Risk Factors and Symptoms of Diffuse Large B-Cell Lymphoma

● Risk factors The causes of lymphoma, including diffuse large B-cell lymphoma, and other blood cancers are mostly unknown. Epidemiological studies have shown that exposure to radiation and certain chemicals may be a cause, and it is thought that when exposure to such substances causes acquired mutations in genes and activates oncogenes, blood cancer develops. However, except in some cases with clear occupational exposure, most cases cannot identify a definite causal relationship, and the common view is that the causes of blood cancers that occur sporadically in the community are unknown.

In addition, patients with autoimmune diseases such as lupus or Sjögren's syndrome tend to have a slightly higher incidence of lymphoma than those without them, and it is known that some specific bacteria or viruses can cause certain subtypes of lymphoma. Diffuse large B-cell lymphoma is more common in people infected with human immunodeficiency virus, and Epstein-Barr virus infection is often observed in patients with primary central nervous system diffuse large B-cell lymphoma.

• Prevention Considering the risk factors and causes described above, basic preventive measures such as avoiding exposure to harmful substances and maintaining hygienic lifestyle habits to help avoid infections can be considered. However, as shown by the fact that the cause of most cases is unknown, there is no special preventive method beyond this.

• Early screening Unlike some digestive cancers, cervical cancer, and prostate cancer, there is no separate special test for early diagnosis of lymphoma, including diffuse large B-cell lymphoma. Regular national health checkups may be helpful. Since the disease can occur in any part of the body, and except for some slow-growing lymphomas the disease generally progresses quickly, if symptoms or signs of discomfort appear and do not improve over time, it is necessary not to ignore them and to visit a medical institution.

● Symptoms Because diffuse large B-cell lymphoma can occur in many possible sites throughout the body, the symptoms are also diverse. The most common symptom is enlarged lymph nodes that can be felt on examination. The areas most commonly noticed are both sides of the neck, the armpits, and the groin. If the tonsils are swollen due to lymphoma, it may be mistaken for ordinary tonsillitis because it is accompanied by a sore throat, and if a lymphoma mass grows large in the abdomen, the patient may complain of abdominal distension and abdominal pain.

When lymphoma occurs in the gastrointestinal tract, the passage of food may become blocked, causing indigestion, vomiting, and constipation, and anemia may develop due to damage to gastrointestinal blood vessels. If lymphoma invades the bone marrow, where blood cells are produced, anemia, leukopenia, and thrombocytopenia may occur; in that case, symptoms may include fatigue due to anemia, shortness of breath on exertion, dizziness, susceptibility to infection due to low white blood cell count, and a tendency to bleed due to thrombocytopenia.

In many lymphomas, including diffuse large B-cell lymphoma, patients may present at diagnosis with characteristic symptoms such as weight loss, fever, and night sweats (sweating at night), which are called B symptoms. Mild weight loss that develops gradually over a long period is not considered a B symptom; medically significant weight loss generally refers to a loss of more than 5–10% of usual body weight within a few months without intentional factors such as diet or exercise.

Fever refers to an abnormal rise in body temperature confirmed by a thermometer, not simply a subjective feeling of heat. Night sweats also refers not to slight sweating, but to severe sweating that soaks clothing at night. Such B symptoms may be completely absent depending on the patient, and it is also possible to have only one or two of the three symptoms, or all three.

So far, we have covered the risk factors and symptoms of diffuse large B-cell lymphoma. In the next part, we will look at the diagnosis of diffuse large B-cell lymphoma.

Source: Korea Disease Control and Prevention Agency National Health Information Portal