What is lymphoma

Lymphoma is the malignant transformation of lymphocytes. According to the "World Health Organization's Pathological Classification of Lymphatic Tumors", there are nearly 70 known pathological types of lymphoma, which can be roughly divided into two categories: Hodgkin's lymphoma and non-Hodgkin's lymphoma. In my country, Hodgkin's lymphoma accounts for 9 to 10 percent of lymphomas and is a group of malignant tumors with relatively good treatment effects; non-Hodgkin's lymphoma accounts for about 90 percent of all lymphoma cases, and the incidence rate has been increasing year by year in the past decade.

Clinical manifestations:

The main symptoms are swollen lymph nodes felt on the body. In the early stage, they are painless and itchy, so they are often ignored. About 60% of lymphomas are first found in swollen lymph nodes in the neck. At first, they are swollen alone, and then the number increases and they become larger. Lymphoma can occur in lymphatic tissues throughout the body, such as the chin, mandible, front neck, clavicle, armpit, groin, mediastinum or abdominal artery. Sometimes it occurs in internal organs and causes compression symptoms. If it occurs in the stomach, small intestine or large intestine, there may be symptoms of peptic ulcer or gastrointestinal dysfunction such as abdominal distension, bloody stool, vomiting, abdominal pain, etc. If lymphoma invades the bone marrow, it may cause pancytopenia such as pale face, fever, abnormal bleeding, and sometimes abnormal lymphocytes can be seen in the peripheral blood.

This disease is equivalent to the categories of "stone carbuncle", "yin carbuncle", "evil stranguria", "evil nucleus", "loss of glory", "phlegm nucleus" in traditional Chinese medicine. The disease is caused by stagnation of cold phlegm, stagnation of qi and phlegm, and deficiency of liver and kidney yin.

Because the sites and ranges of lymphoma cell invasion are different, the clinical manifestations are very inconsistent. The primary site can be in the lymph nodes or in the lymphatic tissue outside the lymph nodes. But in general, there are three manifestations:

(I) Local manifestations

(1) Lymph node enlargement: including superficial and deep lymph nodes. Its characteristics are that the enlarged lymph nodes are progressive, painless, hard, and can be moved. In the early stage, they are not adhered to each other, but in the late stage, they can fuse. Anti-inflammatory and anti-tuberculosis treatments are ineffective. Superficial lymph nodes are more common in the neck, followed by the armpits and abdominal groove. Deep lymph nodes are more common in the mediastinum and beside the abdominal aorta. (2) Local compression symptoms caused by lymph node enlargement: mainly refers to deep lymph nodes, such as enlarged mediastinal lymph nodes, which can compress the esophagus and cause dysphagia; compress the superior vena cava and cause superior vena cava syndrome; compress the trachea and cause cough, chest tightness, dyspnea and cyanosis.

(II) Systemic symptoms

(1) Fever: Fever patterns are often irregular, ranging from 38 to 39°C for many years. Some patients may have continuous high fever, or intermittent low fever, and a few may have periodic fever. (2) Weight loss: Most patients experience weight loss, losing more than 10% of their original body weight within 6 months. (3) Night sweats: Sweating at night or after falling asleep.

(III) Extranodal lesions

Lymphoma can invade all tissues and organs of the body. For example, infiltration of the liver and spleen causes hepatomegaly; infiltration of the gastrointestinal tract causes abdominal pain, bloating, intestinal obstruction and bleeding; infiltration of the lungs and pleura causes cough and pleural effusion; infiltration of bones causes bone pain and pathological fractures; infiltration of the skin causes itching and subcutaneous nodules; infiltration of the tonsils and mouth, nose and pharynx causes dysphagia, nasal congestion and nasal tingling; infiltration of the nervous system causes spinal cord compression and cranial neuropathy, etc. Once a patient has the above symptoms and signs, he should go to the hospital for examination to determine whether he has lymphoma.

Common clinical syndromes:

(1) Yin-cold stagnation type: Symptoms include swollen lymph nodes in the neck, which are painless and itchy. The skin is normal in color and hard as stone. There is also fatigue, cold body and limbs, poor appetite, pale red tongue with thick and greasy coating, and deep and thready pulse.

(2) Liver Qi Stagnation Type: Symptoms include swollen lymph nodes in the neck, armpits and groin, with normal skin color, no pain or itching, accompanied by irritability, chest tightness, swelling in the flanks, weakness, thin tongue coating or petechiae, and a stringy or slippery pulse.

(3) Liver and kidney yin deficiency: symptoms include fever in the five parts of the body, hot flashes in the afternoon, weakness in the waist, knees and legs, and fatigue

(4) Spleen deficiency type: Symptoms include swelling and numbness in the neck, weakness in the limbs, pale complexion, poor appetite, shortness of breath when moving, thin and greasy tongue coating, and weak and thready pulse.