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Essential Haematology > Hodgkin's Lymphoma > Flashcards

Hodgkin's Lymphoma Flashcards

1
Q

What are lymphomas

A

Lymphomas are a group of diseases caused by malignant lymphocytes that accumulates in lymph nodes and cause a characteristic clinical features of lymphadenopathy

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2
Q

Group of diseases caused by malignant lymphocytes that accumulates in lymph nodes and cause a characteristic clinical features of lymphadenopathy

A

Lymphomas

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3
Q

True or false occasionally lymphomas may spill over into blood (leukemic face) or infiltrate organs outside the lymphoid tissue

A

True

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4
Q

What are the two major subdivisions of lymphomas

A

Non-Hodgkin’s lymphoma and Hodgkins lymphoma

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5
Q

What is the main histological difference between Hodgkins and Non-Hodgkins Lymphoma

A

The presence of Reid Sternberg cells in Hodgkins lymphoma

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6
Q

Define Hodgkin’s disease

A

This is a lymphoma in which Reid Sternberg cells are found in the disease tissue

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7
Q

Which virus genome has been detected in 50% or more of cases in Hodgkins tissue

A

Epstein bar virus

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8
Q

What is the peak incidence of Hodgkins Lymphoma

A

Young adults

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9
Q

What is the gender predominance of Hodgkin’s disease

A

2 : 1 male predominance

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10
Q

True or false

Hodgkin’s disease can present at any age but is rare in children

A

True

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11
Q

Describe the lymph nodes that most patients with Hodgkins lymphoma present with

A 
Painless
Nontender
Asymmetrical 
Firm 
Discrete
Rubbery enlargement of superficial lymph nodes
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12
Q

Hodgkin’s lymphoma in which group of nodes present in 60 to 70% of patients

A

Cervical nodes

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13
Q

Hodgkin’s lymphoma in which group of nodes present in 10-15% of patients

A

Axillary Nodes

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14
Q

Hodgkin’s lymphoma in which group of nodes present in 6-12% of patients

A

Inguinal Nodes

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15
Q

Splenomegaly occurs during the course of Hodgkin’s disease in what percent of patients

A

50%

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16
Q

List some clinical features of Hodgkin’s disease

A

Clinical splenomegaly
Cutaneous Hodgkins Disease (late stage)
Constitutional symptoms: fever, pruritis, alcohol induced pain

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17
Q

What is the colour and size of RNCs in Hodgkins Disease

A

Normochromic

Normocytic

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18
Q

What blood line is increased in 1/3rd of pts with Hodgkin’s lymphoma

A

Neutrophilia

Neutrophils

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19
Q

What is the platelet count during early Non Hodgkins disease

A

Normal or increased

Reduced in later stages

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20
Q

What is the ESR and C reactive protein levels in Hodgkins disease

A

Raised

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21
Q

What is serum lactate dehydrogenase (LDH) levels in Hodgkins Disease

A

Raised in 30-40% of cases

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22
Q

How is the diagnosis of Hodgkins Disease made

A

Histological Examination of an excised lymph node

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23
Q

What are the five classic Hodgkin’s lymphoma classifications

A 
Nodular Sclerosis
Mixed Cellularity
Lymphocyte depleted
Lymphocyte rich
Nodular Lymphocyte pre- dominant
24
Q

What are the most frequent types of Hodgkin’s lymphoma

A

Nodular Sclerosis

Mixed Cellularity

25
Q

Which type of Hodgkin’s lymphoma has the most favorable prognosis

A

Nodular Lymphocyte predominant

26
Q

True or false nodular lymphocytes predominant shows Reed Sternberg Cells

A

False it also has many features of non-Hodgkin’s lymphoma and may be treated as such

27
Q

Describe Hodgkin’s lymphoma with mixed cellularity

A

The Reed Sternberg cells are numerous and lymphocytes numbers are intermediate

28
Q

The Reed Sternberg cells are numerous and lymphocytes numbers are intermediate

A

Hodgkins “Mixed Cellularity “
3rd highest related to EBV, 1st is Lymphocyte depleted

29
Q

Describe “nodular lymphocyte predominant” Hodgkin’s disease

A

Reed-Sternberg cells are absent and abnormal polymorphic B cells are present

30
Q

Reed-Sternberg cells are absent and abnormal polymorphic B cells are present

A

“nodular lymphocyte predominant” Hodgkin’s disease

31
Q

Describe” lymphocytes rich” Hodgkin’s lymphoma

A

Scanty Reed Sternberg cells

Multiple small lymphocytes with a few eosinophils and plasma cells

32
Q

Scanty Reed Sternberg cells

Multiple small lymphocytes with a few eosinophils and plasma cells

A

“lymphocytes rich” Hodgkin’s lymphoma

33
Q

Describe Nodular Sclerosis Hodgkin’s lymphoma

A

The cellular infiltrates may be off the lymphocyte predominant, mixed Cellularity or lymphocyte depleted type

