leukaemia and lymphoma Flashcards
who does lymphoma tend to affect?
- those aged 16-65, with peak incidence in 30s
what are the symptoms of Hodgkins?
- cervical lymph node enlargement
- painless, rubbery, contiguous pattern of spread
- found in axillary and inguinal lymph nodes too
- hepatosplenomegaly
- B symptoms: fever (25%), drenching night sweats, weight loss of >10% body weight
- ## alcohol induced pain at lymph nodes
what symptoms would you expect if you had mediastinal lymph node involvement?
- cough
- breathlessness
- SVC obstruction
what cells might you see in hodgkins lymphoma?
what are the risk factors?
- Reed- Sternberg cells
- infectious mononucleosis (EBV)
- increased titres of EB antibodies
what is the most common type of HL?
- nodular sclerosing (75%)
- mixed cellularity 25%
what investigations would you do to confirm diagnosis of HL?
- lymph node biopsy
- imaging (CXR or CT scan to check for mediastinal involvement)
what is the staging criteria called and what classes are there?
Ann-Arbor staging:
- 1: confined to single lymph node
- 2: 2 or more nodes on the same side of diaphragm
- 3: involvement of nodes either side of diaphragm
- 4: spread beyond nodes to liver or bone marrow
how else can HL be divided?
- A: absence of symptoms
- B: symptoms present: weight loss, unexplained fever >38, drenching night sweats
- survival is <40% for those stage 4B, over 90% for stage 1A
what is non-hodgkins?
- malignant tumour of lymphoid cells
- 70% are B cell
- 30% are T cell
what are the core symptoms and signs of non-hodgkins?
how does it differ in presentation to HL?
- peripheral lymphadenopathy (75% have painless superficial lumps)
- B symptoms
- extra nodal, more common than HL, can affect brain, lung, liver
what viruses are associated with NHL?
- human T cell lymphocytic virus
- Herpes virus 8 (causes cancer in HIV patients) so HIV an association
what is the pathogenesis?
- malignant clonal expansion of lymphocytes at different stages of development
- neoplasms of proliferating immature cells (immuno/ lymphoblasts are much more aggressive
what is Burkitts lymphoma?
what is it caused by?
- childhood disease with characteristic jaw lymphadenopathy
- translocation of oncogene between chromosome 8 and 14
- results in up regulation of myc
how can burkitts lymphoma be classified?
- low grade: incurable, widely disseminated
- high grade: more aggressive but long term cure
-30% 5yr survival for low grade, 50% for high grade
what is the peak incidence of leukaemia in children?
- 3 years old in boys
- 2 years in girls
- most common cancer in children
