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Year 4 > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

what is lymphoma?

A

cancer of lymphocytes

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2
Q

how is lymphoma different to lymphocytic leukaemia?

A

lymphocytic leukaemia = cancer of developing lymphocytes in the blood and bone marrow?
lymphoma = cancer of lymphocytes in lymphatic system and lymph nodes

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3
Q

2 main types of lymphoma?

A

hodgkins (has reed sternberg cells)

non-hodgkins (no reed sternberg cells)

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4
Q

how does hodgkins spread?

A

continuously to nearby lymph nodes (rarely extra-nodal)

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5
Q

how does non-hodgknis spread?

A

non-continuously

more extra-nodal involvement than hodgkins

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6
Q

which has better prognosis - hodgkins or non-hodgkins and why?

A

hodgkins (continuous spread to nearby lymph nodes allows direct targeted treatment)

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7
Q

what causes lymphoma>

A

genetic mutation in lymphocytes

possible link to viruses (eg HIV, EBV)

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8
Q

possible complications of lymphoma?

A

metastasis to spinal cord causing compression of cord and sensory/motor deficits
metastasis to bone marrow causing overcrowding of marrow which results in decrease in progenitor cells (erythrocytes/leukocytes/platelets)

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9
Q

how is lymphoma diagnosed?

A

lymph node biopsy

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10
Q

how is lymphoma staged?

A

CT scan

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11
Q

how is lymphoma managed?

A

depends on stage, extent of disease, age, health etc
chemo
stem cell transplant
radiation

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12
Q

who gets hodgkins?

A

bi-modal - young adults and over 55s

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13
Q

who gets non-hodgkins?

A

children and adults

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14
Q

cellular characteristics of hodgkins?

A

B cells

reed sternberg cells

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15
Q

cellular characteristics of non-hodgkins?

A

B cells
T cells
NK cells

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16
Q

how does hodgkins present?

A

painless localized lymphadenopathy

B symptoms

17
Q

how does non-hodgkins present?

A

painless localized lymphadenopathy
B symptoms
and/or symptoms of extra-nodal spread

18
Q

which type of lymphoma is more associated with EBV?

A

hodgkins

or endemic burkitt lymphoma - type of non hodgkins - is closely associated

19
Q

Which is more common hodgkins or non-hodgkins?

A

non hodgkins

20
Q

risk factors for non-hodgkins?

A 
elderly
caucasian
EBV
fam history
history of chemo or radiotherapy
immunodeficiency 
autoimmune disease
21
Q

symptoms of non-hodgkins?

A

painless lymphadenopathy
constitutional/B symptoms (fever, weight loss, night sweats, lethargy)
extra-nodal disease
can have palpable abdo mass or testicular mass

22
Q

describe lymph nodes in non-hodgkins?

A

non-tender
rubbery
asymmetrical

23
Q

types of extra-nodal disease in non-hodgkins?

A 
gastric - dyspepsia, dysphagia, weight loss, abdo pain
bone marrow failure
lungs
skin
CNS - nerve palsies
24
Q

how is hodgkins differentiated from non-hodgkins?

A

biopsy
also have clues in clinical presentation
- extra-nodal disease more common in non-hodgkins
- alcohol induced lymph node pain in hodgkins
- B symptoms occur earlier in hodgkins and later in non-hodgkins

25
Q

investigations in non-hodgkins?

A

excisional node biopsy = diagnostic
CT chest, abdo, pelvis = staging
FBC and blood film (rule out leukaemia)
LDH (marker of cell turnover, prognostic indicator)
other tests depending on clinical picture (LFTs if liver mets suspected, PET or bone marrow biopsy if bone involvement suspected, LP if neuro symptoms)

26
Q

how is lymphoma staged?

A

ann arbour:

  • 1 = one node affected
  • 2 = more than one node on same side of diaphragm
  • 3 = nodes affected on both sides of diaphragm
  • 4 = extra-nodal involvement (eg spleen, bone marrow etc)
27
Q

general management of non-hodgkins?

A

depends on sub-type
can be watchful waiting, chemo or radiotherapy
everyone gets flu/pneumococcal vaccine
patients with neutropenia may require antibiotic prophylaxis

28
Q

complications of non-hodgkins?

A

bone marrow infiltration causing anaemia, neutropaenia or thrombocytopenia
SVC obstruction
metastasis
spinal cord compression
complications related to treatment (eg chemo side effects)

29
Q

blood test features of hodgkins?

A

normocytic anaemia
eosinophilia
raised LDH

Year 4 (83 decks)

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