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MBD/MI (Wothaya) > Introduction To Lymphomas And Myelomas > Flashcards

Introduction To Lymphomas And Myelomas Flashcards

1
Q

What is lymphoma?

A

Cancer of the lymphocytes

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2
Q

What does lymphoma affect?

A

Mature blood cells

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3
Q

What are lymphomas due to?

A

Specific genetic mutations and chromosomal translocations

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4
Q

What are primary lymph organs?

A

Sites where stem cells can divide and become immunocompetent

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5
Q

What are secondary lymph organs?

A

Sites where most of the immune responses occur

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6
Q

What is an adenopathy?

A

When lymph nodes increase in size

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7
Q

What are the types of lymphoma?

A

Non-hodgkins

Hodgkins

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8
Q

What are non-hodgkins lymphomas characterised by?

A

Mature B-cell, T-cell and NK neoplasms

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9
Q

What is a neoplasm?

A

Abnormal tissue growth

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10
Q

What are the warning signs of lymphoma?

A 
Fever
Swelling of the face and neck
Lump in neck, armpits or groin
Excessive sweating at night
Unexpected weight loss
Breathlessness
Itchiness
Feeling of weakness
Loss of appetite
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11
Q

How can you diagnose lymphoma?

A

Lymph node biopsy to check for lymphoma

Then flow cytometry, FISH or NGS to check the type

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12
Q

What are the stages of lymphoma called?

A

I
II
III
IV

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13
Q

What does stage I lymphoma look like?

A

Localised disease

Single lymph node region or organ

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14
Q

What does stage II lymphoma look like?

A

Two or more lymph node regions on the same side of the diaphragm

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15
Q

What does stage III lymphoma look like?

A

Two or more lymph node regions above and below the diaphragm

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16
Q

What does stage IV lymphoma look like?

A

Widespread disease

Multiple organs with or without lymph node involvement

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17
Q

What is the etiology of lymphoma?

A

Malfunctioning of the bodies immune system

Triggers are unknown but generally when a B cell develops a mutation in its DNA

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18
Q

What is hodgkin lymphoma caused by?

A

50% epstein barr virus
Family history
HIV/AIDS

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19
Q

How do you diagnose hodgkin lymphoma?

A

By finding a hodgkin cell in a lymph node biopsy

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20
Q

What does a hodgkin cell look like?

A

Bilobed nucleus

So big you can see by a light microscope

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21
Q

How do you treat hodgkin lymphoma?

A

Chemotherapy with/without radio

Stem cell transplant

22
Q

What is the prognosis for hodgkin lymphoma?

A

5 year survival of 50-90%

23
Q

What do non-hodgkin lymphomas present with?

A

Enlarged lymph nodes

24
Q

What are non-hogkin lymphomas caused by?

A

Chromosome translocations

25
Q

What is the normal role of the tissue specific enhancer on the immunoglobulin gene?

A

Activate the promoter of the rearranged V segment

26
Q

What are the risk factors for non-hodgkins lymphoma?

A

Viral infections and human T cell leukaemia virus in adult T cell lymphoma

27
Q

What happens to the epstein barr virus in highly immunosuppressed individuals?

A

Endogenous latent EBV transform B cells as no cytotoxic T cells

28
Q

What are the classifications of non-hodgkins lymphoma?

A

Low and high grade

29
Q

What are the features of low grade non-hodgkin lymphoma?

A

Normal tissue architecture partially preserved
Slow division
May be present for many months before diagnosis

30
Q

What are the features of high grade lymphoma?

A

Loss of noraml tissue architecture
Divide rapidly
Present for a matter of weeks before diagnosis
Life threatening

31
Q

How can you diagnose non-hodgkin lymphoma?

A

Immunophenotyping
Cylogenics-FISH
Light chain restriction
PCR

32
Q

How can you treat non-hodgkins lymphoma?

A

Chemo
Radio
Stem cell transplant
Monoclonal antibody therapy

33
Q

How does the monoclonal antibody therapy work?

A

Binds NK cells to B cells and enhances cell death

34
Q

What is the prognosis for non-hodgkin lymphoma?

A

Overall 5 year survival rate = 70%

35
Q

What is a multiple myeloma?

A

Tumour of the bone marrow that involves plasma cells

36
Q

What does multiple myeloma present as?

A

Bone pain
bleeding
Frequent infections
Anaemia

37
Q

When does multiple myeloma present?

A

Much later

38
Q

What are the risk factors for multiple myeloma?

A

Obesity
Radiation exposure
Family history
Certain chemicals

39
Q

What are the three aspects associated with multiple myeloma?

A

Suppression of normal bone marrow, blood cell and immune cell function
Bone resorption and release of calcium
Pathological effects of the paraprotein

40
Q

What is a paraprotein?

A

Single monoclonal immunoglobulin in the serum

41
Q

What does high levels of paraprotein mean?

A

Malignancy

42
Q

What does supression of noraml bone marrow, blood cell and immune function cause?

A

Anaemia
Bleeding
Recurrent infections

43
Q

Why do multiple myelomas cause bone resorption and release of calcium?

A

Myeloma cells produce cytokines

  • > bone marrow stromal cells releasing RANKL
  • > osteoclast activation
44
Q

What symptoms are caused by calcium release from the bone?

A

Mental disturbance

45
Q

What are the effects of high paraprotein?

A

Precipitates in kidney tubules causing renal failure
Deposited as amyloid in tissues
Hyperviscosity syndrome (rare)

46
Q

What is hyperviscosity syndrome?

A

Increased viscosity of blood leading to stroke and heart failure

47
Q

How can you diagnose multiple myeloma?

A 
Serum electrophoresis for paraprotein
Urine electrophoresis
Bone marrow biopsy for increased levels of plasma cells
Erythrocyte sedimentation rate
Flow cytometry and cytogenesis 
Radiological investigation
48
Q

Why is the erythrocyte sedimentation rate high in multiple myeloma?

A

Stalking of the RBC

49
Q

How do you treat multiple myeloma?

A

Radio/chemo combination
Targeted therapies
Immunotherapy
Haematopoetic stem cell transplantation in young patients

50
Q

What is the prognosis for multiple myeloma?

A

35% survival for 5 yrs

MBD/MI (Wothaya) (57 decks)

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