FN: Non-hodgkins Lymphoma

Question 1

Features

Answer 1

Lymphadenopathy: 75% @ presentation
Extranodal
B symptoms

Question 2

Lymphadenopathy

Answer 2

Painless
Symmetric
Multiple sites
Spreads discontinously

Question 3

Extranodal

Answer 3

Skin: esp T cell Lymphomas
CNS
Oropharynx and GIT
Splenomegaly

Question 4

B symptoms

Answer 4

Fever
Night sweats
Wt. loss (>10% over 6mo)

Question 5

Blood shows

Answer 5

Pancytopenia
Hyperviscosity
RBC, U+E, LFT, LDH (raised worse prognosis)

Question 6

Bloods films show

Answer 6

Normal or circulating lymphoma cells ± pancytopenias

Question 7

Classification

Answer 7

LN and biopsy

Question 8

Staging

Answer 8

CT/MRI chest, abdomen, pelvis - stage with Ann Arbor system

Question 9

Classification

Answer 9

B cell (high or low grade) or T cell

Question 10

B cell low grade

Answer 10

Usually indolent but often incurable

1. Follicular
2. Small cell lymphocytic (=CLL_
3. Marginal zone (inc. MALTomas)
4. Lymphoplamsacytoid (e.g. Waldenstroms)

Question 11

High grade types

Answer 11

Aggresive but may be curable
Diffuse large B cell (commonest NHL)
Burkitts

Question 12

T cell types

Answer 12

1. Adult T cell Lymphoma: Caribs and Japs = HTLV-1
2. Enteropathy-assoc. T cell Lymphoma: chronic coeliac
   Cutaneous T cell Lymphoma e.g. sezary syn
   Anaplasticarge cell

Question 13

Management

Answer 13

Diagnosis and management in an MDT

Question 14

High grade management

Answer 14

R-CHOP regimen
BMT for relapse
30% 5 yrs

Question 15

Low grade (e.g. follicular) Rx

Answer 15

When clinically indicated (e.g. chloambucil)

50% 5 yrs