Haematology: Introduction to Lymphoid Malignancies Flashcards
What is lymphoma?
- A group of cancers that affect lymphocytes
- They mainly affect B lymphocytes but can also affect T lymphocytes
What are the main functions of the lymphatic system?
- Blood filtration/purification
- Removal of excess fluids from tissues
- Absorption and transport of lipids
- Immune system activation
The lymphatic system contains lymph organs. What are the different types of lymph organ?
- Primary lymph organ - sites where stem cells can divide and become immunocompetent (have ability to produce normal immune response)
- Secondary lymph organ -
Name the primary lymph organs
- Thymus
- Bone marrow
Name the secondary lymph organs
- Lymph nodes
- Spleen
- Appendix
- Tonsils and adenoids
- Peyer’s patches
Briefly explain the effect how lymphoma has on lymphocytes and the effects this has on other organs
- Lymphocytes affected as a result of lymphoma begin to undergo uncontrolled cell division
- Uncontrolled cell division leads to lymph organ enlargement, e.g. lymph nodes (adenopathy) or spleen (splenomegaly)
- Lymphoma cells can then travel from lymph organs and affect other tissues, e.g. liver, bone marrow or lungs
What other things can cause adenopathy apart from lymphoma?
- Autoimmune response
- Infection
Why does it become difficult to identify what type of blood cancer a person has if lymphoma imflitrates into the bone marrow?
- Lymphoma cells won’t be present in lymphatic system and will be in bone marrow instead
- This means that lymphoma may be identified as leukaemia because the lymphoma cells from bone marrow will eventually be released into blood and be detectable there
What are the 2 main types of lymphoma?
- Hodgkin’s lymphoma
- Non-Hodgkin’s lymphoma
What are some of the common symptoms of lymphoma?
- Swelling of the face and neck
- Lumps on the neck, armpit or groin
- Excessive sweating, especially at night
- Feeling of weakness
What are some of the ways in which lymphoma can be diagnosed?
- Lymph node biopsy - lymph sample taken is then viewed under microscope to determine which type of lymphoma a persopn has (Hodkins or Non-Hodgkin’s)
- The following techniques are all used to dteremine the sub-type of lymphoma:
- Immunophenotyping
- Next generation sequencing (NGS)
- Fluorescence in situ hybridisation (FISH)
- Flow cytometry
What other techniques can be used to determine the type of treatment used against lymphoma?
- Staging of lymphoma using positron-emission tomography (PET) also used to determine course of treatment
Explain the concept of staging using PET
- Staging is used to classify lymphoma into different stages based on how much the lymphoma has spread
- PET is used to determine how much the lymphoma has spread throughout the body
- There are 4 stages:
- Stage 1 - Localised, only one lymph node affected
- Stage 2 - Two or more lymph nodes affected on same side of diaphragm
- Stage 3 - Two or more lymph nodes affected on different sides of diaphragm
- Stage 4 - Widespread, multiple organs affected
What are the causes of lymphoma?
- Causes mostly unknown but it is a multifactorial disorder.
- Some of the causes may include:
- Malfunctioning of the body’s immune system
- Exposure to certain infections
Non-hogdkin’s lymphoma can be further classified into two main subtypes. What are these subtypes?
- Mature B-cell neoplasms
- Mature T-cell and natural killer (NK) neoplasms
What is Hodgkin’s lymphoma?
- Clonal B-cell malignancy
What is the main symptom of Hodgkin’s lymphoma?
- Non-painful enlarged lymph nodes (adenopathy)
Name some of the risk factors of Hodgkin’s lymphoma
- Epstein-Barr virus (50% of cases due to virus)
- Family history
- HIV/Aids
What is the main feature of Hodgkin’s lymphoma?
- Presence of Reed-sternberg cells (abnormal B lymphocytes) in lymph
What are some of the characteristics of Reed-sternberg cells?
- Very large compared to normal B lymphocytes
- Contain 2 nuclei