Hodgkin Lymphoma Flashcards
What are the different types of Lymphoma? (2 things)
- Hodgkin Lymphoma (HL)
- Non-Hodgkin Lymphoma (NHL)
What is specific about Hodgkin Lymphoma (HL)?
Characterised by presence of Hodgkin / Reed-Sternberg cells (2 different types of cell)
What is HL?
Haematological malignancy arising from B lymphocytes in lymphatic system
How many people are diagnosed with HL in UK / year?
2,100
What is the peak age for HL?
20-34 years old
What is the prognosis of HL?
Good, 75% survive 10+ years
What is the pathophysiology of HL?
B lymphocytes mutate into 2 types of cell:
1. Hodgkin cells (large mono-nucleated cells)
2. Reed-Sternberg cells (large multi-nucleated cells)
How is HL classified? (2 things)
- Classical HL (95%)
- Nodular lymphocyte-predominant HL (5%)
How is Classical HL further classified? (4 things)
- Nodular sclerosis (70%)
- Mixed cellularity
- Lymphocyte-rich (best prognosis)
- Lymphocyte-depleted (rare) (worst prognosis)
What are the RF for HL? (4 things)
- HIV
- EBV
- AI conditions (e.g RA / sarcoidosis)
- FHx
What are the CF of HL? (7 things)
- Lymphadenopathy (most common)
- “B” symptoms (Fever + Night sweats + WL)
- Malaise
- Fatigue
- Mediastinal mass
- Pruritis
- Hepatosplenomegaly
What are the lymph nodes like in Lymphadenopathy in HL? (3 things)
- Painless
- Firm
- Enlarged
Where is the Lymphadenopathy most commonly found in HL?
Neck
What are the complications of Mediastinal mass (enlarged lymph nodes in mediastinum) in HL?
Compress airway –> SOB + Chest pain
What investigations should you do for sus HL? (2 things)
- Lymph node biopsy (GOLD)
- Bloods
What bloods should you do for sus HL? (4 things)
- FBC
- ESR (raised)
- LDH (raised)
- Viral screen (Hep B/C, HIV)
What signs of HL are you looking for in FBC? (4 things)
- Anaemia
- Lymphopenia
- Thrombocytopaenia
- Neutropenia (poor prognosis)
What level of ESR indicates a poor prognosis of HL?
50+
What investigations help with Staging HL? (3 things)
- PET
- CT
- MRI
What is the staging system used for HL?
Ann Arbor staging system
(used for non-HL a well)
What are the stages of the Ann Arbor staging system for HL? (4 stages)
- Stage 1: Confined to 1 region of lymph nodes
- Stage 2: In 2+ regions but on same side of diaphragm (above / below)
- Stage 3: In regions above AND below diaphragm
- Stage 4: Spread to NON-lymphatic organs e.g liver / lungs
What is the main Mx options for HL?
Chemo + Radio
Is Chemo + Radio usually successful in Tx of HL?
Yes
What are the risks after treating HL? (3 things)
- Relapse
- Other haematological cancers
- Meds side fx
What are the possible Side Fx of the Chemo used for HL? (2 things)
- Leukaemia
- Infertility (50%)
What are the possible Side Fx of Radio? (3 things)
- Cancer
- Tissue damage
- Hypothyroidism (50%)
