Haematology 9: Lymphoma 2 Flashcards
Why is doing Hepatitis B serology important if you suspect a patient has Lymphoma ?
Treatment for the lymphoma will likely deplete B cells and this can cause reactivation of hepatitis B and cause fulminant liver failure
Which protein is over-expressed in Follicular lymphoma and can be stained for in germinal centres ?
Bcl2
Which NHL is associated with chronic antigen stimulation e.g by viruses ?
Marginal zone lymphomas
Give 4 examples of Marginal zone lymphomas and the organism/disease that is associated with it ?
Parotid lymphoma- Sjögren’s syndrome
Gastric MALToma - H.pylori
Thyroid lymphoma - Hashimoto’s thyroiditis
Lacrimal gland lymphoma - Psittaci infection
A patient presents with dyspepsia and epigastric pain. Urea breath testing shows likely H.Pylori infection. Which lymphoma is this patient at risk of ?
Gastric MALToma (marginal zone lymphoma -NHL)
Which T cell marker is expressed in CLL that would not be expressed in normal B cells ?
CD5
Which CD marker is associated with poor prognosis in CLL ?
CD38
Which carries a better prognosis for CLL ?
A) IgH mutated
B) IgH unmutated
A) IgH mutated
Normally B cells only have mutated heavy chains (IgH) after they undergo somatic hypermutation (VDJ recombination) at germinal centres. Mutated heavy chains mean that the B lymphocyte has been selected for its affinity for a particular antigen. In CLL patients 50% have unmutated heavy chains and this is a much worse prognosis
Which Chromosomal abnormality has the words prognosis in CLL ?
17p-
This deletion causes deletion of the P53 tumour suppressor gene
What is a Richter transformation ?
The transformation of CLL into a more aggressive lymphoma, most commonly diffuse large B cell lymphoma
In Richter’s transformation CLL most commonly transforms into ………
Diffuse large B cell lymphoma
Why do CLL patients require irradiated blood products ?
They are at risk of transfusion associated graft versus host disease
What is the 1st line treatment of CLL ?
FCR- Fludarabine, cyclophosphamide and Rituximab
name the characteristic 1-2 week cyclical fever seen in lymphomas ?
Pel Ebstein fever
What is the treatment for Hodgkin’s lymphoma
ABVD
Adriamycin
Bleomycin
Vinblastine
Dacarbazine
