Haem - Lymphoma Flashcards
What is lymphoma?
Cancer affecting lymphocytes inside the lymphatic system
Cancerous cells proliferate inside lymph nodes, causing lymph nodes to become abnormally large (lymphadenopathy)
What are the two categories of lymphoma?
Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma
What are the different peaks for Hodgkin’s lymphoma?
20-25 years old
80 years old
What are the risk factors for Hodgkin’s lymphoma?
HIV
EBV
Autoimmune conditions e.g. RA and sarcoidosis
Family history
What are main types of Non-Hodgkin’s lymphoma?
Diffuse large B cell lymphoma - rapidly growing painless mass in older patients
Burkitt lymphoma - associated with EBV and HIV
MALT lymphoma - affects mucosa associated lymphoid tissue, around stomach
What are the risk factors for non-Hodgkin’s lymphoma?
HIV
EBV
Helicobacter pylori (associated with MALT lymphoma)
Hepatitis B or C
Pesticide exposure
Trichloroethylene exposure
Family history
How does lymphoma present?
Lymphadenopathy
Enlarged lymph node or nodes in neck, axilla or inguinal area
Non-tender, firm or rubbery
May experience lymph node pain after alcohol
B symptoms
What are B symptoms?
Systemic symptoms of lymphoma
- Fever
- Weight loss
- Night sweats
What are the non-specific symptoms of lymphoma?
Fatigue
Pruritis
Cough
SOB
Abdominal pain
Recurrent infections
What investigations are used for lymphoma?
Lymph node biopsy
Critical diagnostic investigation
CT,MRI and PET can be used to help diagnose and stage
What characteristic finding is present in lymph node biopsy in Hodgkin’s lymphoma?
Reed-Sternberg cells
Large cancerous B lymphocytes
- Two nuclei and prominent nucleoli
- Looks like an owl
What classification is used for lymphoma?
Lugano classification
Stage 1
Confined to one node or group of nodes
Stage 2
More than one group of nodes, but same side of diaphragm (above or below)
Stage 3
Affects lymph nodes above and below diaphragm
Stage 4
Widespread involvement, including non-lymphatic organs e.g. liver or lungs
How is lymphoma managed?
Chemotherapy and radiotherapy
Treatment aims to cure disease, usually successful, risk of relapse and side effects from treatment
What can chemotherapy lead to?
Infections
Cognitive impairment
Secondary cancers
Infertility
What can radiotherapy lead to?
Risk of tissue fibrosis
Secondary cancers
Infertility