34
Q

The cellular infiltrates may be off the lymphocyte predominant, mixed Cellularity or lymphocyte depleted type

A

Nodular Sclerosis Hodgkin’s lymphoma

35
Q

Describe lymphocyte depleted Hodgkin’s lymphoma

A

There is either a reticular pattern with dominance of Reed Sternberg cells and sparse numbers of lymphocytes

OR

A diffuse fibrosis pattern where the lymph node is replaced by this ordered connective tissue containing very few lymphocytes

36
Q

There is either a reticular pattern with dominance of Reid Sternberg cells and sparse numbers of lymphocytes

OR

A diffuse fibrosis pattern where the lymph node is replaced by this ordered connective tissue containing very few lymphocytes

A

lymphocyte depleted Hodgkin’s lymphoma

37
Q

The selection of appropriate treatment of Hodgkin’s disease, depends on what?

A

Accurate staging of the extent of disease

38
Q

How is staging of Hodgkin’s disease performed

A

By thorough clinical examination together with chest x-ray and CT scan/PET scan to detect intrathoracic intra-abdominal or pelvic disease

39
Q

Describe stage 1 Hodgkin’s lymphoma

A

Indicates node involvement in one lymph node area

40
Q

Which stage of Hodgkin’s disease is this

“Indicates node involvement in one lymph node area”

A

Stage 1

41
Q

Describe stage II Hodgkin’s disease

A

Indicates disease involving two or more lymph nodal areas confined to one side of the diaphragm

42
Q

Which stage of Hodgkin’s disease is this

“Indicates disease involving two or more lymph nodal areas confined to one side of the diaphragm “

A

Stage II Hodgkins

43
Q

Describe stage III Hodgkin’s disease

A

Disease involving lymph nodes above and below the diaphragm

44
Q

Which stage of Hodgkin’s disease is this

“Disease involving lymph nodes above and below the diaphragm”

A

Stage III

45
Q

Describe stage IV Hodgkin’s disease

A

Indicates involvement outside the lymph node areas and refers to diffuse or disseminated disease in the bone marrow, liver and other extra nodal sites

46
Q

The Hodgkin’s stage number in all four cases is followed by the letter A or B what do tgese letters indicate

A

Absence (A) or presence (B) of one or more of the following:

Unexplained fever >38o C
Night sweats
Loss of >10% of body weight within 6 mths

OR

Whether or not constitutional symptoms are present

47
Q

What are Hodgkin’s patients with lymph node and splenic involvement staged as

A

IIIs

48
Q

How is localized Hodgkin’s extranodal extension from a mass of nodes indicated

A

By subscript E

49
Q

What is the treatment for Hodgkin’s lymphoma

A

Radiotherapy
Chemotherapy
Or a combination of both

50
Q

Patients with Stage I and IIA Hodgkins disease may be cured by what treatment

A

Radiotherapy alone

51
Q

Describe combination therapy for Hodgkin’s disease

A

Allows short courses of chemotherapy to be combined with reduced levels of radiotherapy and the most effective combinations are being assessed in clinical trials

52
Q

What type of Chemotherapy is used to treat Stage III and Stage IV Hodgkin’s disease

A

Cyclical chemotherapy

53
Q

What types and stage sof Hodgkin’s disease is treated by Cyclical Chemotherapy

A

STAGE III and IV

STAGE I and II pts who have bulky disease/ type B symptoms or relapse

54
Q

What combination of drugs is used to treat Hodgkin’s disease in Cyclical Chemotherapy

A

Combination of Adriamycin
Bleomycin
Vinblastine
Dacarbazine

55
Q

Describe the Reed Sternberg cell

A 
Binucleate 
Thick nuclear envelope 
Perinucleolar halo
Large eosinophilic nucleoli
Abundant amphophilic cytoplasm
56
Q

What are three Reed Sternberg cell variants

A

Mononuclear (Hodgkin’s) cell
Lacunar cell
“Popcorn” cell

57
Q

List six differential diagnosis of Hodgkins disease

A 
Infectious mononucleosis 
Immunoblastic lymphadenopathy
Post vaccination
Dilantin hypersensitivity 
Sinus histiocytosis with massive lymphadenopathy 
ATL

Essential Haematology (14 decks)

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