Haem - lymphoma

Question 1

Why are there so many diff subtypes of lymphoma

Answer 1

can arise from cells at many diff stages of lymphoid maturation

Question 2

Why are lymphocytes prone to lymphoma -give 3 reasons

Answer 2

1) Rapid proliferation in infection
2) VDJ recombination
3) Highly dependent on apoptotic process (so if this goes wrong…there is prolif of abnormal cells)

Question 3

eg of oncogenes in lymphoma

Answer 3

c-myc, cyclin D1, bcl2, bcl6

Question 4

Diff in présentation of CLL and lymphoma?

Answer 4

• CLL = symmetrical

- Lymphoma = asymmetrical painless lymphadenopathy

Question 5

Risk factors for lymphoma

Answer 5

• Ag stimulation: H. Pylori/Coeliac disease

- Viral: HTLV1/EBV

Question 6

Hodgkin’s lymphoma - where do the cells tend to arise from

Answer 6

Germinal centre

Question 7

Smear cells

Answer 7

CLL

Question 8

Presentation of hodgkin’s lymphoma

Answer 8

Asymmetrical, painless lymphadenopathy

B - Sx: Drenching night sweats/fever/10% wt loss in 6 months

Question 9

B symptoms of Hodgkin’s lymphoma

Answer 9

• Drenching night sweats
• Fever
• 10% wt loss in 6 months

Question 10

Most common subtype of Hodgkin’s lymphoma

Answer 10

Nodular sclerosing

Question 11

Staging of Hodgkin’s lymphoma

Answer 11

1: one group of LNs
2: more than 1 group of LNs on 1 side of diaphragm
3: both sides of diaphragm involved
4: extra nodal sites

Question 12

What is stained for in ?Hodgkin’s lymphoma

Answer 12

CD15 and CD30

Question 13

2 useful investigations for stagin Hodgkins?

Answer 13

CT/PET

Lymph node biopsy

Question 14

Treatment of Hodgkin’s lymphoma

Answer 14

COMBINATION CHEMOTHERAPY FOR ALL
Adriamycin, Bleomycin, Vinblastin, Dacarbazine

+/-radiotherapy

Question 15

Common dilemma in the management of hodgkin’s lymphoma?

Answer 15

Do we use radiotherapy?

Radiotherapy would cure the lymphoma, but increases risk of malignancy later in life

Question 16

Mx of relapse of Hodgkin’s lymphoma

Answer 16

Intensive chemo + autologous SCT

Question 17

wtf is autologous SCT

Answer 17

PATIENT’S OWN SCs are harvested + frozen

• enables high dose radio/chemo to eradicate malignant cells
• no GvHD

Question 18

3 high grade NHLs

Answer 18

Burkitt’s
Diffuse large b-cell
Mantle cell

Question 19

3 low grade NHLs

Answer 19

Follicular
Small Lymphocytic
Marginal zone

Question 20

starry sky appearance

Answer 20

Burkitt’s

Question 21

Burkitt’s lymphoma

• translocation?
• oncogene?

Answer 21

t(8;14)

c-myc

Question 22

Treatment of Burkitt’s lymphoma

Answer 22

Rituximab

Question 23

t(11;14)

Answer 23

Mantle cell lymphoma

Question 24

Mantle cell lymphoma

• translocation?
• which oncogene is upregulated?

Answer 24

t(11;14)

Cyclin D1

Question 25

t(14;18)

Answer 25

Follicular B-cell lymphoma

Question 26

HTLV1 infection predisposes to which malignancy?

Answer 26

Adult T-cell lymphoma

Question 27

Coeliac disease is associated with which lymphoma?

Answer 27

Enteropathy associated T-cell lymphoma (EATL)

Question 28

Mycosis fungoides is associated with which lymphoma?

Answer 28

Cutaneous T Cell lymphoma

Question 29

t(2;5)

Answer 29

Anaplastic large cell lymphoma (T- cells)

Question 30

Large epithelioid lymphocytes in sheets

Answer 30

Anaplastic large cell lymphoma (T-cells)

Question 31

T-cell lymphoma which affects younger patients

Answer 31

Anaplastic large cell lymphoma

Question 32

4 chemo drugs used to treat hodgkin’s lymphoma

Answer 32

ABVD
Adriamycin
Bleomycin
Vinblastin
Dacarbazine