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Z Year3 Haem Conditions > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

What are two types of lymphoma?

A
  • Hodgkin’s

- Non-hodgkin’s

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2
Q

What age is affected by HL?

A

bimodal incidence 20-30 and 50+

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3
Q

What age is affected by NHL?

A

increases with age

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4
Q

What cell is affected in HL?

A

only b cell

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5
Q

What cell is affected in NHL?

A

B or T cell

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6
Q

Does HL spread?

A

single group of nodes affected

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7
Q

Does NHL spread?

A

tends to affect multiple nodes

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8
Q

What are RF for HL?

A
  1. EBV infection
  2. positive FHx
  3. young adults
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9
Q

What is RF for NHL?

A
  1. age >50 years
  2. EBV
  3. HTLV-1
  4. male sex
  5. Hpylori
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10
Q

What are common types of NHL?

A
  1. Diffuse large b cell lymphoma ( most common in adults)

2. Follicular lymphoma (most common indolent lymphoma)

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11
Q

What are types of HL and how are they differentiated?

A
  1. Nodular lymphocyte predominant HL: men CD20 and CD45

2. Classical HL: CD15 and CD30

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12
Q

What cell does HL have that NHL not have?

A
  • Reed stenberg cells (multinucleated)

- Hodgkin cell (large and mononuclear)

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13
Q

What is key feature of HL?

A

pain after alcohol intake

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14
Q

What are general symptoms of lymphoma?

A
  1. Painless lymphadenopathy
  2. Fever, night sweats, weight loss
  3. Puritus
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15
Q

What are HL signs?

A
  1. Lymphadenopathy
  2. Cachexia
  3. Anaemia
  4. Spleno- or hepatomegaly
  5. Painless cervical lymphadneopathy
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16
Q

What are NHL signs?

A
  1. Extra nodal disease: go anywhere (gut (bowel obstruction), BM (fatigue, easy bruising) , spinal cord (loss of sensation)
  2. Pancytopenia from barrow involvement
  3. Lymphadenopathy
  4. Splenomegaly
17
Q

What are HL DDx?

A
  1. NHL
  2. Lymphadenopathy from other malignancies
  3. Infectious mononucleosis
  4. Reactive lymph nodes
18
Q

What are NHL DDx?

A
  1. Hodgkin’s lymphoma
  2. Acute lymphocytic leukaemia
  3. Infectious mononuecleosis
  4. Hep C
  5. TB
19
Q

What investigations do you do for HL?

A
  • Bloods:
    1. FBC with differential
    2. Metabolic profile
    3. ESR
  • Imaging:
    4. CXR
    5. PET-CT scan
    6. Gallium scan
    7. Contrast CT neck, chest and abdo
  • Other:
    8. Excisional lymph node biopsy
    9. Immunohistochemical studies
20
Q

What investigations do you do for NHL?

A
  • Bloods:
    1. FBC with differential
    2. Blood smear
    3. LFTs
    4. LDH
    5. Basic metabolic panel
  • Other:
    1. Lymph node biopsy
    2. Skin biopsy
    3. BM biopsy
21
Q

What would FBC with differential be with HL?

A
  1. low Hb
  2. platelets
  3. WBC high or low
22
Q

Why do you do an immunohistochemical studies?

A

differentiate HL from other types

23
Q

What is FBC with differential in NHL?

A
  1. thrombocytopenia
  2. pancytopenia
  3. lymphocytosis
24
Q

What would blood smear show in NHL?

A
  1. nucleated rbc

2. left shift

25
What will LDH be in NHL?
high
26
What is the management plan for HL?
- depends on stage, age and general health 1. chemotherapy 2. radiation therapy - For nodular lymphocytes predominant: rituximab
27
What is the management plan for NJL?
1. Chemotherapy and radiation therapy - depends on subtype, aggression, and spreading - If CD20+ can use rituximab
28
What are possible complications of HL?
1. Radiotherapy related thyroid abdnormalties 2. Chemotherapy+ radiotherapy related cardiac disease, secondary malignancies 3. Impaired immunity
29
What are possible complications of NHL?
1. Chemotherapy related complications 2. Radiation related complications 3. BM transplant related complications 4. TLS
30
What system is used in HL?
Ann arbour system
31
Which lymphoma has best prognosis?
1. classical Hodgkin lymphoma, lymphocyte rich has best prognosis 2. HL better than NHL
32
What is a subtype of for NHL?
Burkitt's lymphoma
33
What are RF for Brukitt's lymphoma?
- EBV infection - chronic malaria reduced resistance to EBV infection - HIV - Children in Africa and Brazil
34
What is presentation for Burkitt's lymphoma?
Rapidly enlarging lymph node in jaw
35
What is buzzword for Burkitt's lymphoma?
Starry sky appearance under microscope
36
What is 3 main difference between NHL and HL?
``` HL: 1. Reed-sternberg cells 2. Skin exoriations 3. Neutrophilia NHL: 1. NO reed-sternberg cells 2. Skin rashes e.g. mycosis fungoides 3. Neutropenia ```

Z Year3 Haem Conditions (18 decks)

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