Hodgkin's and Non-Hodgkin's Lymphoma (HL / NHL)

Question 1

Are there Reed-Sternberg cells present in hodgkin’s lymphoma?

Answer 1

Yes! They are characteristic cells with mirror-image nuclei.

They are NOT present in Non-Hodgkins (no reed-sternberg no hodgkins)

Question 2

What is Hodgkin’s lymphoma?

Answer 2

Where there is uncontrolled proliferation of lymphocytes.

Question 3

What demographics are most likely to suffer from uncontrolled proliferation of lymphocytes?

Answer 3

Young Adults

Elderly

Question 4

What is the Male to Female ratio of sufferers with Hodgkin’s Lymphoma?

Answer 4

2:1

male : female

(twice as common in males)

Question 5

What is the 5 year survival rate for Hodgkin’s stage IV Lymphoma without symptoms?

Answer 5

95%

Question 6

What is the 5 year survival for patients with Hodgkin’s stage IV Lymphoma WITH symptoms?

Answer 6

<40%

Question 7

What are the stages of hodgkin’s lymphoma?

Answer 7

Stage I

Stage II

Stage III

Stage IV-A

Stage IV-B

Question 8

What are the B stage symptoms of hodgkin’s lymphoma? (3)

Answer 8

1) Fever
2) Night Sweats
3) Weight Loss

Question 9

How does Hodgkin’s lymphoma present in patients?

Answer 9

• Lymphadenopathy (75% of cases)
• Systemic Symptoms (25% of cases)

Question 10

What are the clinical signs of Hodgkin’s Lymphoma? (4)

Answer 10

Cachexia

Anaemia

Splenomegaly

Hepatomegaly

Question 11

What investigations do we conduct for hodgkin’s lymphoma?

Answer 11

1. Lymph Node Biopsy (assisted with imaging)
2. Bloods

Question 12

What blood tests do we take for hodgkin’s lymphoma? (7)

Answer 12

• Full Blood Count
• Blood Film
• LFT
• LDH (lactate dehydrogenase)
• Urate
• Calcium
• ESR
  
  • N.B. if ESR Raised (or Hg lowered) this suggests a poor prognosis

Question 13

What is the name of staging for Hodgkin’s lymphoma?

Answer 13

Ann Arbor System

Question 14

How do we conduct staging for Hodgkin’s lymphoma?

Answer 14

Through imaging:

CXR

CT

PET-CT

of thorax/abdomen/pelvis

Question 15

How do we treat hodgkin’s lymphoma?

Answer 15

• Chemotherapy
• Radiotherapy
• Preipheral stem-cell transplants

Question 16

What is Non-Hodgkin’s lymphoma?

Answer 16

NHL is the most common type of lymphoma.

it is when there is uncontrolled proliferation of lymphocytes

Question 17

What cell lines are NHLs derived from?

Answer 17

B-cell Lines

(there are no reed-sternberg cells)

Question 18

What causes NHL?

Answer 18

Caused by immunodeficiency.

(i.e. HIV, HTLV-1, H-pylori & medications)

Question 19

What is HTLV-1?

Answer 19

human T-cell leukemia type 1

Question 20

How do NHL present?

Answer 20

• Superficial Lymphadenopathy (75% of cases)
• Extranodal disease

Question 21

What extranodal skin presentation does NHL present with?

Answer 21

T-Cell Lymphomas

Question 22

What extranodal oropharynx presentation does NHL present with?

Answer 22

Sore throat that can obstruct breathing.

(Waldeyer’s Ring Lymphoma)

Question 23

What extranodal gut presentations does NHL present with? (3)

Answer 23

• Gastric MALT (mucosa-associated lymphoid tissue)
• Non-MALT gastric symptoms
• Small bowel lymphomas

Question 24

What are the systemic symptoms associated with Non-hodgkin’s lymphoma?

Answer 24

Fever

Night Sweats

Weight Loss