Lymphoma

Question 1

What is lymphoma?

Answer 1

Disorder caused by malignant proliferations of lymphocytes. These accumulate in the lymph nodes causing lymphadenopathy, but may be found in peripheral blood or infiltrate organs.

Question 2

How is lymphoma divided histologically?

Answer 2

Hodgkin’s and non-Hodgkin’s

Question 3

What do baseline bloods show in lymphoma and which investigations is primarily used to diagnose lymphoma?

Answer 3

1. Relatively normal

2. Lymph node biopsy

Question 4

What is Hodgkin’s lymphoma and what specific cells are seen in the condition?

Answer 4

Malignancy arising from mature B-cells, characterised by the presence of Hodgkin’s cells and Reed-Sternberg cells.

Question 5

What are the clinical features of Hodgkin’s lymphoma?

Answer 5

Painless cervical/supraclavicular lymphadenopathy in a young adult. Also itchy skin and hepatosplenomegaly. B-symptoms are a sign of advanced disease.

Question 6

What are the risk factors for Hodgkin’s lymphoma?

Answer 6

EBV infection, FHx, young adults from high socio-economic class.

Question 7

What is the most common malignancy in ages 15-24 and the elderly?

Answer 7

Hodgkin’s lymphoma

Question 8

What is non-Hodgkin’s lymphoma and what are the clinical features?

Answer 8

1. Includes al lymphomas without Reed-Sternberg cells.

2. Lymphadenopathy and splenomegaly, B-symptoms less common.

Question 9

What are the risk factors for non-Hodgkin’s lymphoma?

Answer 9

> 50 years old, male, immunocompromised, HIV, EBV, H. pylori increases GALT lymphoma, coeliac.

Question 10

What are the different types of non-Hodgkin’s lymphoma?

Answer 10

1. B-cell - indolent (controllable, cure rare)/aggressive (can be cured)
2. T-cell - aggressive (poor response to therapy)

Question 11

What is the difference between indolent and aggressive non-Hodgkin lymphomas?

Answer 11

1. Indolent (marginal zone) - disseminated, slowly progressive, controllable, 8-10 year survival.
2. Aggressive (diffuse large B cell) - rapidly progressive, can be fatal if untreated, curable, most common.

Question 12

What is the lymphoma staging system?

Answer 12

Ann-Arbor system:
I - one lymph node region
II - 2 or more lymph node regions, same side of diaphragm
III - on both sides of diaphragm
IV - extranodal sites (liver, bone marrow, lungs)
A - no B symptoms
B - B symptoms