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
Symptoms of MZL
Most commonly arise in stomach, usually present with epigastric pain, ulceration or bleeding
What is Enteropahy Associated T cell lymphoma
T cell NHL seen in patients with Coeliac disease
mature T cells (not precursor)
Involving small intestine Jejunum and Ileum
Has an aggressive nature
Causing abdo pain, bleeding
