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Cancer Care- Blood Results > Hodgkin's Lymphoma > Flashcards

Hodgkin's Lymphoma Flashcards

1
Q

What is Hodgkin’s Lymphoma?

A
  • This is a cancer of the lymphatic cancer
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2
Q

What are the lymph organs?

A
  • Adenoids
  • Tonsils
  • Thymus
  • Spleen
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3
Q

What is the function of the spleen?

A
  • The spleen acts as a blood filter, it removes the red blood cells and plays a role in the immune response
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4
Q

What is the function of the Thymus?

A
  • The Thymus is responsible for development and maturation of T lymphocyte cells
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5
Q

What is the physiology of lymph nodes?

A
  • Lymph nodes are kidney shaped
  • They play an important role in the immune response to infection
  • Each node contains T lymphocytes, B lymphocyte
  • Lymph nodes enter the node through the afferent lymphatic channels and leaves through the efferent lymphatic channels
  • They are able to mount an immune response if they detect the presence of a pathogen
  • This is why lymph nodes are typically found to be palpable
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6
Q

What are the lymph vessels?

A
  • The lymphatic vessels transport lymph fluid around the body
  • Superficial vessels - arise in the subcutaneous tissue, follow venous flow and drain into the deep vessels
  • Deep vessels - drain the deeper structures of the body, follow the deep arteries
  • drainage of lymph begins in lymph channels to lymph nodes and then lymphatic trunks which are your right lymphatic duct and thoracic duct
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7
Q

What does the right lymphatic duct drain?

A
  • The right upper quadrant part of the body
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8
Q

What does the Thoracic duct drain?

A
  • The remaining part of the body
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9
Q

What is Lymph Fluid?

A
  • Lymph is a transudative fluid (transparent and yellow), it is formed when fluid leaves the capillary bed due to hydrostatic pressure
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10
Q

How much lymphatic fluid does an average adult produce?

A
  • 3/4Litres
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11
Q

What is the composition of lymph?

A
  • Water, proteins, lipids, carbs, ions and lymphocytes
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12
Q

What is Chyle?

A
  • Chyle is lymph that is produced in the GI system
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13
Q

What are the groups of lymph nodes called?

A
  • Neck (cervical)
  • Groin (inguinal)
  • Armpits (axillary)
  • Internal abdominal lymph nodes (Mesenteric/ Retroperitoneal)
  • Chest cavity (mediastinal)
  • Lower Abdomen (pelvic)
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14
Q

What cells are seen under the microscope with Hodgkin’s Lymphoma?

A
  • Reed Sternberg cells
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15
Q

What are Reed Sternberg cells

A
  • These are a type of B lymphocytes which have become cancerous.
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16
Q

What are the different types of Hodgkin’s Lymphoma?

A
  • Classical Hodgkin Lymphoma
  • Nodular lymphocyte predominant Hodgkin Lymphoma
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17
Q

What is the difference between Classical HL and Nodular Lymphocyte predominant HL?

A
  • NLPHL is not very common
  • In NLPHL there are very few Reed- Sternberg cells
  • In NLPHL there are abnormal cells known as Popcorn cells
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18
Q

What is the Classical HL?

A
  • Nodular Sclerosing (most common type of HL, most common type in young adults, usually found at an early stage)
  • Mixed Cellularity (affects a few groups of lymph nodes, contain lymphocytes and other blood cells)
  • Lymphocyte rich (lymphocytes look small)
  • Lymphocyte depleted
19
Q

What is the classification system for Lymphoma?

A
  • Lugano classification
  • Ann Arbor Staging
20
Q

What are B symptoms?

A
  • High temperatures that come and go, often at night
  • heavy sweating at night
  • unexplained weight loss
21
Q

What is Bulky disease?

A
  • A lymph node that is 10cm or more
  • Lymphoma in the mediastinum which is at least a third of the width of your chest
22
Q

What is Stage 1?

