Lymphogranulomatosis refers to the development of a malignant tumor, which is accompanied by the defeat of the hematopoietic cells located in lymph nodes and other organs. The impetus to the development of the disease is the mutation of a non-rover cell against the background of infection, radioactive radiation or contact with a chemical agent, although the causes of lymphogranulomatosis remain unclear until the end. Particularly actively studied by physicians is the version of the viral nature of the disease, in particular, it is associated with the Epstein-Barr virus.
Signs of lymphogranulomatosis
In the first stages, the disease proceeds imperceptibly, and the only thing that can attract the attention of the patient is an increase in the lymph node, the consistency of which is dense. Usually lymph nodes on the neck first swell, but in some cases the nodes of the mediastinum, armpits and groin are initially affected; extremely rarely - retroperitoneal nodes.
Palpation of the enlarged lymph node is not accompanied by painful sensations. A dense, elastic content is felt, which later becomes denser and less mobile.
Listening the symptoms of lymphogranulomatosis, one can not fail to note such an important sign as an elevated body temperature, which can not be knocked down either by Aspirin, Analgin, or antibiotics. Most often, fever begins at night and is accompanied by heavy sweating, with no chills.
In 30% of cases, the first symptom of lymphogranulomatosis is itchy skin, which can not be removed by any means.
Also, patients complain of pain in the head, joints, decreased appetite, fatigue. There is a sharp weight loss.
Diagnosis of lymphogranulomatosis
Based on the patient's complaints about fever and an enlarged lymph node in a certain part of the body, the doctor may suspect lymphogranulomatosis, and the blood test will help objectively evaluate the symptoms. So, in the laboratory, neutrophilic leukocytosis, relative or absolute lymphocytopenia, increased erythrocyte sedimentation rate is detected. Platelets in the first stages of the disease, as a rule, are normal.
Further diagnosis involves excision of the node that was struck first. In a biopsy, the so-called giant Reed-Berezovsky-Sternberg cells and / or Hodgkin cells are found. They also perform ultrasound of internal organs and a bone marrow biopsy.
Course of the disease and prognosis
In addition to lymph nodes, the disease in some cases affects the spleen, lungs, liver, bone marrow, nervous system, kidneys. Against the background of the weakening of immunity, fungal and viral infections develop, which can become even worse after radiation and chemotherapy . Most often recorded:
- herpes zoster;
- toxoplasmosis ;
- pneumocystis pneumonia;
- candidiasis;
- meningitis.
There are four stages of lymphogranulomatosis:
- The tumor is localized only in the lymph nodes or outside of them in one single organ.
- The tumor affects the lymph nodes in several areas.
- The tumor passes to the lymph nodes on both sides of the diaphragm, the spleen is affected.
- The tumor diffusely affects the liver, intestines and other organs.
As a treatment for lymphogranulomatosis, chemotherapy is used in combination with radiotherapy or separately. Also, a variant of treatment with high doses of chemotherapeutic drugs is acceptable, after which the patient is transplanted with bone marrow.
With regard to life expectancy for lymphogranulomatosis, combined treatment provides a remission in 10 to 20 years in 90% of patients, which is a high index. Even in the last stages of the disease, a correctly selected therapy regimen gives in 80% of cases 5 years of remission.