3 - lymphoma

Question 1

what is lymphoma?

Answer 1

group of cancers of lymphocytes in lymph nodes

Question 2

what are the 2 peaks of ages common for lymphoma?

Answer 2

20s and 75 yrs

Question 3

what are risk factors of hodgkins lymphoma?

Answer 3

• immunosuppression e.g. HIV
• autoimmune disorders e.g. rheumatoid & sarcoidosis
• EBV
• fam history

Question 4

what are the 3 types of non-hodgkin lymphoma?

Answer 4

1. burkitt lymphoma - associated EBV, malaria, HIV
2. MALT lymphoma - associated H.pylori
3. diffuse B cell lymphocyte - rapidly growing, common for over 65s

Question 5

what are risk factors for non-hodgkin lymphoma?

Answer 5

• infections = HIV, EBV, H.pylori
• hep B or C
• exposure to pesticides or chemicals
• fam history

Question 6

what is clinical presentation of lymphoma?

Answer 6

• lymphadenopathy = non-tender, rubbery, pain when drink alcohol
• general cancer = fever, night sweats, weight loss
• itch with no rash
• symptoms of organ involvement e.g. lungs breathless

Question 7

what are investigations for lymphoma?

Answer 7

• lactate dehydrogenase (LDH) raised (not specific to hodgkins)
• elevated ESR & decreased Hb = poor prognosis
• also do CT, MRI scans

Question 8

what is buzzword biopsy seen for lymphoma?

Answer 8

reed sternberg cells = large B cells w multiple nuclei

Question 9

what is chemo treatment of hodgkin lymphoma?

Answer 9

chemo = ABVD (adriamycin, bleomycin, vinblastine, dacarbazine)

*can get long term toxicity like secondary cancers, CV disease infertility

Question 10

what chemo treatment for non-hodgkin lymphoma?

Answer 10

R-CHOP = rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine (oncovin), prednisolone

Question 11

why are steroids used as treatment? why not used before biopsy?

Answer 11

because they’re good at helping effect of chemo & also kill lymphocytes?

• steroids are important treatment
• can’t be used before biopsy as causes cell necrosis & disrupts architecture