Hodgkin's Lymphoma Flashcards

1
Q

Classic cell on biopsy in Hodgkins

A

Reed-Sternberg cell

large cells that are either multinucleated or have a bi-lobed nucleus with prominent eosinophilic inclusion-like nucleoli
“owls eye appearance”

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2
Q

Bimodal age distribution for Hodgkins

A

3rd decade (30s)
7th decade (70s)

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3
Q

What are the 4 histological classifications of Hodgkins?

A

Nodular sclerosing
Mixed cellularity
Lymphocyte predominant
Lymphocyte depleted

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4
Q

Which of the histological subtypes has the best and worst prognosis?

A

Lymphocyte predominant = BEST

Lymphocyte depleted = WORST

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5
Q

B symptoms indicate a poor prognosis in Hodgkins. Give examples of these

A

weight loss
fever
night sweats

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6
Q

Other factors which may indicate a poor prognosis in Hodgkins

A

Male
age > 45
stage 4
Low Hb
Lymphocyte count <8%

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7
Q

What viruses increase the risk f developing Hodgkin’s lymphoma?

A

HIV
Epstein-Barr virus

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8
Q

Clinical features of Hodgkin’s

A

Painless, asymmetrical lymphadenopathy

alcohol-induced lymph node pain

‘B symptoms’

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9
Q

Findings on blood tests in Hodgkins

A
  • normocytic anaemia
  • eosinophilia
    (caused by production of cytokines e.g. IL-5)
  • raised LDH
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10
Q

Describe Ann Arbor Staging

A

I: single lymph node

II: 2 or more lymph nodes/regions on the same side of the diaphragm

III: nodes on both sides of the diaphragm

IV: spread beyond lymph nodes

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11
Q

What is the difference between A and B staging in Hodgkins

A

A - no systemic symptoms
B - presence of B symptoms

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12
Q

Management options in Hodgkins

A
  • chemotherapy
  • radiotherapy
  • combined modality therapy (CMT)
    => chemotherapy followed by radiotherapy
  • hematopoietic cell transplantation (for relapse/refractory disease)
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13
Q

Chemotherapy regimens used in Hodgkins

A

ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine)

BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone)

=> better remission rates but higher toxicity

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14
Q

What secondary malignancies are patients with Hodgkin’s at higher risk of?

A

solid tumours: breast and lung

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