Primary vaginal malignant lymphoma

　　First, etiology

　　The etiology of primary vaginal malignant lymphoma is not yet clear and may be related to local infection. EB virus and HIV virus infection can be found in patients with vulvar malignant lymphoma, and the incidence of non-Hodgkin's lymphoma (NHL) is relatively high. The occurrence of the disease is closely related to immunosuppression, and some congenital immune deficiencies often occur with malignant lymphoma. Certain bacterial infections such as Helicobacter pylori (HP) and environmental factors such as the use of pesticides and agricultural chemicals can also lead to the disease.

　　Second, pathogenesis

　　1. Histological classification:Perin et al. reported a case of vaginal Hodgkin's disease of the nodular sclerosis type. Due to the lack of stage and immunotyping in some vaginal non-Hodgkin's lymphoma data, and the use of outdated classification criteria, it is difficult to count the histological types, but the majority are diffuse large cell lymphoma. According to the 'Revised European-American Lymphoma Classification' (REAL) criteria, Vang et al. found that 8 cases of primary vaginal non-Hodgkin's lymphoma were all diffuse large B-cell lymphoma (DLBCL). Reviewing past data suggests that about 83% of primary vaginal NHL patients are DL-BCL. In addition, there are NK/T-cell lymphoma, follicular lymphoma, and marginal zone B-cell lymphoma, etc.

　　2. Immunohistochemistry:The common leukocyte antigen CD45 is positive. B-cell type also shows CD20, CD45RA, CD45RB, CD74, and CD79a positivity, while T-cell type is mostly positive for CD3, CD4, and CD45RO. NK/T-cell lymphoma is positive for CD56 and CD2. Hodgkin's disease is positive for CD30.

　　3. Molecular biology:Monoclonal immunoglobulin heavy chain gene rearrangements can be detected in some B-cell lymphomas using Southern hybridization or PCR methods. Some T-cell lymphomas can detect TCR gene rearrangements.

　　Lymphoma patients should also pay attention to avoiding the occurrence of complications:

　　1. Skeletal complications:Clinical manifestations include local bone pain and secondary neurological compression symptoms.

　　2. Liver and gallbladder complications:If the liver parenchyma is invaded, it can cause pain in the liver area.

　　3. Gastrointestinal complications:Gastrointestinal complications that may occur in malignant lymphoma include decreased appetite, abdominal pain, diarrhea, abdominal mass, intestinal obstruction, and bleeding.

　　4. Skin complications:Lymphoma patients should also be cautious of non-specific damage, which is common, including pruritus and urticaria.

　　5. Complications of tonsils and the mouth, nose, and pharynx:Experts state that patients with lymphoma involving the mouth, nose, and pharynx may experience difficulty in swallowing, nasal congestion, and epistaxis.

　　6. Other complications:Lymphoma can also infiltrate the pancreas and cause malabsorption syndrome.

　　About 63% of patients with primary vaginal malignant lymphoma initially present with vaginal bleeding, accompanied by vaginal discharge. Generally, a vaginal mass is found after several months, with possible lower abdominal pain, sexual difficulty, and at the same time, there may be frequent urination, occasional fever, and weight loss. Vaginal examination shows that 80% of patients have a vaginal mass, with sizes ranging from 2.5 to 12 cm, and it is obviously tender. Some of the surface mucosa is ulcerated, and most of the masses involve the surrounding tissues of the vagina, such as the posterior vaginal septum, bladder, rectum, and urethra.

　　The three major symptoms of early-stage vaginal cancer

　　1. Vaginal bleeding:It is more common in contact bleeding, usually occurring after sexual intercourse, or after the use of instruments and amenorrhea.

　　2. Vaginal discharge:Abnormal vaginal discharge is mainly related to necrotic tumor tissue and infection, and the discharged body can be watery, sometimes like congee, or mixed with blood in the discharge.

　　3. Compression symptoms:After the late-stage tumor compresses the adjacent organs, it can show corresponding compression symptoms. For example, when compressing the bladder and urethra, it can cause urgency, frequent urination, hematuria; when compressing the rectum, it can cause difficulty in defecation and urgent need to defecate; late-stage patients may also show hematochezia, symptoms of tumor penetration into the rectum.

　　Early diagnosis is an effective way to prevent and treat vaginal cancer. It is best for elderly women and high-risk patient groups to undergo Pap smear examination annually. Breakline, inquiry of health products. Traditional Chinese medicine treatment methods for primary vaginal malignant lymphoma.

