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Y3 Haematology > Lymphadenopathy > Flashcards

Lymphadenopathy Flashcards

1
Q

what are the possible differentials of lymphadenopathy?

A

INDAM

infections/inflammation 
neoplasms 
drugs or toxins 
autoimmune 
metabolic
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2
Q

what are the B symptoms seen in lymphoma?

A

fever
night sweats
weight loss (10% over 6 months)

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3
Q

how can lymphoma present?

A

painless lump
B symptoms
itch
alcohol induced pain

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4
Q

describe the characteristics of the lymphadenopathy seen in lymphoma

A 
painless
rubbery 
soft 
smooth 
no inflammation 
not tethered
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5
Q

what investigations are done into lymphadenopathy?

A

FBC
biochemistry
biopsy
imaging

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6
Q

what is seen on FBC in chronic lymphocytic leukaemia (CLL)?

A

lymphocytosis

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7
Q

how is CLL diagnosed?

A

FBC

immunophenotyping

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8
Q

what is needed for a definitive diagnosis of lymphoma?

A

biopsy

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9
Q

what sample is taken for biopsy in lymphoma?

A

excise the whole node

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10
Q

what tests are done on the biopsy sample in lymphoma?

A

immunohistochemistry

genetic analysis

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11
Q

what is CD20 a marker of?

A

B cells

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12
Q

what is CD30 a marker of?

A

hodgkin lymphoma

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13
Q

what genetic tests can be done for lymphoma?

A

chromosome analysis

FISH or PCR

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14
Q

what genetic abnormality can be seen in follicular lymphoma?

A

T(14;18)

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15
Q

what genetic abnormality can be seen in burkitt lymphoma?

A

T (8;14)

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16
Q

what are the two types of lymphoma?

A

hodgkin

non hodgkin

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17
Q

what is the most common type of NHL?

A

B cell

18
Q

what are the risk factors for lymphoma?

A

immunosuppression
autoimmune disorders
infections
genetics

19
Q

what staging system is used to stage lymphoma?

A

ann arbor staging system

20
Q

what is a stage I lymphoma?

A

involves only one lymph node or extra lymph node area

21
Q

what is a stage II lymphoma?

A

involves two or more lymph nodes on one side of the diaphragm

22
Q

what is a stage III lymphoma?

A

involves two or more lymph nodes on both sides of the diaphragm

23
Q

what is a stage IV lymphoma?

A

disseminated disease or diseases affected multiple extra nodal areas

24
Q

how is the presence of B symptoms noted in the staging of lymphoma?

A

adding B to the stage

i.e. IIB

25
Q

what blood test can be done to provide information about prognosis in lymphoma?

A

lactate dehydrogenase (LDH)

26
Q

when is the peak incidence of hodgkin lymphoma?

A

third decade

27
Q

what infection has a link with hodgkin lymphoma?

A

EBV

28
Q

describe the lymph node spread in hodgkin lymphoma

A

orderly - affects one side of the diaphragm before the other

29
Q

what cell is seen on histology in hodgkin lymphoma?

A

reed-sternberg cells

30
Q

how is hodgkin lymphoma managed?

A

multi-agent chemotherapy ± radiotherapy

31
Q

what are the possible long term toxicity effects of treatment in hodgkin lymphoma?

A

secondary cancers
cardiovascular disease
infertility

32
Q

what can be done for patients with hodgkin lymphoma who are not responding to chemotherapy?

A

immunotherapy or stem cell transplant

33
Q

what is the most common high grade NHL?

A

diffuse large B cell lymphoma

34
Q

what types of NHL can often have extra-nodal disease?

A

T cell NHL

burkitt lymphoma

35
Q

how is NHL managed?

A

multi agent chemotherapy ± radiotherapy

36
Q

what monoclonal antibody can be used for B cell NHL?

A

rituximab

37
Q

what monoclonal antibody can be used for T cell NHL?

A

brentuximab

38
Q

what viruses are associated with burkitt lymphoma?

A

EBV

HIV

39
Q

what genetic abnormalities are seen in burkitt lymphoma?

A

chromosomal translocations involving c-myc

40
Q

what characterises tumour lysis?

A 
hypokalaemia 
hypercalcaemia 
hyperphosphataemia 
hyperuricaemia 
renal failure
41
Q

what type of drug can be added to chemo regimens for lymphoma?

A

steroids

Y3 Haematology (23 decks)

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