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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
Which type of Hodgkin’s lymphoma has the most favorable prognosis
Nodular Lymphocyte predominant
26
True or false nodular lymphocytes predominant shows Reed Sternberg Cells
False it also has many features of non-Hodgkin’s lymphoma and may be treated as such
27
Describe Hodgkin’s lymphoma with mixed cellularity
The Reed Sternberg cells are numerous and lymphocytes numbers are intermediate
28
The Reed Sternberg cells are numerous and lymphocytes numbers are intermediate
Hodgkins “Mixed Cellularity “ 3rd highest related to EBV, 1st is Lymphocyte depleted
29
Describe “nodular lymphocyte predominant” Hodgkin’s disease
Reed-Sternberg cells are absent and abnormal polymorphic B cells are present
30
Reed-Sternberg cells are absent and abnormal polymorphic B cells are present
“nodular lymphocyte predominant” Hodgkin’s disease
31
Describe” lymphocytes rich” Hodgkin’s lymphoma
Scanty Reed Sternberg cells | Multiple small lymphocytes with a few eosinophils and plasma cells
32
Scanty Reed Sternberg cells | Multiple small lymphocytes with a few eosinophils and plasma cells
“lymphocytes rich” Hodgkin’s lymphoma
33
Describe Nodular Sclerosis Hodgkin’s lymphoma
The cellular infiltrates may be off the lymphocyte predominant, mixed Cellularity or lymphocyte depleted type
34
The cellular infiltrates may be off the lymphocyte predominant, mixed Cellularity or lymphocyte depleted type
Nodular Sclerosis Hodgkin’s lymphoma
35
Describe lymphocyte depleted Hodgkin’s lymphoma
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
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
lymphocyte depleted Hodgkin’s lymphoma
37
The selection of appropriate treatment of Hodgkin’s disease, depends on what?
Accurate staging of the extent of disease
38
How is staging of Hodgkin’s disease performed
By thorough clinical examination together with chest x-ray and CT scan/PET scan to detect intrathoracic intra-abdominal or pelvic disease
39
Describe stage 1 Hodgkin’s lymphoma
Indicates node involvement in one lymph node area
40
Which stage of Hodgkin’s disease is this “Indicates node involvement in one lymph node area”
Stage 1
41
Describe stage II Hodgkin’s disease
Indicates disease involving two or more lymph nodal areas confined to one side of the diaphragm
42
Which stage of Hodgkin’s disease is this | “Indicates disease involving two or more lymph nodal areas confined to one side of the diaphragm “
Stage II Hodgkins
43
Describe stage III Hodgkin’s disease
Disease involving lymph nodes above and below the diaphragm
44
Which stage of Hodgkin’s disease is this | “Disease involving lymph nodes above and below the diaphragm”
Stage III
45
Describe stage IV Hodgkin’s disease
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
The Hodgkin’s stage number in all four cases is followed by the letter A or B what do tgese letters indicate
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
What are Hodgkin’s patients with lymph node and splenic involvement staged as
IIIs
48
How is localized Hodgkin’s extranodal extension from a mass of nodes indicated
By subscript E
49
What is the treatment for Hodgkin’s lymphoma
Radiotherapy Chemotherapy Or a combination of both
50
Patients with Stage I and IIA Hodgkins disease may be cured by what treatment
Radiotherapy alone
51
Describe combination therapy for Hodgkin’s disease
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
What type of Chemotherapy is used to treat Stage III and Stage IV Hodgkin’s disease
Cyclical chemotherapy
53
What types and stage sof Hodgkin’s disease is treated by Cyclical Chemotherapy
STAGE III and IV | STAGE I and II pts who have bulky disease/ type B symptoms or relapse
54
What combination of drugs is used to treat Hodgkin’s disease in Cyclical Chemotherapy
Combination of Adriamycin Bleomycin Vinblastine Dacarbazine
55
Describe the Reed Sternberg cell
``` Binucleate Thick nuclear envelope Perinucleolar halo Large eosinophilic nucleoli Abundant amphophilic cytoplasm ```
56
What are three Reed Sternberg cell variants
Mononuclear (Hodgkin’s) cell Lacunar cell “Popcorn” cell
57
List six differential diagnosis of Hodgkins disease
``` Infectious mononucleosis Immunoblastic lymphadenopathy Post vaccination Dilantin hypersensitivity Sinus histiocytosis with massive lymphadenopathy ATL ```

Essential Haematology (14 decks)

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