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year 5 path > haematology - lymphoma > Flashcards

haematology - lymphoma Flashcards

1
Q

define lymphoma

A

neoplastic tumour of lymphoid tissue found in
- lymph nodes (often)
- other lymphoid tissue (sometimes)
- anywhere (rarely)

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2
Q

Hodgkin’s lymphoma

A

20% of lymphomas
M>F, 20-29 and >60yrs

spreads contiguously to adjacent lymph nodes

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3
Q

Hodgkin’s lymphoma is associated with

A

EBV

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4
Q

clinical presentation of Hodgkin’s lymphoma

A

asymmetrical painless lymphadenopathy
+/- obstructive/mass effect symptoms
FLAWS

mediastinal/cervical nodes
pain in affected nodes after alcohol

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5
Q

investigations for Hodgkin’s lymphoma

A

CT/PET
LN/BM biopsy (cells stain with CD15 and CD30)
blood film (Reed Sternberg cells)

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6
Q

Reed Sternberg cells

A

seen in Hodgkin’s lymphoma

bi-nucleate/multinucleate owl eyed mature lymphocytes

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7
Q

Staging system for Hodgkin’s Lymphoma

A

Ann Arbor

1: 1 LN region
2: 2+ LN regions on same side of diaphragm
3: 2+ LN regions on opposite sides of diaphragm
4: extra nodal sites

A = no constitutional symptoms
B = constitutional symptoms

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8
Q

treatment overview for Hodgkin’s lymphoma

A

combination chemotherapy
radiotherapy
intensive chemo and autologous SCT

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9
Q

combination chemotherapy for Hodgkin’s lymphoma

A

used in most cases

ABVD - adriamycin, bleomycin, vinblastine, and dacarbazine

stage 1/2 = 2-4 cycles
stage 3/4 = 6-8 cycles

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10
Q

radiotherapy for Hodgkin’s lymphoma

A

used in conjunction with chemo in bulky areas or limited disease

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11
Q

caution of radiotherapy for Hodgkin’s lymphoma

A

high risk of breast cancer in women

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12
Q

intensive chemotherapy for Hodgkin’s lymphoma and autologous SCT

A

for relapsed patients

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13
Q

prognosis of Hodgkin’s lymphoma

A

excellent especially if young and intensively treated

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14
Q

Where are stem cells harvested from for a transplant

A

peripheral blood
BM
umbilical cord blood

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15
Q

Collecting stem cells from peripheral blood requires

A

stimulation by G-CSF

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16
Q

SCTs

A

enables high dose chemo/radiotherapy to eradicate malignant cells at the cost of BM ablation

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17
Q

autologous SCTs

A

patient’s own SCs harvested, frozen, and reintroduced

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18
Q

autologous SCTs used in

A

multiple myeloma
lymphoma

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19
Q

benefits of autologous SCTs

A

no graft vs leukaemia effect
no GVHD
lower risk of infection

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20
Q

allogenic SCTs

A

HLA-matched donor SCs harvested and introduced to colonise ‘empty’ BM

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21
Q

risks associated with allogenic SCTs

A

GVHD
opportunistic infections
infertility
secondary malignancies

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22
Q

Non-Hodgkin’s Lymphoma

A

80% of lymphomas
classified according to:
- mature/immature
- histology
- B/T cell lineage

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23
Q

high grade non-Hodgkin’s lymphomas

A

very aggressive: Burkitt’s

aggressive: Diffuse large B cell, Mantle cell

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24
Q

low grade non-Hodgkin’s lymphomas

A

indolent - follicular, marginal zone, small lymphocytic

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25
Q

B cell lymphomas

A

Burkitt’s
Diffuse large B cell (DLBC)
Mantle cell lymphoma
follicular
MALT

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26
Q

T cell lymphomas

A

anapaestic large cell lymphoma
peripheral T cell lymphoma
adult T cell leukaemia/lymphoma
enteropathy associated T cell lymphoma (EATL)
cutaneous T cell lymphoma

