Lym-phobia

Question 1

What is a lymphoma?

Answer 1

malignant tumour of lymphoid origin that can arise anywhere lymphoid tissue is present

Question 2

What are the two major classificaitions of Lymphomas?

Answer 2

Hodgkin’s

Non-Hodgkins

Question 3

What is the incidence for lymphomas?

Answer 3

incidence is rising
slightly more common in males
age-dependant incidence, varies with type

Question 4

What is the lymphatic system?

Answer 4

network of various tissues, glands, organs and ducts (lymph nodes, bone marrow, spleen, liver, thymus)
produces, stores and transports lymph

Question 5

What is lymph

Answer 5

A portion of blood plasma separated from intersititial fluid
contains waste from cells
travels oneway toward the subclavian veins to be returned to the venous system
along the way lymph nodes treat and filter harmful entities

Question 6

What are the similarities of hodgkin’s vs non-hodgkin’s lymphoma?

Answer 6

lymphocyte origin
painless swelling of lymph nodes
can occur anywhere in the body (most frequently occur in lymph nodes
general symptoms are weight loss, fevers, night sweats

Question 7

What are the pathological features of hodgkin’s lymphoma?

Answer 7

Reed/Sternberg Cells (are the hallmark cells of HD
arise mostly from b-cells
distinct under light micro (appear enlarged, multi- or bi-lobed nucleus, maybe retracted cytoplasm

Question 8

What are the age group differences between HD vs NHL?

Answer 8

HD: two age groups 15-40 and 55+
NHL: risk increases with age (60+)

Question 9

What are the site differences between HD vs NHL?

Answer 9

HD: more often in upper body
usually contiguous nodes
rarely extra-nodal
-Distinct Type

NHL: no site predominance
widely disseminated node groups (non-contiguous)
common extra-nodal involvement (~90% Stage III or IV (inc. bone marrow involvement)
>30 Different Types

Question 10

What is the Aetiology of Hodgkin’s?

Answer 10

Genetic

• Familial (e.g. siblings esp identical twins)
• socioeconomic status: higher
• Environmental (?)
• Infections: Epstein-barr virus, glandular fever, HIV

Question 11

What are the four histological subtypes of hodgkin’s?

Answer 11

• Lymphocyte Predominant
• Nodular Sclerosis (Grade 1, Grade 2)
• Mixed Cellularity
• Lymphocyte Depleted

Question 12

What are the signs and symptoms for Hodgkin’s?

Answer 12

-Lymphadnompathy (cervical and sup clav mostly mediastinal involvement)
-Splenomegaly/ Abdo mass (~30%)
-Spread to contiguous nodes
-alcohol induced pain (<10%)
Systemic (pruritus, fatigue, bone pain)
“B” Symptoms (Fever, Weight loss, night sweats)

Advanced Disease (extranodal) (Liver involvement, bone marrow, bone involvement, lung involvement)