Haematology - Cancer Flashcards
what is myeloma?
a malignancy of plasma cells
what produces antibodies?
plasma cells
what is a paraprotein?
increased monoclonal Ig production (due to myeloma usually)
features of myeloma?
lytic bone lesions (back pain) marrow failure renal failure hypercalcaemia anaemia
why does renal failure occur in myeloma?
Tamm Horsfall protein produced
combines with free light chains
insoluble casts produced with cause a cast nephropathy
Ix for myeloma? results?
FBC (anaemia) Ca (high) U+Es/creatinine urine electrophoresis serum electrophoresis CT/MRI
Tx for myeloma?
chemo and remission
bisphosphonates
opiates
(symptomatic relief and monitoring by paraprotein level)
what is MGUS?
high paraprotein with no evidence of myeloma/organ damage
higher risk of developing myeloma
what happens in amyloidosis?
light chains produced precipitate in tissues to form an insoluble beta pleated sheet (amyloid)
features of amyloidosis?
nephrotic syndrome cardiomyopathy hepatomegaly neuropathy wt loss fatigue malabsorption
risk factors for amyloidosis?
MGUS
FHx
inflam conditions
IBD
Ix for amyloidosis?
organ biopsy with congo red staining - shows apple green birefringence under polarised light
SAP scan
who gets waldenstrom’s macroglobulinaemia?
old men
what happens in waldenstrom’s macroglobulinaemia?
disorder of cells that are an intermediate between lymphocyte and plasma cell
IgM paraprotein produced
features of waldenstrom’s macroglobulinaemia?
wt loss
hepatosplenomegaly
raynaud’s
bruising
who gets AML? features?
old
Ix and results for AML?
marrow failure
DIC
blood film = excess myeloblasts
auer rods
who gets CLL? features and Ix?
elderly
lymphadenopathy
elevated WBC
who gets ALL? features? Ix?
kids
anaemia, infections, bleeding, bone pain
blood film = excess lymphoblasts
what is CML?
myeloproliferative disorder of bone marrow cells
RBC, granulocytes, platelets
what genetic mutation is assoc with CML?
BCR- ABL1
philadelphia chromosome
what are features of CML?
gout
splenomegaly
thrombosis
hypermetabolic
Ix and Tx for haematological malignancies?
immunophenotyping
chemo
what is hodgkin’s lymphoma a disease of?
B cell disease
Ix for hodgkin’s lymphoma? what virus is associated?
blood film = reed sternberg cells
EBV
what is Non hodgkin’s lymphome a disease of? Tx?
B or T cells
RCHOP chemo
what are features of lymphoma?
night sweats infections wt loss itch fatigue alcohol induced pain lymphadenopthy
what does lymphoma lymphadenopathy feel like?
rubbery smooth non tender non inflamed non tethered
Ix for lymphoma?
biopsy
CT
