2: Lymphoma Flashcards
What is lymphoma
Abnormal proliferation of lymphocytes which then collects in lymph nodes. If these spill into circulation can cause a leukaemia phase
What type of lymphomas are 85%
B-cell lymphoma
What % of lymphomas are T-cells
15%
What are the two types of B cell lymphoma
Hodgkin and Non-Hodgkin
What is Hodgkins Lymphoma
- Malignant proliferation of lymphocytes with pathognomic cells termed reed-sternberg cells
What gender is Hodgkins lymphoma more common
Male
What age is Hodgkin’s lymphoma more common in
15-24 year-olds and over 65
What is the most common malignancy int he young
Lymphoma
What infection is Hodgkin lymphoma associated with
EBV
what is the main symptom of hodgkin lymphoma
Painless lymphadenopathy
explain spread lymph nodes in hodgkin lymphoma
Spread between lymph nodes is in a contagious manner, no extra-lymph node involvement
what group of symptoms are present in hodgkin lymphoma
B-symptoms
what are B symptoms
Night Sweats
Weight Loss
Fever
what is a documented feature of lymphoma
Alcohol-Induced Pain
what is characteristic of hodgkin lymphoma
Reed-Sternberg Cells
what are Reed-Sternberg cells
Plasma cells, lost ability to produce antibodies
what are two markers of Reed-Sternberg cells
CD30 and CD15
what are 3 basic blood tests ordered in lymphoma
- FBC
- ESR
- LDH
what does raised LDH indicate
Increase cell-turnover
what confirmatory test is used in lymphoma
Lymph node excision biopsy
what is used to stage lymphoma
CT CAP
what staging system is used for lymphoma
Ann-Arbor
what is stage 1
Single Node
what is stage 2
Two Nodes - same side diaphragm
what is stage 3
Two Nodes- opposite side diaphragm
what is stage 4
Extra-Nodal
what does A on the end of the stage mean
A= no systemic symptoms
what does B on end of stage mean
B = B symptoms (weight loss, fever, night-sweats)
what does E on end of stage mean
Localised extra-nodal extension, but does not qualify for stage 4
what is offered for management of Hodgkin lymphoma
AVBD
what is the AVBD regimen
Adriamycin
Bleomycin
Vincistine
Dacarbazine
what is the risk of radiotherapy
Increases risk secondary malignancy and lung fibrosis
what is more common Hodgkin or Non-hogkin lymphoma
NHL
What is Non-hodgkin lymphoma
All lymphomas that do not have Reed-Sternberg cells
what % of NHL is B-cell Lymphoma
85
Explain spread in NHL lymphoma
Non-contigous
Often extra-nodal involvement
how can B-cell NHL be divided
- Indolent (Low-Grade)
2. Aggressive (High-Grade)
what are the 4 indolent B-cell NHL
- Hair-Cell Leukaemia
- Waldenstrom’s macroglobulinaemia
- Small lymphocytic lymphoma
- Follicular lymphoma
- MALT lymphoma
what profile does hairy cell leukaemia occur in
Middle-age men
what cells are present in hairy leukaemia
Hair cells
how does hairy cells present
Cytoplasmic projections on smear
what does waldenstroms macroglobulinaemia involve
IgM
what is the most common low-grade lymphoma in adults
Follicular lymphoma
what translocation is follicular lymphoma associated with
14:18
what is MALT lymphoma associated with
H.Pylori
What are 3 types of aggressive NHL
- Burkitt lymphoma
- Diffuse large B-Cell lymphoma
- Mantle cell lymphoma
What are the 3 types or burkitt’s lymphoma
- HIV associated
- Sporadic
- Endemic
What is sporadic burkitt’s
Occurs in children. Lymphoma of the abdomen - commonly presents with bowel obstruction
what translocation is associated with sporadic burkitt’s lymphoma
8:14
what is endemic burkitt’s associated with
EBV Virus
how does endemic burkitt’s present
- Occurs more commonly in Africa, South America
- Presents with enlarged lymph nodes of mandible and maxilla
what type of lymphoma is 85%
NHL
explain prevalence of NHL
NHL increases with age - peaks at 50 years
what chromosomal translocation is associated with NHL
14:18
How does NHL present clinically
Painless lymphadenopathy
Hepatosplenomegaly
Extra-nodal disease
B-symptoms
what is first-line investigation for NHL
Excision biopsy
when is FISH required in NHL and why
FISH is ordered to look for MYC arrangement in all individuals with newly-diagnosed high-grade B cell lymphoma
what is used to stage NHL
FDG-PET CT
what staging system is used in NHL
Ann-Arbor
what regimen is used to treat NHL
R-CHOP
