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Haematology > Lymphadenopathy and Lymphoma > Flashcards

Lymphadenopathy and Lymphoma Flashcards

1
Q

what can cause lymphadenopathy

A

lymphoma
infection
mets
CTD (sarcoidosis, SLE)

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2
Q

what can cause night sweats

A

lymphoma/ other malignancy
infection
menopause
too thick duvet/ heating

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3
Q

what usually causes regional lymphadenopathy

A

bacterial infection

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4
Q

what usually causes generalised lymphadenopathy

A

viral infection

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5
Q

what are nodes like in viral infections

A 
tender
hard
smooth
no skin inflammation 
not tethered
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6
Q

what are nodes like in bacterial infection

A 
tender 
hard 
smooth 
skin inflamed 
maybe tethered
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7
Q

what are nodes like in lymphoma

A 
non tender 
rubbery/soft 
smooth 
no skin inflammation 
no tethered
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8
Q

what are nodes like in mets

A 
non tender 
hard 
irregular surface 
no skin inflammation 
tethered
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9
Q

what Ix if you suspect lymphoma/ malignancy

A

biospy: FNA or core biopsy

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10
Q

can lymphoma be diagnosed by CT

A

no

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11
Q

what is the role of the lymph node biopsy

A

exclude other reactive causes
classification of lymphoma (guides Tx and prognosis)
understand pathogenesis

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12
Q

how do you assess lymph node pathology

A 
histology- microscopic appearances 
immunohistochemistry solid node 
immunophenotyping blood/ marrow 
genetic analysis 
molecular analysis
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13
Q

is a whole node sample or CT guided biopsy prefered in lymphoma

A

whole node biopsy

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14
Q

what is the role of immunohistochemistry in lymphoma

A

confirms lymphoma diagnosis
helps to subclassify
looks at pattern of proteins on the surface of lymphoma cells uses antibodies against these ans enzyme reactions
brown= +ve

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15
Q

what is the role of immmunophenotyping

A

uses blood or bone marrow cells
tags with antibodies attached to fluorochrome
determines patterns of CD numbers: v uselful in leukaemias and lymphomas involving marrow (e.g. burkitts)

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16
Q

how is cytogenic analysis done

A

(looks for chromosomal abnormalities)
G banding (aspirate node)
FISH

17
Q

what does molecular analysis do

A

analyses patterns of gene expression

helps classify and find subtypes suitable for specific Txs

18
Q

what are the types of lymphoma

A

hodgkins
T cells NHL (10%)
B cell NHL (90%): low grade B cell, high grade B cell, burkitts, mantel cell lymphoma, marginal zone NHL

19
Q

what cells do hodgkins lymphomas have

A

reed-sternberg cells

20
Q

what determins the treatment and prognosis of lymphoma

A

classification of the type and stage

21
Q

what are the two types of hodgkins lymphoma

A 
classical HL (more common, nodular sclerosis, mixed cellularity, lymphomcyte rich/ depleted)
nodular lymphocyte predominant HL (doesnt have reed-sternberg cells, more common in immunosuppressed and EBV)
22
Q

what infection is seen in 50% of patients with HL

A

EBV

23
Q

how does HL present

A

large asymptomatic lymph node in lower neck/ supraclavicular region
mediastinal masses common, seen on CXR: chest discomfort, cough, dyspnoea
systemic symptoms (aka b symptoms: night sweats, unexplained fever)
alcohol induced pain at sited of nodal disease
lymphadenopathy, hepatomegaly, splenomegaly

24
Q

what is NHL more likely to do than HL

A

disseminate to extra nodal sites

25
Q

what is the prognosis for NHL

A

low grade= ~10 years

high grade = many can be cured

26
Q

what are the classifications of NHL

A

precursor B lymphoblastic lymphoma
mature (peripheral) B cell neoplasms (high grade e.g. burkits and low grade (e,g, follicular)
Precursor T-lymphoblastic lymphoma
mature (peripheral) T cell neoplasms: high grade and low grade

27
Q

what is the median age for NHL

A

> 50

28
Q

what are the most common types of NHL

A 
follicular lymphomas (low grade) 
diffuse large B cell lymphoma (high grade)
29
Q

how do low grade lymphomas present

A

painless slow peripheral lymphadenopathy
systemic symptoms present in end stage disease
spleno and hepato megaly
cytopenia

30
Q

how do high grade lymphomas present

A

rapidly growinf and bulky lymphadenopathy
system symptoms
extra nodal involvement (GI, skin, bone marrow, sinuses, GU, thyroid, CNS))

31
Q

how does burkitts lymphoma commonly present

A

with a large abdominal mass and symptoms of bowel obstruction

Haematology (27 decks)

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