105 - Hodgkin's Lymphoma Flashcards

1
Q

HL is defined as lymphoma of __ __ cells. It makes up to _% of lymphomas. High cure rate- _%

A

adult
B
10
85

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2
Q

HL is more common in __ __. Typical age at diagnosis is divided to two peaks- __ and __

A

white
men
20
80`

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3
Q

HL is classified into 4 types:

A

nodular sclerosis
lymphocyte rich
mixed cellularity
lymphocyte depleted

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4
Q

__ and __ make 95% of HL. Young patients usually have __, while HIV/elders/3rd world have more __

A

nodular sclerosis
mixed cellularity
nodular sclerosis
mixed cellularity

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5
Q

The presence of __ cells is enough to diagnose the disease.

A

Reed-Sternberg

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6
Q

Reed Sternberg cells are __ with a lot of __, __/__ nuclei. They are positive for __ and rarely express __/__. 85% will express __, and 100% express __

A
large
cytoplasm
bilobed/multi
PAX5
CD19/20
CD15
CD30
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7
Q

Most patients with HL will present with palpable __. It will be __, usually in the __/__/__. 50% of patients will present with __ lymphadenopathy.

A

lymphadenopathy
unpainful
neck/axilla/supraclavicular
mediastinal

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8
Q

30% HL patients will show __symptoms, and __ (Pel–Ebstein fever). Rare presentation may also include lymph node pain when consuming __

A

B
FUO
alcohol

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9
Q

In order to diagnose HL- perform __ and look for tumor mass of __ cell origin with __ infiltration.

A

biopsy
B
inflammatory

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10
Q

It is important to look for comorbidities when diagnosing HL, especially __ and __, due to the treatment’s __

A

lung
CHF
S/E

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11
Q

DDx for HL includes: 4

A

NHL
mononucleosis
infectious process
adenopathy due to phenytoin (anti seizure)

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12
Q

HL staging is done with __. It is more accurate in locating __ involvement.

A

PET CT

BM

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13
Q

HL early disease early disease is- __, late disease is -__

A

1-2

3-4

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14
Q

HL stage 1:

Involvement of __ lymph node region or lymphoid structure

A

1

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15
Q

HL stage 2:

Involvement of __ lymph node region or lymphoid structure on the same side of the __

A

> 1

diaphragm

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16
Q

HL stage 3:

Involvement of lymph node region or lymphoid structure on both sides of the __

A

diaphragm

17
Q

HL stage 4 is defined as involvement of __ sites.

A

extranodal

18
Q

Another HL staging is to:
A- ___
B- unexplained __/__/__ during the 6 months before staging investigation
E- __/__ involvement of __ tissue excluding the __+__

A
asymptomatic
weight loss/fever/night sweats
localized/solitary
extralymphatic 
liver/BM
19
Q

IPS score is used for advanced HL, every category gives 1 point and worsen the prognosis: 7

A
male
>45
S IV
Alb < 4g/dL
Hb < 10.5 g/dL
WBC < 15K
Lymphocytes < 600 / 8% of total weight count
20
Q

HL prognosis ranges between __% without and RF, to __ with >4 RF (very rare)

A

88

62

21
Q

HL therapy usually includes __ alone or combined with __. When it is advanced we treat with __ only

A

chemotherapy
radiation
chemotherapy

22
Q

The commonly used regiment for chemotherapy in HL is __ (__, __, __, __)

A

ABVD

A – doxorubicin (Adriamycin) B – bleomycin. V – vinblastine. D – dacarbazine (DTIC)

23
Q

HL cycles consists of __ treatments, given every __ week

A

2

2nd

24
Q

Low risk HL should go through ___ cycles, without radiation.

A

4-6

25
Q

Advanced HL should get __ cycles of chemo. Consider __, but remember it improves __ but not __, and is usually given for __ disease.

A
6
radiation
recurrence 
survival 
bulky
26
Q

Anti CD__ (__) could be benefitable for advanced HL patients when combined with __.

A

30
brentuximab
AVD

27
Q

Recurrent HL are given __ chemotherapy- __ (__,__,__) or __ (__,__,__).

A

salvage
ICE (Ifosfamide, Carboplatin, Etoposide)
GNC (Gemcitabine, Navelbine, Doxorubicin)

28
Q

Over __% of recurrent HL who had almost full response to salvage chemo, can be cured with __ __ __.

A

50
allogenic
BM
transplantation

29
Q

Recurrent HL who did not respond to salvage chemotherapy may benefit from __.

A

radiation

30
Q

Recurrent HL patients with advanced disease who did not respond to salvage chemotherapy should be given __ as bridging until __. __ inhibitors are also useful.

A

brentuximab
allogenic transplantation
PD1

31
Q

NLPHL= __

A

Nodular lymphocyte-predominant Hodgkin lymphoma

32
Q

NLPHL has similar characteristics to __ NHL, and may transform into __.

A

indolent

DLBCL

33
Q

NLPHL is found mostly in __ (__%), usually in __ or __. Prognosis is usually __

A
men
75
childhood
30-40
good