malignant lymphoma Malignant lymphoma refers to a tumor formed by the malignant proliferation of lymphocytes in lymphoid tissue. Lymphoma is one of the earliest discovered malignant tumors of the hematopoietic system, mainly divided into Hodgkin's lymphoma and non-Hodgkin's lymphoma.

Malignant lymphoma refers to the malignant proliferation of lymphocytes within the lymphatic tissue, forming tumors. Lymphoma is one of the earliest discovered malignant tumors of the hematopoietic system and is mainly classified into Hodgkin lymphoma and non-Hodgkin lymphoma.

Infection

Research has shown that 20% of Hodgkin lymphoma patients have been found to have antibodies and viral particles of the Epstein-Barr virus (EBV) in their serum and lymph nodes, indicating a possible association between the onset of some lymphomas and EBV. Additionally, human immunodeficiency virus (HIV) and human T-cell lymphotropic virus type 1 (HTLV-1) have also been linked to an increased risk of lymphoma to varying degrees.

Studies also suggest that hepatitis C virus and Helicobacter pylori may be associated with the onset of certain types of lymphoma.

Immune Status

Both genetic and acquired immune deficiencies are factors in the etiology of the disease. Non-Hodgkin lymphoma is more common in patients with human immunodeficiency virus (HIV). Among those who develop malignant tumors after long-term use of immunosuppressants following organ transplantation, one-third of cases involve lymphoma. The incidence of lymphoma in patients with Sjögren's syndrome is higher than in the general population.

Genetic Predisposition

Studies have confirmed that small lymphocytic lymphoma has a familial aggregation, and the risk of developing the same disease is significantly increased for relatives of lymphoma patients.

Painless lymphadenopathy

Approximately 90% of Hodgkin lymphoma cases present with the progressive enlargement of superficial lymph nodes as the initial symptom, commonly manifesting as painless enlargement of cervical or supraclavicular lymph nodes, followed by axillary lymph node enlargement. The enlarged lymph nodes can be mobile, or they can also fuse together into a mass, with a cartilage-like feeling upon palpation. Enlargement of mediastinal lymph nodes caused by Hodgkin lymphoma can lead to symptoms such as coughing, chest tightness, dyspnea, and cyanosis due to tracheal compression.

Involvement of extranodal organs

Hodgkin lymphoma can involve systemic tissue and organs through direct invasion or hematogenous spread (mainly the spleen, lungs, and pleura). Typical symptoms of lung involvement include irritative dry cough, mucopurulent sputum, and chest pain; pleural involvement can lead to pleural effusion. Non-Hodgkin lymphoma often involves the gastrointestinal tract, originating from the submucosal lymphoid follicles. In the early stages, there may be no symptoms, but as the condition progresses, symptoms such as dyspepsia and discomfort in the stomach may appear. As the lesion enlarges, there may be hematemesis, melena, and abdominal masses. Small intestinal lymphoma is most commonly found in the duodenum and ileum, and clinical manifestations may include abdominal pain, diarrhea, malabsorption, gastrointestinal bleeding, anemia, and emaciation.

Compression symptoms

The mediastinum is a common site for malignant lymphoma. In the early stages, there are no symptoms, but as the mediastinal lymph nodes enlarge and fuse into a mass, corresponding compression symptoms can occur. For example, compression of the esophagus can cause dysphagia; compression of the superior vena cava can lead to superior vena cava syndrome; compression of the trachea can cause coughing, chest tightness, and dyspnea.

Systemic symptoms

Patients often present with systemic symptoms such as fever, night sweats, pruritus, and emaciation. Fever may be continuous or intermittent, and sometimes exhibits distinct periodicity. Moreover, it is rarely relieved by antihistamines.

Life Care

Create a quiet, clean, and well-ventilated rest environment, and ventilate regularly and use ultraviolet air disinfection. Minimize visits and companionship. Keep the patient's room quiet during nap and nighttime rest. Before going to bed, the patient can soak their feet in hot water or drink warm milk to promote sleep. For those who still have difficulty falling asleep, sedatives can be administered as per the doctor's instructions.

Symptomatic Care

High fever care

When the patient experiences a fever, physical cooling methods such as tepid sponging and ice packs on the head pillow can be used, and wet clothes and bed sheets soaked with sweat should be changed promptly, ensuring cleanliness and dryness while avoiding chilling. The patient should be encouraged to drink plenty of water, and antipyretics and electrolyte supplementation can be administered as prescribed.

Pain management

Patients may experience pain and pathological fractures due to skeletal muscle involvement. Patient activity should be minimized, and even during activity, collisions should be avoided as much as possible to prevent injury. Additionally, the patient should be helped to divert attention from the pain or be administered analgesics as prescribed.

Nausea and vomiting

Nausea and vomiting are common adverse reactions during chemotherapy. When a patient experiences vomiting, family members should observe the frequency and content of nausea and vomiting and keep records. After vomiting, the patient should rinse their mouth promptly to clear the vomitus.

Diet

Provide a high-calorie, high-protein, easily digestible diet, with an emphasis on consuming fresh fruits and vegetables, while avoiding spicy and irritating foods. Consumption of hard, prickly foods should be prohibited, and processed meats, salted meats, and pickled foods should be avoided.

Exercise and Rest

Patients in good physical condition can engage in appropriate physical exercise with the doctor's permission, as this can improve physical fitness and alleviate the stress caused by the disease. Patients with weaker physical strength should primarily rest in bed and can engage in indoor activities with companionship. Bedridden patients can perform some muscle massage and lower limb exercises to prevent the occurrence of lower limb venous thrombosis.

Skin Care

Patients undergoing radiotherapy should maintain local skin cleanliness and dryness to avoid infection. If redness and swelling occur, vitamin AD ointment can be applied, and dressings should be changed daily.

Avoid contact with lead, mercury, phenoxyacetic acid, and chloroform, and if contact is unavoidable due to occupational reasons, protective measures should be taken.

Pay attention to physical examinations and monitor one's own health status. For individuals with a family history of malignant lymphoma, it is advisable to inform the doctor during routine check-ups and request a separate examination of superficial lymph nodes.