haematological malignancies (see DM)

Question 1

what are the main lymph node regions

Answer 1

1. cerviacle;
2. axillary;
3. inguinal;
4. mediastinal;
5. para-aortic;
6. spleen

Question 2

high grade vs low grade

Answer 2

high grade - fast growing, cells are rapidly dividing;
low grade - slow growing

Question 3

“rules of thumb” for high grade lymphomas (7)

Answer 3

1. short history;
2. grows quickly;
3. patient usually symptomatic (B symptoms);
4. treatment always required immediately;
5. potentially curable;
6. intensive chemo to treat;
7. one chance to cure

Question 4

“rules of thumb” for low grade lymphomas (7)

Answer 4

1. often longer or “no” history;
2. grows slowly;
3. patients often asymptomatic
4. treatment often not required (watch and wait);
5. life long illness;
6. less intense chemo for treatment;
7. can treat multiple times

Question 5

what is Ann Arbor staging

Answer 5

staging for lymphoma;
stage 1 - localised disease;
stage 2 - disease in more than one lymph node region on the same side of the diaphragm;
stage 3 - disease above and below the diaphragm;
stage 4 - extra nodal disease

A or B is added respective to whether B symptoms are present (B) or not present (A)

Question 6

what is needed for a lymphoma diagnosis

Answer 6

core biopsy or whole node excision

Question 7

what is Burkitt lymphoma

Answer 7

a very rapidly growing subtype of NHL, the fastest growing tumour known to humans

Question 8

what mutation is Burkitt lymphoma associated with

Answer 8

8 -> 14 chromosome translocation

Question 9

what causes endemic Burkitt lymphoma

Answer 9

epstien-barr virus

Question 10

characteristic of sporadic Burkitt’s lymphoma cells

Answer 10

highly vacuolated

Question 11

what cells are involved in CLL

Answer 11

B lymphocytes

Question 12

what happens to the aggressiveness of the cancer as the cell is more mature

Answer 12

less aggressive the more mature a cell is

Question 13

what mutation occurs in chronic myeloid leukemia

Answer 13

translocation of 9<->22 (philadelphia chromosome)

Question 14

how can CML be tested for using genetics

Answer 14

Fluorescent in situ hybridization (FISH) - looks for t(9:22), the BCR and ABL genes are labeled and in normal individuals these will appear as spearate signals as they are on normal chromosomes, in CML a fusion signal is seen (yellow)

Question 15

ALL vs AML demographic

Answer 15

ALL - children;
AML -adults/elderly