ВТОРОЕ МЕДИЦИНСКОЕ ЗАКЛЮЧЕНИЕ
Lymphoma

 Lymphoma, also known as lymph cancer, occurs as a result of uncontrolled growth and rapid proliferation of cells called lymphocytes, which take part in the body's defense mechanism, and/or their longer survival than normal lymphocytes.  Malignant lymphocytes, like normal lymphocytes, can multiply in lymph nodes, spleen, bone marrow, blood and other organs. The most common areas of lymphoma are the lymph nodes, one of the body's most important defense mechanisms. Lymph nodes are a part of the immune system, which has a very important place in the fight against infections and some acute-chronic diseases. Lymph nodes enlarge in response to infection and certain diseases, but when the current disease ends, they return to their original status. In the case of lymphoma development, the lymph nodes enlarge excessively as a result of excessive and uncontrolled growth of lymphocytes and require appropriate treatment for the subtype of lymphoma.

Lymphomas are divided into two subgroups as Hodgkin lymphoma and non-Hodgkin lymphoma. The symptoms of both can be similar. Since the treatment options are different, it is necessary to determine the type of lymphoma. Hodgkin lymphoma is most common in young adults, between the ages of 20 and 40, and is more common in men.  Non-Hodgkin lymphomas are divided into B-cell and T-cell lymphomas according to the cell group from which they originate. The disease can be seen in lymphoid tissues such as lymph nodes and spleen, as well as from lymph tissue in organs such as stomach and intestines. Malignant lymphocytes from these regions can also spread to other parts of the body through the blood and lymph circulation. Although non-Hodgkin lymphomas can be seen at any age, the prevelance of some types increases with advancing age.

Although different symptoms may occur in many different types of lymphomas, enlarged lymph nodes (mostly painless), weakness, fever without infection, weight loss, night sweats, cough, chest pain, abdominal pain and swelling, and itching can be seen. There are some risk factors for the development of lymphoma. These include some viral infections (EBV, HIV, HTLV, HHV-8, Hepatitis C), some bacterial infections (Helicobacter Pylori), some chemicals (some pesticides), some chemotherapy medications, some genetic diseases, Sjogren's syndrome, Celiac disease, some rheumatological diseases such as lupus can be counted. Having any of these risk factors does not necessarily mean that they will have lymphoma, and lymphoma may develop in individuals without risk factors.

Physical examination, some blood tests, lymph node biopsy (by removing the entire lymph node), bone marrow biopsy, CT (computerized tomography), PET-CT have an important place in the diagnosis stage.

Among the factors affecting the treatment of lymphoma are the subtype of the lymphoma, the stage of the disease, the growth rate, the age of the patient, and the presence of other chronic health problems (such as heart, kidney, lung problems). In some cases, a follow-up decision is made in line with the presence of certain criteria, while in some cases chemotherapy and/or radiotherapy come to the fore. High-dose chemotherapy and bone marrow transplantation, radiotherapy, high-dose chemotherapy alone are applied in cases that are resistant to treatment or in cases of disease recurrence after treatment. Following the end of the treatment, patients are followed up to 5 years, the first 2 years closer, in terms of the possibility of recurrence.

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