Concepts in Malignant Haematology Flashcards
What is lymphoma?
Type of cancer affecting the lymphocytes inside the lymphatic system
What is Hodgkin’s Lymphoma?
Most common specific type of lymphoma
It has a bimodal age distribution with peaks around 20-25 and 80 years
Risk factors for Hodgkin’s lymphoma include..
HIV
Epstein-Barr virus
Autoimmune conditions, such as rheumatoid arthritis and sarcoidosis
Family history
What are the different types of Non-Hodgkin Lymphoma?
Diffuse large B cell lymphoma - rapidly growing painless mass in older patients
Burkitt lymphoma - EBV and HIV
MALT lymphoma - mucosa-associated lymphoid tissue, usually around the stomach
Risk factors for non-Hodgkin’s lymphoma
HIV, EBV
H. pylori (MALT lymphoma)
Hepatitis B or C infection
Exposure to pesticides/ trichloroethylene
Family history
Enlarged lymph nodes that are non-tender and feel firm or rubbery
Lymphadenopathy - lymphoma
B symptoms refer to systemic symptoms of lymphoma. These are..
Fever
Weight loss
Night sweats
Ix for lymphoma
Lymph node biopsy
CT/MRI/PET
What does the lymph node biopsy show?
Reed-Sternberg cells - lymphoma
What classification system is used for lymphoma?
Lugano:
Stage 1: Confined to one node or group of nodes
Stage 2: In more than one group of nodes but on the same side of the diaphragm (either above or below)
Stage 3: Affects lymph nodes both above and below the diaphragm
Stage 4: Widespread involvement, including non-lymphatic organs, such as the lungs or liver
Malignant haemopoiesis is usually characterised by..
Increased numbers of abnormal & dysfunctional cells
Loss of normal activity
What can cause malignant haemopoiesis?
Increased proliferation (in the absence of a stimulus)
Lack of differentiation/maturation and apoptosis
Differentiate between acute leukaemia and chronic myeloproliferative disorders/neoplasm regarding haemopoiesis
Acute leukaemia: Proliferation of abnormal progenitors
with block in differentiation/maturation (e.g. Acute Myeloid Leukaemia)
Chronic myeloproliferative disorders/neoplasm (MPN): Proliferation of abnormal progenitors, but NO differentiation/maturation block (e.g. Chronic Myeloid Leukaemia)
Which type of mutation which affect proliferation and cellular growth? Driver or passenger?
Driver
Drive mutations can select clones. What does this mean?
Normal haemopoiesis is polyclonal
Malignant is monoclonal/clonal
Clone is a population of cells derived from a single parent cell. How would you know it came from the parent cell?
This parent cell has a genetic marker (driver mutation or
chromosomal change) that is shared by the daughter cells
Driver’ mutations confer growth advantage on the cells and are selected during the evolution of the cancer. This is contrast to..
Passenger mutations. Do not confer growth advantage, but
happened to be present in an ancestor of the cancer cell when it acquired one of its drivers
Initial development of the lymphoid/myeloid progenitor cells take place in the..
Marrow/blood
Initial development of the red cells/neutrophils/platelets/t/b cells progenitor cells take place in the..
Lymph nodes/other sites
T or F: Cells at different developmental stages can undergo neoplastic transformation
True
T or F: Involvement of different anatomical regions unique to the celltype, either at the point of origin, or after migration
True
Classify the cancers of the haemopoietic and lymphoid systems (anatomical site)
Leukaemia
Classify the cancer of the haemopoietic and lymphoid systems (anatomical site)
Lymphoma
Classify the cancer of the haemopoietic and lymphoid systems (lineage)
Classify the cancer of the haemopoietic and lymphoid systems (stage of development/histology)
______________ & ______________ are histologically
and clinically more aggressive than chronic leukaemias & lowgrade lymphomas
Acute leukaemias & high-grade lymphomas are histologically
and clinically more aggressive than chronic leukaemias & lowgrade lymphomas
Features of histological aggression
Large cells with high nuclear-cytoplasmic ratio, prominent nucleoli, rapid proliferation
Classify acute lymphoblastic leukaemia
Bood/marrow involving primitive, lymphoid malignancy
Classify acute myeloid leukaemia
Blood/marrow involving, primitive, myeloid malignancy
Classify chronic lymphocytic leukaemia
Blood/marrow involving (and nodal), less primitive, lymphoid malignancy
Classify high grade B/T cell (non Hodgkin) lymphoma
Nodal, lymphoid malignancy, less primitive, clinically aggressive
Classify low grade B cell (non Hodgkin) lymphoma
Nodal, lymphoid malignancy, less primitive, clinically less aggressive
Classify Hodgkin lymphoma
Nodal, lymphoid malignancy, less primitive, less aggressive
Classify Myeloma
Plasma cell malignancy usually, not exclusively, in the bone marrow
Classify Chronic myeloproliferative neoplasms disorders
Primitive, myeloid compartment, maturation preserved (e.g. chronic myeloid leukaemia)
Classify Burkitt leukaemia/lymphoma
Blood/marrow involving (and nodal), less primitive, lymphoid malignancy
