Hodgkin's Lymphoma Flashcards
What are lymphomas?
A group of cancers that affect the lymphocytes inside the lymphatic system.
What happens in the lymph nodes?
These cancerous cells proliferate within the lymph nodes and cause the lymph nodes to become abnormally large (lymphadenopathy).
What are the 2 main categories of lymphoma?
Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma
What type of disease is Hodgkin’s lymphoma?
Specific disease
What type of disease is non-hogkins’s lymphoma?
It encompasses all other lymphomas
What is Hodgkin’s lymphoma characterised by?
The presence of Reed-Sternberg cells
What are the age distributions of Hodgkin’s lymphoma?
Bimodal age distribution
Around 20 and 75 years
What are the main risk factors of Hodgkin’s lymphoma?
- HIV
- Epstein-Barr Virus
What is the main presentation of Hodgkin’s lymphoma?
Painless lymphadenopathy- non-tender, rubbery, asymmetrical lump
Where does the painless lymphadenopathy tend to present in Hodkin’s lymphoma?
Cervical (main)
Axilla (armpit)
Inguinal (groin) region.
What is another term for the systemic symptoms?
Constitutional or B symptoms
What are the systemic symptoms of Hodgkin’s lymphoma?
- Fever
- Weight loss
- Night sweats
- Itching
What is the key diagnostic test for Hodgkin’s lymphoma?
Lymph node biopsy
What would you find in a lymph node biopsy with Hodgkin’s lymphoma?
Reed-Sternberg cell
What are Reed-Sternberg cells?
Abnormally large B cells that have multiple nuclei that have nucleoli inside them.
This can give them the appearance of the face of an owl with large eyes.
What additional investigations could you do for Hodgkin’s lymphoma?
Blood test- Raised LDH
CT, MRI, PET for staging
What staging system is used for Hodgkin’s and non-Hodgkin’s lymphoma?
Ann Arbor Staging
What is stage 1 of Ann Arbor staging?
single lymph node affected
What is stage 2 of Ann Arbor staging?
2 or more lymph nodes/regions on same side of diaphragm
What is stage 3 of Ann Arbor staging?
nodes on both sides of diaphragm affected
What is stage 4 of Ann Arbor staging?
Spread beyond lymph nodes
How is end stage lymphoma classified?
Classified as either A or B
What is subdivision A of end stage lymphoma?
No systemic symptoms other than pruritus
What is subdivision B of end stage lymphoma?
Weight loss > 10% in last 6 months
Fever > 38c
Night sweats (poor prognosis)
What is the main treatment of Hodgkin’s lymphoma?
Chemotherapy
What are the possible risks of chemotherapy?
Leukaemia
Infertility
What are the possible risks of radiotherapy?
Damage to tissues
Hypothyroidism.
What can cause pain in teh lymph node in someone with hodgkin’s lymphoma?
Alcohol induced lymph node pain
What is the most common type of hodgkin’s lymphoma?
Nodular sclerosing
Which form of hodgkin’s lymphoma has the best prognosis
Lymphocyte predominant
Which form of hodgkin’s lyphoma has the worst prognosis?
Lymphocyte depleted
Which form of hodgkin’s lymphoma is associated with a large number of reed-sternburg cells?
Mixed cellularity
Which symptoms indicate a poor prognosis in someone with hodgkin’s lymphoma?
B symptoms:
–weight loss > 10% in last 6 months
–fever > 38ºC
–night sweats
What other features would indicate a poor prognosis in soemone with hodgkin’s lymphoma?
age > 45 years
stage IV disease
Male
What is another possibel symptom of hodgkin’s lymphoma?
Mediastinal mass
What chemotherapy regime is used for Hodgkin’s lymphoma?
ABVD
or
BEACOPP