104 - Non Hodgkin Lymphoma Flashcards by Salman Majid

NHL (Non Hodgkin lymphoma) is a group of cancers of adult __, __, __ cells

B
T
NK

How well did you know this?

Not at all

Perfectly

Unlike HL (Hodgkin lymphoma), NHL does not have __ cells and have other biological and clinical characteristics

RS (Reed Sternberg)

How well did you know this?

Not at all

Perfectly

The prognosis of NHL __greatly, Unlike HL where the prognosis is __ even under __ only

varies
good
chemotherapy

How well did you know this?

Not at all

Perfectly

NHL is __ times more common than HL, and makes up to __% of all new cancers in the US

How well did you know this?

Not at all

Perfectly

NHL is more common in __ __, and the frequency increases with __, especially when > __

white
men
age
40

How well did you know this?

Not at all

Perfectly

Patients with __ are more prone to develop __

prone

NHL

How well did you know this?

Not at all

Perfectly

__and Burkitt are considered more aggressive and are more common in children

DLBCL

How well did you know this?

Not at all

Perfectly

Which infections are correlated with NHL? 7
__- linked with Burkitt and CNS lymphoma
__- linked with T cell lymphoma
__- linked with aggressive B cell
__- linked with gastric MALT
__- linked with cutaneous MALT
__- linked with lymphoplasmacytic and MZL of the spleen
__- linked with HIV lymphoma including Castleman disease

EBV
HTLV-1
HIV
H. Pylori
Borrelia 
HCV
HHV-8

How well did you know this?

Not at all

Perfectly

Immunosuppressive patients are linked to NHL due to __

EBV

How well did you know this?

Not at all

Perfectly

__% of NHL are __ cells lymphomas

How well did you know this?

Not at all

Perfectly

Physical examination of NHL patients may suggest __ vs __ disease. Look for __ symptoms

aggressive
indolent
B

How well did you know this?

Not at all

Perfectly

Important lab workout for NHL include: 5

CBC/chemistry/LFT
protein electrophoresis (monoclonal)
B-2 microglobulin/LDH
LP
HBV/HCV/HIV

How well did you know this?

Not at all

Perfectly

The recommended imaging modalities for NHL are:

CT-C/A/P- for staging
PET CT- for DLBCL and HL
MRI- for bone/BM/CNS

How well did you know this?

Not at all

Perfectly

There are two main groups of NHL: __ which require immediate treatment with chemotherapy and considered treatable, and __ which is treated symptomatically but hard to achieve complete cure

aggressive

indolent

How well did you know this?

Not at all

Perfectly

The most common aggressive NHL is __, while the most aggressive is __

DLBCL

Burkitt

How well did you know this?

Not at all

Perfectly

The most common indolent NHL is __. Other lymphomas include : 3. __ is considered intermediate between the two groups

FL
MZL
LPL
HCL
MCL

How well did you know this?

Not at all

Perfectly

Burkitt lymphoma is more common in ___. Biopsy will reveal monotonic infiltration: __ size cells with __ nucleolus, multiple __, and __ cytoplasm. Remember- __

children 
medium
round
nuclei
basophilic 
Starry sky

How well did you know this?

Not at all

Perfectly

Burkitt lymphoma markers include: 5

BCL2
BCL6
CD10
CD20
CD19

How well did you know this?

Not at all

Perfectly

DLBCL is the most common __ cell lymphoma. More common in __, median age of __. Very often associated with __.

B
men
64
EBV

How well did you know this?

Not at all

Perfectly

DLBCL contains __ proliferation of __ and __ lymphocytes.

diffuse
large
atypical

DLBCL expresses: 3

CD79a
CD20
CD19

In DLBCL __ is positive in 25-80% of times, and __ in 10%

BCL2

MYC

In DLBCL when both __ and __ are positive- double hit lymphoma

BCL

MYC

DLBCL=__

Diffuse large B-cell lymphoma

What is the first line of treatment for DLBCL?

R-CHOP | rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone

When DLBCL is localized, choose one of two options- R-CHOP every _ weeks for _ cycles or R-CHOP for _ cycles followed by localized __

3 6 3-4 radiation

When DLBCL is advanced- full __

chemotherapy

Another option for DLBCL with mediastinal involvement and double hit (__+__)is- __

MYC+BCL | R-EPOCH

If DLBCL is refractory and/or 2 lines have failed- __

CAR-T

FL=__

Follicular lymphoma

FL is the __ most common NHL preceded by __

2nd | DLBCL

FL has __ organization. To confirm we must look for immunogenic phenotype: 6. Translocation of __ and inappropriate __ are in >85% of cases

follicular CD6, CD10, CD19, CD20, CD23, BCL6 14:18 BCL2

WHO classifies FL to 3 stages according to number of centroblasts: I: _-_ II: _-_ III: >_

0-5 6-15 15

The typical clinical presentation of FL is of unpainful __, typically in number of sites, even in atypical location such as __

lymphadenopathy | epitrochlear

Asymptomatic FL patient should be __ rather than __

monitored | treated

Treating FL is done with __ alone or in combination with __. ___ is also useful, and patients will usually live for _-_ years

rituximab chemotherapy transplantation 15-20

MZL is the second most common __ lymphoma. There are 3 types- __, __, __.

indolent splenic extranodular nodular

__ is a type of MZL, usually in the stomach.

MALT

Lymphocytic lymphoma usually correlates with __. Most patients are diagnosed when in stage __.

IgM | IV

Lymphocytic lymphoma with high IgM are referred to as- __, and may suffer from __ symptoms. __ mutation is found in __% of cases. __ is used when hypercoagulability is present

``` Waldenstorm macroglobulinemia hypercoagulability MYD88 90 plasmapheresis ```

Lymphocytic lymphoma is treated with __, and when refractory- consider __ inhibitor, __ and oral __.

rituximab mTOR Everolimus BTK

MCL (__), is an intermediate lymphoma, between indolent and aggressive. Median survival is _-_ years

Mantle cell lymphoma | 5-10

MCL variant __ is more indolent, while __ is more aggressive

SOX11 (splenomegaly) | Blast (high Ki67)

Mycosis fungoides is a __ cell lymphoma, known as __, with a median age of __

T cutaneous 50

In mycosis fungoides, __ continues to __ and from there to __. When continues to general erythroderma (widespread reddening of the skin) and tumor cells in circulation- __ syndrome

patch plaque tumors Sézary

PTCL (__) involve the __, __, __, and __. Prognosis of __ years survival

``` Peripheral T-cell lymphoma BM liver spleen skin 2 ```

PTCL will usually have positive __ and __. Treatment is usually with __

CD3 CD4 CHOP

``` Other T cells NHL include: AITL (__) ALCL (__) ATLL (__) Extranodal NK/T cell lymphoma- __ type () ```

angioimmunoblastic T-cell lymphoma- hyperglobulinemia anaplastic large cell lymphoma- more in children adult T-cell leukemia/lymphoma- more in japan- HTLV-1 nasal type- associated with EBV