　　The therapeutic principles of traditional Chinese medicine for this disease are to promote blood circulation and remove blood stasis, break through hard masses, detoxify and remove dampness. However, the specific application needs to be based on the main symptoms. Generally, in the early stage of the disease, when the body is strong and the pathogen is strong, surgery should be the main treatment, supplemented with traditional Chinese medicine preparations to break blood stasis and eliminate symptoms. In the middle and late stages, according to the condition, or attack should be the main treatment, supplemented by supplementation, or both attack and supplementation should be implemented, to grasp the degree of 'attacking until half of it is reduced'. At the same time, attention should be paid to the application of radiotherapy, chemotherapy, and other methods of treatment.

　　The goal of treating vaginal malignant tumors is to (1) eliminate the focus; (2) improve the body's resistance to disease, promote the reversal of the tumor. For this purpose, the general principles of the following three stages can be referred to for treatment.

　　1. In the early stage, the patient has no自觉 symptoms, the mass exists, there is no pain, and most of the tongue coating and pulse are normal. At this time, the body is strong and the pathogen is strong, so it is advisable to use detoxifying and expelling Chinese herbal formulae as the main treatment, supplemented with oral administration of drugs to assist the body's own resistance. At the same time, surgery is recommended in Western medicine.

　　2. In the middle stage, the patient has appeared systemic discomfort symptoms, and the tumor has developed to a certain extent, which belongs to deficiency of the body and excess of the pathogen, or the body and the pathogen are in equilibrium. Both attack and supplementation should be implemented. It is advisable to adopt surgery or targeted chemotherapy and radiotherapy with strong anticancer drugs, and配合 traditional Chinese medicine anticancer preparations. To reduce side effects, improve efficacy, and improve the quality of life.

　　3. In the late stage, when the tumor has already occurred distant metastasis, the mass is hard as stone, the patient is pale and emaciated, and the bones are thinned, it belongs to the body being unable to resist the pathogen. If cancer is attacked, it will damage the body's own resistance, so it is advisable to strengthen the body and regulate the symptoms, enhance the body's resistance to disease, control the development of the disease, and attack through supplementation.

　　In summary, the treatment of vaginal malignant tumors should be surgical in the early and middle stages, supplemented by radiotherapy, chemotherapy, and traditional Chinese medicine therapy. In the late stage, symptomatic treatment can be adopted according to the situation.

　　Prognosis

　　Vang et al. reported on 8 cases of primary vaginal NHL followed up for 1.8 to 21 years, with an average of 8.2 years, and found that except for 1 patient who died, the others survived without tumor. At the same time, it was found that 19 previously reported primary patients were followed up for 7 months to 20 years, with a 5-year survival rate of 88%. In addition to the case reported by Bai Ping et al., where a FIGO III patient had the vaginal mass disappear after radiotherapy, but recurred in the vulva and metastasized distantly one month later, the other individual case reports followed up for 1 to 6 years, all survived.

　　1. Laboratory tests
　　Immunohistochemical detection and cytogenetic testing and histopathological examination.
　　2. Other auxiliary examinations
　　Colposcopy examination.
　　Since primary vaginal malignant lymphoma is rare, it is easy to misdiagnose or miss the diagnosis, increasing the difficulty of diagnosis. The criteria for diagnosing primary vaginal malignant lymphoma, in addition to the site of onset, are the same as those for primary vulvar lymphoma. Cytology often cannot be determined, and the best method is to use vaginal biopsy.

　　First, dietary recipes for chemotherapy treatment

　　1, Chinese wolfberry softshell turtle lean pork soup:30 grams of Chinese wolfberry, 1 softshell turtle (about 500 grams), 150 grams of lean pork. First place the softshell turtle in hot water to move around, allowing it to urinate, then kill and cut it open, remove the internal organs, wash and cut into pieces, add an appropriate amount of water, and stew with Chinese wolfberry and lean pork until tender, and take in 2 to 3 servings.

　　2, Chinese wolfberry sea cucumber lean pork stew:15 grams of Chinese wolfberry, 250 grams of sea cucumber, 100 grams of lean pork. First soak the sea cucumber in water to soften, wash and clean, then cut into slices with the lean pork, add an appropriate amount of water, and cook until tender, season with salt, and eat in several servings. Beijing Tumor Hospital, Tumor Radiotherapy Department, Xu Gang

　　3, Mushroom Cordyceps stewed chicken:20 grams of mushrooms, 15 grams of Cordyceps sinensis, 1 chicken (about 10 kg) that has not laid eggs. Remove the stem of the mushrooms, and remove the feathers, head, feet, and internal organs of the chicken. Put the mushrooms and Cordyceps sinensis into the chicken's abdomen, seal with bamboo skewers, add an appropriate amount of water, and simmer over low heat for 2 hours, season with salt, and take the food in 2 to 3 servings.

