Of the aggressive forms of Non-Hodgkin B cell lymphomas, the
most aggressive is Burkitt lymphoma, which is caused by the EBV
virus. This disease has to be treated very quickly with strong
chemotherapy but a cure is possible, although not everyone can
withstand the strong drugs that have to be used. Various forms of
large B-cell lymphoma are also rather aggressive.
With aggressive lymphomas, the treatment may be as likely to kill
the patient as the cancer so the doctor has to consider the health
and youth of the patient, the aggressiveness of the cancer and the
patient's own desire to decide on the treatment. It is therefore
important to type or classify the lymphoma accurately, so that the
oncologists can predict its prognosis and use the most appropriate
therapy.
A little lump in the throat was likely an enlarged lymph node.
Bruises all over the body can be due to low platelet count, which
may occur because the cancer has replaced the bone marrow. Swelling
of the face and breathing problems when lying down may occur with a
large mediastinal tumour such as primary mediastinal large B-cell
lymphoma more common in females and located in the chest cavity but
to know the type, you need to look at the histology. We can keep on
speculating but there are quite a number of possibilities so you
will have to ask the doctor as to what is the histological
diagnosis.
Many people do not realize that with cancers it is not the GP,
surgeon or oncologist you see who makes the diagnosis. It is made
by a pathologist, who works behind the scene to provide
consultation to various medical doctors. Lymphoma diagnosis is more
difficult than other cancers, requiring advanced techniques using
immunohistochemistry and increasingly, techniques in molecular
genetics. For example, in this case, one must confirm or exclude
Burkitt lymphoma, a very aggressive tumour, by its immunophenotype
and whether there is a translocation of a gene, known as
c-myc.
