antibody T29/33 is described. This antibody recognizes a 200,000-dalton pan-hematopoietic glycoprotein antigen. Staining in nearly 200 hematopoietic tumors was positive for T29/33, although three of six plasmacytomas were negative for this antibody. Five undifferentiated tumors that were proved to be lymphomas by subsequent electron microscopic and immunohistologic studies were positive for T29/33. Conversely, 11 of 12 undifferentiated tumors with ultrastructural and clinical features of carcinoma or sarcoma were T29/33-negative. The only exception was one sarcoma that was T29/33-positive. Thus, monoclonal antibody T29/33 is a valuable tool for characterizing neoplasms that cannot be diagnosed by histopathologic examination alone.

Malignant lymphoma prevention

Preventive measures, when initiated early, may help patients with NHL/CLL who have a higher risk of developing NMSC in the future. Patients who have significantly sun-damaged skin with multiple actinic keratoses may be candidates for aggressive regional treatments with either topical chemotherapy or photodynamic therapy. Aggressive treatment of these chronically sun-damaged sites may prove beneficial in decreasing the development and aggressive behavior of NMSC in these patients. Effective sun-protective efforts in patients with NHL/CLL is also important.

A patient with NHL/CLL that sun protects rigorously on a daily basis may be at risk for vitamin D deficiency. Patients with NHL/CLL and a history of multiple aggressive and/or recurrent NMSC may be considered for systemic retinoids and perhaps other forms of preventive systemic chemotherapy.

Female and male infants have essentially the same overall cancer incidence rates, but white infants have substantially higher cancer rates than black infants for most cancer types. Relative survival for infants is very good for neuroblastoma, Wilms’ tumor and retinoblastoma, and fairly good (80%) for leukemia, but not for most other types of cancer.

Tips on Cancer Prevention

1. Limit alcohol.

2. Maintain a healthy weight.

3. Stay physically active.

4. Consider limiting fat in your diet.

5. Avoid prolonged exposure to the sun and other UVA/UVB sources, such as tanning beds.

6. Use ample amounts of sunscreen or sunblock with an SPF of 15 or higher every day, even if it is cloudy.

7. Wear large framed or wrap-around sunglasses to protect the eye area.

8. Have your skin checked by a dermatologist regularly.

9. Do avoid all poisonous chemical substances such as cigarettes, alcohol, car exhaust fumes, as well as fumes belched by factory chimneys, which are very toxic.

10. Anilin is a carcenogenic substance used for colouring food, so try to avoid artificially dyed foods and instead look for natural foods.

Reference of malignant lymphoma

Malignant Lymphomas: Biology and Treatment: An Update (ESO Monographs)

In the last few years a good deal of information related to the biology and treatment of malignant lymphomas has been accumulated and published in journals and monographs. There is, however, no book that gives a concise and objective update of this information or presents a general survey of the subject. The contributors to this book are international authorities, and on the basis of their personal experience and data from the literature they have written a high-level update on malignant lymphomas which will be of interest to both specialists and nonspecialists.

Malignant Lymphomas (Atlas of Clinical Oncology.)

Malignant Lymphomas is a volume in the acclaimed American Cancer Society Atlas of Clinical Oncology series. Dr. Grossbard and his team have summarized current knowledge on the pathology, epidemiology, molecular biology, presentation and management of patients with both non-Hodgkin’s lymphoma and Hodgkin’s disease. The experts address the disease group by type – indolent B-cell lymphoma, diffuse large cell lymphomas, Burkitt’s/high-grade non-Hodgkin’s lymphoma – as well as the key therapies of chemotherapy, monoclonal antibody, radiation, vaccine, hematopoietic stem cell transplants and more. This text’s multi-author approach is a necessity now that management and classification of lymphoma have grown so complex. Malignant Lymphomas will be a valuable resource in the practice of those seeing patients with the disease, as well as a springboard for the continued inquiry into advances being made into the pathophysiology, diagnosis and management of lymphoma.

Malignant Lymphoma

This text discusses the full range of scientific and clinical developments that have occurred in the investigation and treatment of Hodgkin’s disease and non-Hodgkin’s lymphomas. With contributions from around the world, it covers both current views and likely future developments, and addresses a broad spectrum of clinical care, from the routine to the highly experimental.

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Recommended Reading

• lymphatic cancer
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