The lymph is the fluid which goes around the lymphatic system in the human body.It is similar to blood plasma and it returns excess interstitial fluid and proteins into the bloodstream. Also the lymph may destroy the bacteria by picking the up and transport it into the lymph nodes and it also transports fats from the digestive system via chylomicrons to the blood.This fluid is formed when the fluid which lies in the interstices of all tissues in the body is collected through the lymph capillaries. Then through the larger lymphatic vessels it is transported to the lymph nodes and then it is cleaned there by the lymphocytes. After they are cleaned there are emptied into the left or the right subclavian vein and there it mixes with the blood.The composition of the lymph changes as it goes around the lymphatic system because the blood and cells exchange the substances with the interstitial fluid continuously. The interstitial fluids forms at the end of capillaries and when it enters the lymph capillaries it enters as the lymph and when is formed it is a clear watery liquid with the same composition as the interstitial fluid which, however as it flows through the lymph nodes it comes in contact with the blood and tends to have more cells like lymphocytes and proteins.
To prevent a buildup of tissue the fluid surrounding the cells in it is complementing the venous system in the lymphatic system. Tissue fluid can pass into the surrounding lymph vessels, and eventually ends up rejoining the blood and when sometimes the removal of tissue fluid does not function correctly, and there is a build-up and this can cause swelling, often around the feet and ankles, which is generally known as edema.
While the blood goes around the body the gases,wastes and nutrients are exchanged between the interstitial fluid and the blood. The hydrostatic and osmotic pressures are operating at the tips where arteries and veins meet calle capillary beds and those pressures cause the fluid to be reabsorbed at the vein end. However the fluid which remains behind in the tissue spaces between the capillary beds becomes a part of the interstitial fluid and this leaked fluid along with plasma proteins that also have escaped but from the bloodstream must be returned for the cardiovascular system to work properly.
The mucosa that lines the small intestine is covered with projections called villi. There are blood capillaries and special lymph capillaries, called lacteals, in the center of each villus. The blood capillaries absorb most nutrients, but the fats and fat-soluble vitamins are absorbed by the lacteals.
Hodgkin lymphoma is an uncommon cancer that develops in the lymphatic system.The lymphatic system is part of human’s immune system. Clear fluid called lymph flows through the lymphatic vessels and contains infection-fighting white blood cells, known as lymphocytes.In Hodgkin lymphoma, B-lymphocytes start to multiply in an abnormal way and begin to collect in certain parts of the lymphatic system, such as the lymph nodes. The affected lymphocytes lose their infection-fighting properties, making the person more vulnerable to infection.
The most common symptom of Hodgkin lymphoma is a swelling of the neck, groin or armpits also the swelling is usually painless, although some people find that it aches.
It is caused by an excess of affected lymphocytes collecting in a lymph node
Hodgkin lymphoma is caused by a mutation in the DNA of a type of white blood cell called B lymphocytes, although the exact reason why this happens isn't known.
The DNA gives the cells a basic set of instructions, such as when to grow and reproduce. The mutation in the DNA changes these instructions so the cells keep growing, causing them to multiply without any control.The abnormal lymphocytes usually begin to multiply in one or more lymph nodes in a particular area of the body, such as your neck or groin. Over time, it's possible for the abnormal lymphocytes to spread into other parts of your body, such as your:
bone marrow,spleen,liver,skin or lungs.
There are 4 different stages of this disease:
stage 1 – the cancer is limited to one group of lymph nodes, such as your neck or groin nodes either above or below your diaphragm.
stage 2 – two or more lymph node groups are affected, either above or below the diaphragm.
stage 3 – the cancer has spread to lymph node groups above and below the diaphragm.
stage 4 – the cancer has spread through the lymphatic system and is now present in organs or bone marrow.
To diagnose this disease a biopsy may be required and it involves removing some or all of an affected lymph node, which is then studied in a laboratory under the microscope.
If the biopsy will show that the disease is present , further test will be done such as:
Samples of blood will be taken throughout the diagnosis and treatment to check the general health, the levels of red and white cells and platelets in blood, and how well organs such as your liver and kidneys are working
Another biopsy may be carried out to see if the cancer has spread to your bone marrow; this involves using a long needle to remove a sample of bone marrow from your pelvis.
X ray of the chest can check whether the cancer has spread to chest or lungs
computerised tomography scan which takes a series of X-rays that build up a 3D picture of the inside of the body to check the spread of the cancer
magnetic resonance imaging scan and this scan uses strong magnetic fields to build up a detailed picture of areas of the body, to check the spread of the cancer
positron emission tomography scan and this measures the activity of cells in different parts of the body and can check the spread of the cancer and the impact of treatment.
The specific treatment plan will depend on the general health and the age of the patient and also how far the cancer has spread is also an important factor in determining the best treatment.The discussion of the treatment will be discussed by several doctors not only one.
The main treatments for the Hodgkin lymphoma are chemotherapy which is a type of a treatment where the medicine is used to kill the mutated cancer cells.
There are also different ways to use the chemotherapy which depends on the stage of the cancer. If the cancer is curable the chemotherapy will be put directly into a vein however if it not really curable there will be given the chemotherapy tablets which will relieve the symptoms of the disease.This type of a treatment is given over a period of a few months so the patient do not need to sit in a hospital bed for the whole time however it depends if the symptoms are troublesome then the patient will have to stay in hospital for their own safety. The chemotherapy have it’s own side effects. The main one is that it damage the bone marrow and with this there are other side effects because of that such as increased vulnerability to infection, bleeding and bruising easily,fatigue and breathlessness.If the patient will experience those problems the treatment may need to be stopped for a period of time so the patient can produce the healthy blood cells. The other side effects of chemotherapy include the diarrhoea,vomiting, tiredness, hair loss, mouth ulcers,loss of appetite,infertility, skin rashes.
If the regular chemotherapy is not successful or the disease will come back then the patient may receive the treatment at the higher dose.
Second treatment may be the radiotherapy which is used to treat the early stage of the Hodgkin lymphoma where the cancer is only in one part of the body and the treatment is given in short daily sessions over several weeks and the patients do not need to stay in the hospital between the sessions. The treatment is painless however it have it’s side effects such as tiredness, dry mouth,vomiting and loss of the appetite, most of those side effects are temporary,however there is a risk of developing a long term problems such as infertility and also a permanently darkened skin in the area of a treatment.
Another type of treatment are the steroid medication are used but with the chemotherapy as a more intensive treatment and the side effects are problems with sleeping,indigestion,increase of the appetite with can lead to weight gain, feeling agitate however as the treatment improves the patient's health ,the side effects after those steroid medication will improve as well.
Rituximab is a medication which will be given to a patient if he’s diagnosed with a rare type of the disease and will be combined with the chemotherapy. This medicine is a type of a
biological therapy called monoclonal antibody. It works by attaching itself to the surface of the cancerous cells and it stimulates the immune system to attack and kill the mutated cell.
The medication is given through drip directly to the patient’s vein over the period of a few hours. The side effect of this medication include tiredness,nausea,diarrhoea,flu like symptoms.On the other hand additional medication may be given to the patient to prevent or reduce the side effects.
After the period of treatment ends, the patients must have regular checkups to monitor their recovery and to check if the cancer is not coming back.