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27
Q

Burkitt’s lymphoma

A

aggressive
fast growing
rapidly responsive to treatment

28
Q

Burkitt’s lymphoma histology

A

‘starry sky’ appearance

29
Q

chromosomal abnormality in Burkitt’s lymphoma

A

t(8; 14) translocation
c-myc oncogene overexpression

30
Q

types of Burkitt’s lymphoma

A

endemic
sporadic
immunodeficient

31
Q

endemic Burkitt’s lymphoma

A

EBV associated
most common malignancy in equatorial Africa

32
Q

characteristic features of endemic Burkitt’s lymphoma

A

jaw involvement
abdominal masses

33
Q

sporadic Burkitt’s lymphoma

A

EBV associated found outside Africa

34
Q

immunodeficient Burkitt’s lymphoma

A

non-EBV associated
HIV/post-transplant patients

35
Q

treatment of Burkitt’s lymphoma

A

chemotherapy (rituximab) and leukaemia protocol

36
Q

action of rituximab

A

anti CD20 (found on B cells)

37
Q

Diffuse large B cell lymphoma (DLBC)

A

aggressive
Richter’s transformation

38
Q

DLBCL is most commonly seen among

A

middle aged and elderly

39
Q

Richter’s transformation

A

other lymphomas occur secondary to DLBCL

40
Q

histology of DLBCL

A

sheets of large lymphoid cells

41
Q

treatment of DLBCL

A

R-CHOP
auto-SCT for relapse

42
Q

Mantle cell lymphoma

A

aggressive
disseminated at presentation

43
Q

Mantle cell lymphoma seen in

A

middle aged
more commonly men

44
Q

chromosomal abnormality in mantle cell lymphoma

A

t(11; 14) translocation
cyclin D1 deregulation

45
Q

histology of mantle cell lymphoma

A

angular/clefted nuclei

46
Q

treatment of mantle cell lymphoma

A

R-CHOP
auto-SCT for relapse

47
Q

follicular lymphoma

A

indolant and mostly curable

48
Q

chromosomal abnormality in follicular lymphoma

A

t(14; 18) translocation

49
Q

histology of follicular lymphoma

A

follicular pattern
nodular appearance

50
Q

treatment of follicular lymphoma

A

watch and wait
rituximab/obinutuzumab + CVP

51
Q

MALT lymphoma

A

marginal zone NHL
seen in middle aged

52
Q

aetiology of MALT lymphomas

A

chronic antigen stimulation
- H. pylori (gastric MALT lymphoma)
- Sjogren’s syndrome (parotid MALT lymphoma)

53
Q

treatment of MALT lymphomas

A

remove antigen stimulus
H. pylori triple therapy
chemotherapy

54
Q

t(8; 14) translocation

A

c-myc oncogene overexpression in Burkitt’s lymphoma

55
Q

t(11, 14) translocation

A

cyclin D1 deregulation in mantle cell lymphoma

56
Q

t(14; 18) translocation

A

follicular lymphoma

57
Q

c-myc oncogene overexpression

A

t(8; 14) translocation
Burkitt’s lymphoma

58
Q

cyclin D1 deregulation

A

t(11, 14) translocation
mantle cell lymphoma

59
Q

follicular lymphoma chromosomal mutation

A

t(14; 18) translocation

60
Q

R-CHOP chemotherapy

A

rituximab

cyclophosphamide
doxorubicin hydrochloride
vincristine (oncovin)
prednisolone

61
Q

CVP chemotherapy

A

cyclophosphamide
vincristine sulfate
prednisolone

62
Q

anaplastic large cell lymphoma

A

aggressive
children and young adults
large ‘epithelioid’ lymphocytes
t(2; 5) translocation
alk-1 protein expression

63
Q

peripheral T cell lymphoma

A

aggressive
middle aged and elderly
large T cells

64
Q

adult T cell leukaemia/lymphoma

A

aggressive
seen more commonly in Carribean and Japanse
HTLV-1

65
Q

HTLV-1

A

human T-lymphotropic virus type 1
oncogenic human retrovirus causing ATL

66
Q

EATL

A

enteropathy associated T cell lymphoma
associated with longstanding coeliac disease

67
Q

Cutaneous T cell lymphoma

A

associated with mycosis fungicides

year 5 path (16 decks)

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