A
  • Lymphoma in a single lymph node, or one group of lymph nodes or an organ of the lymphatic system
  • Lymphoma in an extranodal site
23
Q

What is Stage 2?

A
  • Lymphoma in two or more groups of lymph nodes
  • Lymphoma in an extranodal site and one/ more groups of lymph nodes
  • Both side of the diaphragm
24
Q

What is Stage 3?

A
  • Lymphoma is in lymph nodes on both sides of the diaphragm
  • Lymphoma is in lymph nodes above diaphragm/ Lymphoma in an organ of the lymphatic system
25
Q

What is Stage 4?

A
  • Lymphoma is in an extranodal site and lymph nodes are affected
  • Lymphoma is in more than one extranodal site (liver, bones or lungs
26
Q

What are extranodal sites of the lymphatic system?

A
  • Lungs, Liver, Blood, Bone Marrow, Kidneys, Brain and Spinal Cord
27
Q

What is the treatment for Stage 1 HL?

A
  • 2/4 cycles of chemotherapy with/without radiotherapy
28
Q

What is the treatment for Stage 2 HL?

A
  • 2/4 cycles of chemotherapy with/ without radiotherapy
29
Q

What is the treatment for Stage 3 HL?

A
  • 6/8 cycles of chemotherapy
  • Steroids possibly included
  • with/ without radiotherapy
30
Q

What is the treatment for Stage 4 HL?

A
  • 6/8 cycles of chemotherapy
  • Steroids are apart of this
  • with/ without radiotherapy
31
Q

What are the symptoms of HL?

A
  • Painless swelling in the lymph node
  • Heavy sweating
  • High temperatures
  • Weight Loss
  • Itching of the skin worse after alcohol
  • Cough/ SOB
  • Abdominal Pain/ Vomiting after drinking alcohol
  • Nerve pain
  • Swelling in the arms due to blockage of the lymphatic fluid
  • Jaundice of the skin due to blocking of the bile
32
Q

What are the symptoms of HL in the bone marrow?

A
  • SOB/ tiredness = anaemia due to low red blood cell count
  • Increased infections because of low WCC
  • Low platelet count = nosebleeds, very heavy periods, rashes under the skin
33
Q

What are the risks of developing HL?

A
  • Male
  • Age (20-40 and abover 75)
  • Lowered immunity (HIV, SLE, RA)
  • EBV
  • Family History
  • Being Overweight
  • Smoking
34
Q

What investigations are done for Lymphoma?

A
  • Excision biopsy of the lymph node
35
Q

What bloods are done?

A
  • FBC
  • U+E
  • LFTS
  • LDH
  • Uric Acid
  • ESR
  • HIC, Hep B and C
36
Q

What imaging is done for Lymphoma?

A
  • Chest X-ray
  • PET CT (staging)
  • CT neck, chest, abdomen and pelvis
  • MRI
37
Q

What is additional investigations are there?

A
  • LP and CSF analysis
  • ECHO
  • PFTs
  • Bone Marrow Biopsy
38
Q

What is the Chemotherapy Regime for HL?

A
  • ABVD
  • Doxorubicin (A)
  • Bleomycin (B)
  • Vinblastine (V)
  • Dacarbazine (D)
39
Q

What is important to note about blood transfusions for patients with HL?

A
  • The blood must be irradiated
40
Q

What are the long term side effects of Chemotherapy?

A
  • Loss of fertility
  • Menopause
  • Second Cancers (Risk of getting another type of cancer)
  • Heart or Lung Problems (Bleomycin = pulmonary fibrosis)
41
Q

What is the mainstay of treatment for HL?

A
  • Chemotherapy and Radiotherapy
  • Stem cell transplants ( allogenous)
42
Q

What is a targeted treatment for HL that has come back after treatment?

A
  • Brentuximab
43
Q

What is a targeted treatment for advanced NLPHL?

A
  • Rituximab
44
Q

What is a targeted treatment for HL which has come back after treatment or is not responding to treatment?

A
  • Pembrolizumab

Cancer Care- Blood Results (27 decks)

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