Haematological Malignancies Flashcards
Recall the paediatric and adult thresholds for clinically significant lymphadenopathy
Adult >1cm or 1.5cm at level 2
Child > 2cm
Or any node that is persistent and has associated head and neck symptoms
Outline 6 potential bacterial causes of cervical lymphadenopathy
- Streptococcus Group A
- Staph Aureus
- Strep Pneumonia
- Anaerobes e.g. Fusobacterium (teeth)
- Bartonella - cat scratch disease
- Note - Toxoplasmosis is a parasitic infection not a bacteria!
Name the 4 main viral causes of cervical lymphadenopathy
- Adenovirus
- Rhinovirus
- Coxsackie viruses A and B
- EBV
Name the most commonly implicated organism in atypical TB infection
Mycobacterium avium
Outline the 4 most common types of metastatic nodes found in the neck
- Mucosal squamous carcinoma
- Thyroid cancer
- Salivary gland cancer
- Skin cancer (squamous or melanoma)
Recall the 5 main types of cancer which may metastasise to the cervical lymph nodes
- Breast
- Stomach
- Lung
- Pancreas
- Thyroid
Recall the cell types that characterised Hodgkin’s and Non Hodgkin’s lymphoma respectively
Hodgkin’s - Reid Sternberg cells
Non Hodgkin’s - Diffuse or nodular abnormal lymphocytes
Give an example of a low grade non hodgkin’s lymphoma
Follicular lymphomas
Give 2 examples of high grade non hodgkin lymphomas
- Diffuse large B cell lymphoma
2. Burkitt’s lymphoma
Outline the 4 clinical stages of lymphoma
Stage 1 - One group of lymph nodes is affected
Stage 2 - Two or more groups of nodes are affected, but the lymphoma is restricted to one side of the diaphragm only
Stage 3 - Lymphadenopathy is evident both above and below the diaphragm
Stage 4 - The lymphoma has spread beyond the lymph nodes to other organs e.g. Spleen, bone marrow, liver or lungs
Define Reed-Sternberg cells
Large cells that are either multinucleated cells or have bilobed nuclei - characteristically seen in Hodgkin’s lymphoma
Outline the bimodal distribution of Hodgkin’s Lymphoma
Seen in patients between 15-30 years of age or those older than 50 yrs
Outline the 4 principle histological stages of Hodgkin’s lymphoma
- Lymphoctye predominant
- Nodular sclerosis
- Mixed cellularity
- Lymphocyte depleted
What is the most common symptom associated with Hodgkin’s lymphoma?
Painless lymphadenopathy
Recall the ‘B symptoms’
- Fever
- Weight loss
- Night sweats
Define the term leukaemia
Malignant neoplastic process involving one of the white blood cell lines
Myeloid leukaemia involved what type of white blood cell?
Neutrophils
Name the 2 most common forms of leukaemia in children and young adults
AML - Acute myeloid leukaemia
ALL - Acute lymphocytic leukaemia
Suggest 3 potential risk factors for the development of lymphoma
- Family history
- Reduced immunity
- Infection (EBV)
Suggest 4 differentials for the development of purpuric/echymotic rashes
- TTP - Thrombotic thrombocytopenic purpura
- HUS - Haemolytic uraemia syndrome
- Infections e.g. meningioccocal sepsis
- Haemotalogical malignancy e.g. leukaemia
Name the immunotherapy agent used in the treatment of diffuse large B cell lymphoma
Rituximab
What are the FBC derangements associated with multiple myeloma?
- Anemia
2. Thrombocytopenia
Briefly outline the classical presentation of multiple myeloma
Older patient with significant back pain that is associated with anemia and hypercalcaemia
What are Bence Jones proteins?
Monoclonal globulins that may be detected in the urine and are pathognomonic of multiple myeloma
