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Hodgkin Lymphoma Flashcards

1
Q

What are Hodgkin lymphoma

A

Lymphoid neoplasms affecting lymph node

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2
Q

Macro Hodgkin lymphoma

A

Large dysplastic mononuclear and multi ulcerated cells

Surrounded by mixture of mature non neoplastic inflammatory cells

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3
Q

Is lymphadenopathy common in Hodgkin lymphoma

A

Yes

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4
Q

Who discovered Hodgkin lymphoma

A

Thomas Hodgkin

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5
Q

Who discovered the abnormal cell that defines Hodgkin lymphoma

A

Dorothy reed

Carl sternberg

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6
Q

Key characteristics of Hodgkin lymphoma

A

R-S cells presence in cancerous areas
B cell origin cancerous cells
EBV in 40-50% cases
Overproduction of IL-13

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7
Q

What are R-S cells

A

Bi or multinucleated cells

Each nucleus contains one prominent nucleolus

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8
Q

Are all Hodgkin’s cells multinucleated

A

No only R-S

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9
Q

What cells do you see in lymph node with Hodgkin lymphoma

A 
Tumor cells 
Réactive lymphocytes
Plasma cells
Macrophages 
Neutrophils 
Eosinophils
Fibrosis
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10
Q

Incidence higher in women or men

A

Men

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11
Q

Peaking age of Hodgkin lymphoma

A

Third decades

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12
Q

Main type of Hodgkin lymphoma

A

Classical HD - 90%

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13
Q

Peak age for classical Hodgkin lymphoma

A

15-35

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14
Q

Type of Hodgkin lymphoma that tend to occur in young adults

A

Nodular sclerosis Hodgkin lymphoma

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15
Q

Occupational hazard that lead to Hodgkin lymphoma

A

Wood dust
Benzene exposure
Nitrous oxide in dental anesthetics

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16
Q

Virus that is associated with Hodgkin lymphoma

A

EBV

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17
Q

Type of Hodgkin lymphoma with highest incidence of EBV

A

Mixed cellularity Hodgkin lymphoma

18
Q

Type of population with Hodgkin lymphoma most affected by EBV

A

Children and elderly with mixed cellularity

19
Q

Genes associated with Hodgkin lymphoma

A

T(14;18)

BCL2 protein in R-S cells

HIV virus

20
Q

How much does HIV elevates risk of Hodgkin lymphoma

21
Q

Why are molecular studies difficult in Hodgkin lymphoma

A

R-S malignant cells comprise less than 2% of total cells in nodes of Hodgkin lymphoma

22
Q

Method used to find point putation in P53 in Hodgkin lymphoma

23
Q

Cytokines that increase in Hodgkin lymphoma

A

IL1-9
TGF-beta
TNF

24
Q

Clinical features of Hodgkin lymphoma

A

Peripheral lymphadenopathy
Spread through lymph
B symptoms - night sweats, fever, weight loss
Alcohol induced pain in affected lymoh node
Cough , chest pain, dysnoea ( young patients)

25
2 types of Hodgkin lymphoma based on immunochemistry and morphology
Classical HL - 90% | Nodular lymphocyte predominant Hodgkin lymphoma
26
Histo logical classsifiation of Hodgkin lymphoma
Lymphocyte rich - 5% Nodular sclerosing- 70% Mixed cellularity - 20-25% Lymphocyte depleted- less than 2%
27
What is lymphocyte rich Hodgkin lymphoma
Infiltrate with small lymphocyte , few eosinophils, R-S cells , mononuclear cells
28
What is nodular sclerosing Hodgkin lymphoma
Broad bands of connective tissue divide lymph node into nodules Mixture of R-S, mononuclear H cells, plasma cells, macrophages, eosinophils
29
What is mixed cellularity Hodgkin lymphoma
Infiltrate of same cells like other types with a lot of R-S cells Focal necrosis Fibrosis
30
Lymphocyte depleted Hodgkin lymphoma
High mononuclearr hogdkin cells R-S present Few lymphocytes
31
In which stage of Hodgkin lymphoma do you mostly see lymphocyte depleted Hodgkin lymphoma
III or IV
32
Is lymphocyte depleted Hodgkin lymphoma common in HIV + patients
Yes
33
Staging of Hodgkin lymphoma
34
Diagnosis of Hodgkin lymphoma
``` History Physical exam Lymph node biopsy FBC comment Bone marrow staging LDH Uris acid Spleen size imaging to see involvement Cx ray - intrathoracic involvement CT chest , abdomen , pelvis - extranodal pulmonary involvement ```
35
Prognosis worse for male or female
Male
36
Poor prognosis marker
``` Male Old age , more than 50 yo Advanced disease Low albumin Anemia ```
37
Treatment Hodgkin lymphoma
Chemotherapy | Radiotherapy
38
Treatment of choice in combination chemotherapy for advanced disease Hodgkin lymphoma
``` ABVD Adriamycin Bleomycin Vincristine Darcabazine ```
39
COPP combination chemotherapy consists of
Cyclophosphamide Oncovin Prednisolone Procabazine
40
What do you give in relapses or refractory disease
Brentuximab -CD 30 directed antibody
41
How can you evaluate response to treatment
``` Clinical examination Abnormal investigation Évaluation after 3-4 courses of chemotherapy Palpation for masses, lymph noes Pet scan for residual disease ```
42
Percentage of patients with Hodgkin lymphoma that can be cured
85%

Hematology (24 decks)

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