8. lymphomas brain tumours...

Question 1

define lymphoma

what is their classification

Answer 1

neoplastic proliferations of lymphoid cells of various types (any type of lymphoid tissue) solid- form a mass

Hodgkin’s

non Hodgkin’s: lymphocytic lymphoma is most common and important (includes Hodgkin’s disease)

Question 2

define leukaemia

Answer 2

neoplastic proliferations of the cells (mainly blood white cells and their precursors) of the haemopoietic bone marrow. Liquid

• Myeloid or lymphocytic

Question 3

CLINICAL FEATURES AND BEHAVIOUR of lymphoma

Answer 3

• Most present clinically with LYMPHADENOPATHY - lymph node enlargement, localised or generalised
• Some may also infiltrate liver (HEPATOMEGALY), spleen (SPLENOMEGALY) or bone marrow (marrow replacement, with haematological consequences)
• Bad prognosis types may diffusely infiltrate other organs

Question 4

types of Hodgkin’s disease

Answer 4

Nodular Lymphocyte-predominant Hodgkin’s (good)

Classical:

• ​Lymphocyte rich Hodgkin’s (good)
• Mixed cellularity Hodgkin’s (in between)
• Nodular sclerosing Hodgkin’s (in between)
• Lymphocyte-depleted Hodgkin’s (bad)

Question 5

what is the type of cell is classical hodgkin’s disease

Answer 5

REED-STERNBERG CELL. Other cells present are mainly lymphocytes, with some eosinophils & fibroblasts. Attract by releasing cytokines

Question 6

cells in

• Lymphocyte rich Hodgkins
• Lymphocyte depleted Hodgkins
• Mixed cellularity Hodgkin’s
• Nodular sclerosing Hodgkin’s

Answer 6

• FEW R-S cells and lots of lymphocytes
• LOTS of R-S cells and few lymphocytes
• roughly equal proportions of R-S cells and lymphocytes
• as mixed cellularity, but different architecture

Question 7

what are the types of lymphocytic lymphoma

Answer 7

B CELL LYMPHOMA - low grade (good)- mature lymphoid cells

B CELL LYMPHOMA - high grade (bad)- large transformed lymphoid cells

T CELL LYMPHOMA - low grade (good)

T CELL LYMPHOMA - high grade (bad)

t cell normally has a rash

Question 8

myeloma

Answer 8

tumour of mature plasma cells It presents with bone tumours, osteolytic, painful, but with interesting systemic effects.

Can erode bone, can also circulate blood stream but mainly in bone marrow

Can cause pathological fracture

Question 9

what is the most common brain tumour

Answer 9

tumour of glial cells- glioma

• Astrocytes
• Oligodendrocytes
• Ependymal cells

astrocytomas most common

grades 1-4, 4 is bad

Question 10

EMBRYONAL TUMOURS

Answer 10

• Mainly in young children
• Highly malignant
• Spread early and widely by lymphatics and veins
• Sensitive to chemotherapy because rapidly growing
• Formerly rapidly fatal, chemotherapy has revolutionised prognosis
• Expected to survive due to treatment

Question 11

common embryonal tumours

Answer 11

• Nephroblastoma (Wilms’ tumour) - in kidney, most common.
• Neuroblastoma - in adrenal gland, derived from primitive adrenal medullary precursors (neuroblasts); next commonest.

Question 12

rarer embryonal tumours

Answer 12

• Retinoblastoma - retina; often bilateral; genetic basis.
• Medulloblastoma - cerebellum
• Hepatoblastoma – liver

Question 13

TERATOMAS

in ovaries facts

in testes facts

Answer 13

mainly occur in ovaries and testes because of embryonal origin

• Young women
• BENIGN
• Invariably cystic (‘benign cystic teratoma)
• Cyst contains keratin (“dermoid cyst of ovary”)
• Skin, hair, bronchial &gut epithelium, thyroid, neuroglia, bone, cartilage into the cyst
• GOOD PROGNOSIS- if removed cured
• Young men
• Painless swelling of testis
• MALIGNANT if untreated
• Malignancy varies according to type
• Spreads early via blood stream (-> lung & liver etc.)
• Chemotherapy has revolutionised prognosis
• Tumour markers- management (if goes to base line- then cured)