Lecture 37 - Lymphomas Flashcards
________ is the term that describes swollen lymph nodes. Mostly these are not cancerous, but if they are, __-_______ lymphoma represents about 85% of cases while _____ lymphoma represents about 15% of cases.
Lymphadenopathy
Non-Hodgkins
Hodgkins
Because the vast majority of Lymphadenopathies are benign/due to infection, they can resolve within a _____ (how long?) Thus, it is VERY important to consider the patient’s history and rule out infection before ordering a biopsy. Think about how you’d treat the patient if you suspected bacterial infection.
Week
Infectious ________ is often mistaken for Hodgkin Lymphoma. Patients are typically young adults that present with fever, general lymphadenopathy, and enlarged _______ (which organ?). The EBV virus infects B-cells, so there will be a CD8+ T-cell expansion. Which area of the lymph node should exhibit hyperplasia in this case? These patients also present with ____ cells on blood smear, which are the CD8+ T-cells that target the infected B-cells
Mononucleosis
Spleen
Hyperplasia in the Paracortical area
Downey cells
Benign Lymphadenopathies can also arise from autoimmune diseases and ___ hypersensitivity. ________ prescribed to patients with epilepsy is a good example of the latter. It occurs within several months of initiation and abates withing several _____ of discontinuation.
Drug
Anticonvulsants
Weeks
Lymphomas can be Nodal or Extranodal in origin. The latter is more common in which Lymphoma, Hodgkin or Non-Hodgkin?
Non-Hodgkin
Lymph nodes are often ______ when they are enlarged because of infection. This is NOT true of Lymphomas, so this can be used diagnostically.
Tender
Hodgkin Lymphoma is a neoplasm of ___ lymphocytes. These cells (Hodgkin cells) appear large and pleimorphic with a prominent nucleolus in the shape of a ____. ___-____ cells are a good indicator of Hodgkin lymphoma, and they present as binucleate Hodgkin cells with an ____ eye appearance.
B-lymphocytes
Halo
Reed-Sternberg cells
Owl eye
In Hodgkin lymphoma, the cancer arises in a single lymph node and spreads to anotomically contiguous lymph nodes. Is this the same in Non-Hodgkin lymphoma (NHL)? Keep in mind 95-98% of the cells in Hodgkin Lymphoma are normal, infiltrating ______ cells (neoplastic cells comprise only about 2% of the tumor.)
No
Inflammatory
Patients with Hodgkin Lymphoma typically present with painless lymphadenopathy in the _____ (along the midline) lymph nodes - most often Mediastinal. This disease typically peaks in two age groups: ____-____ years old and ___-___ years old. There’s a higher incidence of Hodgkin lymphoma with infectious _______. Keep in mind this is a B-cell lymphoma, but the neoplastic cells are negative for B-cell markers. Instead, they are positive for CD___ and CD___.
Axial
20-30
50-60
Mono
CD15+ and CD30+
There is a variation of Hodgkin Lymphoma called _______ Predominant, which accounts for about 5% of Hodgkin Lymphomas. It is mostly found in males between ___ and ___ years old, and the affected lymph nodes are typically isolated to the cervical or axiallry. ___-_____ cells are RARE –> instead, L&H cells (aka Popcorn cells) are present. They are CD___+, but negative for CD15 and CD30, unlike classical Hodgkin Lymphoma.
Lymphocyte Predominant
30-35
Reed-Sternberg
CD20+
Hodgkin Lymphoma can be staged, unlike most lymphomas and leukemias.
Stage I: 1 lymph node involved –> Treated with Radiation alone
Stage II: At least ____ lymph nodes involved on the same side of the _____ or with limited, contiguous extralymphatic tissue involvement. treated with
Stage III: Both sides of the _____ are involved, may include spleen or local tissue.
Stage IV: Multiple/disseminated foci with at least 1 extralymphatic organ involved (i.e. bone marrow)
Note: Anything greater than stage I is treated with Combination Chemo + Radiation.
Stage 2: at least 2
Diaphragm
Stage 3: Bot sides of the Diaphragm
