Lymphoma Flashcards
Where are lymphomas found?
lymph nodes, bone marrow and/or blood (the lymphatic system)
lymphoid organs; spleen or the gut-associated lymphoid tissue
Skin (often T cell disease)
Why are lymphocytes prone to forming cancers
Lymphocyte: DNA molecules are 1) cut and recombined 2) subjected to deliberate DNA mutagenesis (somatic hypermutation)
Rapid cell proliferation in the germinal centre
Dependent on apoptosis
Presentation of HL
• Asymmetrical painless lymphadenopathy +/- obstructive/mass effect symptoms • “B-symptoms” • Pain in affected nodes after alcohol • Nodes tend to be mediastinal / cervical but not always
Investigations of HL
CT/PET. Tissue diagnosis: LN or BM biopsy - cells stain with CD15 & CD30
• Reed-Sternberg cell – bi-nucleate/multinucleate (‘owl eyed’) cell on a background
of lymphocytes & reactive cells
Ann Arbor staging
Stage 1 – one LN region (LN region can include spleen)
Stage 2 – two or more LN regions on the same side of the diaphragm Stage 3 – two or more LN regions on opposite sides of the diaphragm Stage 4 – extranodal sites (liver, BM)
Treatment of HL
Chemo- AVBD- 2-6 cycles Adriamycin Bleomycin Vinblastine DTIC
Radiotherapy- risk of Breast cancer
What NHL are aggressive
Burkitt Lymphoma
T or B cell Lymphoblastic leukaemia/lymphoma
What NHL are indolent
Small lymphocytic/CLL Mucosa associated (MALT)
Histology of Burkitts
“Starry sky” appearance
Histology of DLBC
“Sheets of large lymphoid cells”
Treatment of NHL
Rituximab
Symptoms of Burkitts
Jaw effected in endemic- EBV associated
Histology of Mantle cell lymphoma
“Angular/ clefted nuclei”
Which NHL are treated with CHOP in combo with rituximab
Mantle and DLBC
What drugs are used in CHOP
Cyclophosphamide
Adriamycin
Vincristine
Prednisolone
