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Haematology > 2: Lymphoma > Flashcards

2: Lymphoma Flashcards

1
Q

What is lymphoma

A

Abnormal proliferation of lymphocytes which then collects in lymph nodes. If these spill into circulation can cause a leukaemia phase

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2
Q

What type of lymphomas are 85%

A

B-cell lymphoma

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3
Q

What % of lymphomas are T-cells

A

15%

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4
Q

What are the two types of B cell lymphoma

A

Hodgkin and Non-Hodgkin

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5
Q

What is Hodgkins Lymphoma

A
  • Malignant proliferation of lymphocytes with pathognomic cells termed reed-sternberg cells
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6
Q

What gender is Hodgkins lymphoma more common

A

Male

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7
Q

What age is Hodgkin’s lymphoma more common in

A

15-24 year-olds and over 65

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8
Q

What is the most common malignancy int he young

A

Lymphoma

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9
Q

What infection is Hodgkin lymphoma associated with

A

EBV

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10
Q

what is the main symptom of hodgkin lymphoma

A

Painless lymphadenopathy

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11
Q

explain spread lymph nodes in hodgkin lymphoma

A

Spread between lymph nodes is in a contagious manner, no extra-lymph node involvement

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12
Q

what group of symptoms are present in hodgkin lymphoma

A

B-symptoms

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13
Q

what are B symptoms

A

Night Sweats
Weight Loss
Fever

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14
Q

what is a documented feature of lymphoma

A

Alcohol-Induced Pain

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15
Q

what is characteristic of hodgkin lymphoma

A

Reed-Sternberg Cells

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16
Q

what are Reed-Sternberg cells

A

Plasma cells, lost ability to produce antibodies

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17
Q

what are two markers of Reed-Sternberg cells

A

CD30 and CD15

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18
Q

what are 3 basic blood tests ordered in lymphoma

A
  • FBC
  • ESR
  • LDH
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19
Q

what does raised LDH indicate

A

Increase cell-turnover

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20
Q

what confirmatory test is used in lymphoma

A

Lymph node excision biopsy

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21
Q

what is used to stage lymphoma

A

CT CAP

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22
Q

what staging system is used for lymphoma

A

Ann-Arbor

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23
Q

what is stage 1

A

Single Node

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24
Q

what is stage 2

A

Two Nodes - same side diaphragm

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25
Q

what is stage 3

A

Two Nodes- opposite side diaphragm

26
Q

what is stage 4

A

Extra-Nodal

27
Q

what does A on the end of the stage mean

A

A= no systemic symptoms

28
Q

what does B on end of stage mean

A

B = B symptoms (weight loss, fever, night-sweats)

29
Q

what does E on end of stage mean

A

Localised extra-nodal extension, but does not qualify for stage 4

30
Q

what is offered for management of Hodgkin lymphoma

A

AVBD

31
Q

what is the AVBD regimen

A

Adriamycin
Bleomycin
Vincistine
Dacarbazine

32
Q

what is the risk of radiotherapy

A

Increases risk secondary malignancy and lung fibrosis

33
Q

what is more common Hodgkin or Non-hogkin lymphoma

A

NHL

34
Q

What is Non-hodgkin lymphoma

A

All lymphomas that do not have Reed-Sternberg cells

35
Q

what % of NHL is B-cell Lymphoma

A

85

36
Q

Explain spread in NHL lymphoma

A

Non-contigous

Often extra-nodal involvement

37
Q

how can B-cell NHL be divided

A
  1. Indolent (Low-Grade)

2. Aggressive (High-Grade)

38
Q

what are the 4 indolent B-cell NHL

A
  • Hair-Cell Leukaemia
  • Waldenstrom’s macroglobulinaemia
  • Small lymphocytic lymphoma
  • Follicular lymphoma
  • MALT lymphoma
39
Q

what profile does hairy cell leukaemia occur in

A

Middle-age men

40
Q

what cells are present in hairy leukaemia

A

Hair cells

41
Q

how does hairy cells present

A

Cytoplasmic projections on smear

42
Q

what does waldenstroms macroglobulinaemia involve

A

IgM

43
Q

what is the most common low-grade lymphoma in adults

A

Follicular lymphoma

44
Q

what translocation is follicular lymphoma associated with

A

14:18

45
Q

what is MALT lymphoma associated with

A

H.Pylori

46
Q

What are 3 types of aggressive NHL

A
  • Burkitt lymphoma
  • Diffuse large B-Cell lymphoma
  • Mantle cell lymphoma
47
Q

What are the 3 types or burkitt’s lymphoma

A
  • HIV associated
  • Sporadic
  • Endemic
48
Q

What is sporadic burkitt’s

A

Occurs in children. Lymphoma of the abdomen - commonly presents with bowel obstruction

49
Q

what translocation is associated with sporadic burkitt’s lymphoma

A

8:14

50
Q

what is endemic burkitt’s associated with

A

EBV Virus

51
Q

how does endemic burkitt’s present

A
  • Occurs more commonly in Africa, South America

- Presents with enlarged lymph nodes of mandible and maxilla

52
Q

what type of lymphoma is 85%

A

NHL

53
Q

explain prevalence of NHL

A

NHL increases with age - peaks at 50 years

54
Q

what chromosomal translocation is associated with NHL

A

14:18

55
Q

How does NHL present clinically

A

Painless lymphadenopathy
Hepatosplenomegaly
Extra-nodal disease
B-symptoms

56
Q

what is first-line investigation for NHL

A

Excision biopsy

57
Q

when is FISH required in NHL and why

A

FISH is ordered to look for MYC arrangement in all individuals with newly-diagnosed high-grade B cell lymphoma

58
Q

what is used to stage NHL

A

FDG-PET CT

59
Q

what staging system is used in NHL

A

Ann-Arbor

60
Q

what regimen is used to treat NHL

A

R-CHOP

Haematology (19 decks)

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