　　4, Milk and egg white lotus seed paste:250 milliliters of fresh milk, 2 fresh eggs, 50 grams of stone lotus seed. Grind the stone lotus seed into powder, add an appropriate amount of water to cook the lotus seed powder into a paste, add rock sugar or white sugar to taste, then add milk and egg white, mix well, and boil before serving. Take once a day or every other day.

　　5, Chicken gizzard, grain sprout, ginger, rabbit meat soup:12 grams of chicken gizzard, 30 grams of grain sprout, 3 slices of ginger, 100 grams of rabbit meat. Add an appropriate amount of water, boil together, season with a little salt, drink the soup and eat the meat. Take once a day or every other day.

　　6, Amomum villosum and Chinese yam stewed pig stomach:15 grams of amomum villosum, 50 grams of Chinese yam, 1 pig stomach. Break the amomum villosum, clean and remove the fat from the pig stomach. Put the amomum villosum and Chinese yam into the pig stomach, add an appropriate amount of water, and simmer over low heat until the pig stomach is tender, season with a little salt, and drink the soup or eat with food.

　　Second, dietary recipes for radiotherapy treatment

　　1, Bird's nest stewed with American ginseng:6 grams of bird's nest, 9 grams of American ginseng. Soak the bird's nest in warm water, remove the feathers, slice the American ginseng, add an appropriate amount of water, and simmer for 12 hours before taking.

　　2, Pear juice, sugarcane syrup, water chestnut dew:Snow pear juice 1 portion, sugarcane juice 2 portions, water chestnut 1 portion. Mix and serve cold, or heat and serve warm.

　　3. Astragalus and fructus lycii stewed water turtle:30g astragalus, 20g fructus lycii, one water turtle (about 500g). Wrap the astragalus with gauze, remove the scales and internal organs of the fish, wash and cut into pieces. Add an appropriate amount of water, simmer until tender, remove the astragalus residue, add a little oil and salt for seasoning, and take it in several doses.

　　4. Turtle and pork trotter ginseng soup:One turtle (about 150g to 250g), 250g pork trotters, 10g ginseng. First, blanch the turtle with boiling water to make it excrete urine, cut off the head and claws, remove the internal organs, wash it clean, and cut it into pieces. Add an appropriate amount of water, simmer until tender, and take it in several doses.

　　Three. What is good for eating for patients with primary vaginal malignant lymphoma

　　3. Eat more foods with anti-myeloma, osteosarcoma properties, such as kelp, undaria pinnatifida, siliquaria, sea clam, undaria pinnatifida, almond, peach kernel, plum.

　　1. Pain should eat turtle shell, turtle meat, rhinoceros horn, oyster, crab, shrimp, walnut.

　　2. Spleen enlargement should eat turtle, eel, sea eel, clam, kelp, undaria pinnatifida.

　　3. Anemia should eat pork liver, mushrooms, sesame, bee milk, yellow croaker, peanuts, sea cucumber, grass carp, abalone.

　　4. Eat more foods that enhance the immune system: turtle, tortoise, sea turtle, sandworm, crucian carp, shark, water snake, shrimp, white flower snake, crucian carp, mulberry, fig, lychee, walnut, loquat, almond, luffa.

　　The three major symptoms of early-stage vaginal cancer

　　1. Vaginal Bleeding

　　It is more common in contact bleeding, usually occurring after sexual intercourse, or after the use of instruments and amenorrhea.

　　2. Vaginal Discharge

　　Abnormal vaginal discharge is mainly related to necrotic tumor tissue and infection, and the discharged body can be watery, sometimes like congee, or mixed with blood in the discharge.

　　3. Compression Symptoms

　　After the late-stage tumor compresses the adjacent organs, it can show corresponding compression symptoms. For example, when compressing the bladder and urethra, it can cause urgency, frequent urination, hematuria; when compressing the rectum, it can cause difficulty in defecation and urgent need to defecate; late-stage patients may also show hematochezia, symptoms of tumor penetration into the rectum.

　　Early diagnosis is an effective method for the prevention and treatment of vaginal cancer. Elderly women and high-risk patient groups are best to undergo Pap smear examination annually.