Lymphoma

Lymphoma is a malignancy of the lymph system, a component of the immune system. Lymphoma can have many different forms. There are three common lymphomas:

• Follicular lymphoma: its origin is germinal center B-cell; most common type of "indolent" lymphoma, usually widespread at presentation. It is often asymptomatic but not curable (some exceptions) and transformation to aggressive lymphoma can occu asymptomatic, treatment is "watch-and-wait and treatment options var chemotherapy

• Diffuse large B-cell lymphoma: its origin is germinal center B-cell. It is most common type of "aggressive" lymphoma and usually symptomatie Extra nodal involvement is common and 40% curable rate. B-cell lymphoma is less frequent than non Hodgkin lymphoma. Male is affected more than female and peak incidence in third decade. Signs and symptoms are lymphadenopathy, contiguous spread, extranodal sites relatively uncommon except in advanced disease and presence of "B" symptoms,

• Hodkin lymphoma: Hodgkin's disease is a chronic, progressive neoplastic disorder of lymphatic tissue characterized • Hodgkin's disease by the painless enlargement of lymph nodes with progression to extra-lymphatic sites such as the spleen and liver. The exact cause of the disease is unknown. The risk factors may be age 15-40 yrs >55 yrs, positive family history, male (slightly chance), past- Epstein Barr infection, ionizing radiation and immunosuppression or immunodeficiency.

Pathophysiology of Hodgkin's disease

• The tissue macrophage system's Reed-sternberg cells, aberrant histiocytes that are a component of Hodgkin's disease, proliferate.
• As these abnormal glial cells proliferate, they displace other cellular components that are typically present in lymph nodes.
• The lymphatic system's cells can proliferate abnormally and spread outside of it.
• The body's ability to fight infection is compromised as the disease develops.

Signs and Symptoms

• Weight loss of 10% or more in just six months
• Illness, sluggishness, and ongoing weariness
• Hepatosplenomegaly
• System
• Itching (pruritus) (pruritus)
• Nodes in the lower cervical region that are larger, non-tender, firm, and mobile.
• Reduced appetite
• Intermittent recurrent fever
• Sweats at night

Diagnosis

• Physical exam: systematic spread
• Reed-Sternberg cells positive in lymph node biopsy
• MRI, CT, and gallium scan
• Bone marrow biopsy and a blood test

Staging

• Stage I: Restricted to a specific organ or region of the lymph nodes.
• Stage II: The cancer only affects the area of the body above or below the diaphragm, and it is located in two different lymph nodes.
• Stage III: Although the cancer spreads to the lymph nodes both above and below the diaphragm, it has not yet reached other organs.
• Stage IV: In its severe form, the disease not only affects the lymph nodes but also the liver and bone marrow.

Treatment

• Radiation therapy 
• Chemotherapy
• Laparotomy
• Splenectomy

Non-Hodgkin's Lymphoma

It is a tumor that develops in lymphatic tissue and is very dissimilar to Hodgkin's lymphoma. Non-Hodgkin's lymphoma has the following characteristics:

• Controlling a primary tumor is challenging.
• Undifferentiated cells have a widespread disease.
• Early tumor dissemination
• Includes a variety of disease entities, such as Burkitt's lymphoma, reticulum cell sarcoma, and lymphosarcoma.

Signs and symptoms depend on anatomic site and extent of the involvement. The nature of disease is rapid onset and progression and may have advanced disease at diagnosis. Medical management are:

• Chemotherapy: Multiple regimens
• Radiotherapy: Primary treatment in localized disease
• Surgery: For diagnosis and staging

Nursing Interventions include:

• Care for those undergoing radiation therapy.
• Administer chemotherapy as directed, while keeping an eye on/reducing side effects.
• Keep the client from getting sick.
• Offer assistance and better coping skills.