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Path Y > Haematology - Lymphoma 2 > Flashcards

Haematology - Lymphoma 2 Flashcards

1
Q

How do Reed Sternberg cells appear on the blood film?

A

Giant cell surrounded by reactive eosinophils

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2
Q

What is the age distribution of Hodgkin’s lymphoma?

A

young & middle aged

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3
Q

What are the symptoms of Hodgkin’s lymphoma?

A

Painless lymphadenopathy, that becomes painful on drinking alcohol
Constitutional B symptoms
If advanced lymphadenopathy, may –> obstructive symptoms

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4
Q

What is the cause of constitutional B symptoms in lymphoma?

A

Hyper-catabolic state

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5
Q

Which investigation is used to diagnose hodgkin’s lymphoma, and which diagnosis is used for staging?

A

Diagnosis: LN biopsy
Staging: FDG-PET

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6
Q

Recall the different stages of Hodgkin’s lymphoma

A

I: one group of nodes
II: >1 group of nodes, on one side of the diaphragm
III: Nodes on both sides of the diaphragm
IV: extranodal spread
Then:
A: no B symptoms
B: one/ any of fever/ weight loss/ night sweats

ann arbor

(new is lugano)

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7
Q

Which subtype of lymphoma is most likely to affect young women?

A

Nodular sclerosing Hodgkin’s

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8
Q

What type of chemotherapy is used in Hodgkin’s lymphoma?

A

ABVD

Adriamycin,bleomycin,vinblastine and dacarbazine

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9
Q

After how many cycles of chemotherapy for Hodgkin’s lymphoma should the FDG-PET be repeated to check response?

A

2

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10
Q

What is the risk of giving radiotherapy for Hodgkin’s lymphoma?

A

It produces a lot of collateral damage, and when given alongside chemotherapy increases the risk of secondary malignany significantly

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11
Q

Recall 3 bad prognostic markers in CLL

A

LDH raised
CD38 +ve
11q23 del

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12
Q

How aggressive is diffuse large B cell non-Hodgkin’s lymphoma?

A

High grade

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13
Q

How aggressive is follicular non-Hodgkin’s lymphoma?

A

Indolent

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14
Q

How is diffuse large B cell non-Hodgkin’s lymphoma treated?

A

R-CHOP and immunotherapy

R - rituximab

C – cyclophosphamide

H – doxorubicin hydrochloride

O – vincristine (which used to be called Oncovin)

P – prednisolone (a steroid)

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15
Q

What mutation is commonly associated with follicular non-Hodgkin’s lymphoma?

A

t(14;18)
Translocation of Bcl2 –> oncogene

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16
Q

Which subtype of non-Hodgkin’s lymphoma is associated with chronic H. pylori?

A

Extra-nodal marginal zone lymphoma

17
Q

What are the symptoms of extra-nodal marginal zone lymphoma?

A

Epigastric pain, ulceration and bleeding

18
Q

How aggressive is enteropathy-associated non-hodgkin’s lymphoma?

A

Very aggressive

genreally fatal as responds poorly to chemo

19
Q

What is the main association of enteropathy-associated non-hodgkin’s lymphoma?

A

Coeliac

20
Q

What finding on a blood film is typial of CLL?

A

Smear/ smudge cells

21
Q

Recall the surface markers of intermediate B cells vs mature B cells vs CLL mature B cells

A

Intermediate B cell: CD5 positive
normal Mature B cell: CD19 positive, CD5 negative
normal mature T cell: CD19 negative, CD5 positive
Mature CLL B cell: CD5 positive AND CD19 positive

22
Q

What are the 2 staging methods that can be used in CLL?

A

Rai staging
Binet staging

23
Q

How can pre- and post-germinal centre CLL be differentiated?

A

VDJ sequencing

variability, diversity, and joining

24
Q

Which mutation is associated with a particularly poor prognosis in CLL?

A

17p deletion (P53)

25
Q

What is Richter’s syndrome?

A

Rare transformation of CLL to high grade lymphoma

26
Q

2 signs of Richter’s transformation

A

elevated serum levels of lactate dehydrogenase, and rapidly enlarging lymph nodes.

27
Q

give 2 drugs that can be used in CLL if p53 deletion

A

alemtuzumab
ibrutnib - 1st

28
Q

Recall 3 good prognostic markers in CLL

A

hyper mutated Ig gene
low ZAP-70 expression
13q14 del

29
Q

outline the stages of Binet staging

A

A- high WBC, less than 3 groups of enlarged lymph nodes, usually no treatment needed (watchful waiting)

B - more than 3 groups of lymph nodes

C - anaemia or thrombocytopenia

30
Q

why is there an increased risk of infection in CLL

A

although lymphocytes are high, they are monoclonal so not useful for antibody production

normal B cells are suppressed = hypogammaglobulinaemia

31
Q

1st line drug in CLL if p53 intact

A

FCR - Fludarabine, cyclophosphamide and rituximab

32
Q

who does CLL tend to affect

A

old
caucasian
relatives has 7x risk

its an indolent leukaemia, typically picked up in blood test for something else

33
Q

fastest growing human cancer?

A

burkitt’s lymphoma

34
Q

whats an aggressive NHL. whats the treatment

A

diffuse large B cell

treat w Rituximab-CHOP (6-8 cycles)

R - rituximab

C – cyclophosphamide

H – doxorubicin hydrochloride

O – vincristine (which used to be called Oncovin)

P – prednisolone (a steroid)

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