Lymphoma

Question 1

Non-Hodgkin’s vs Hodgkin’s

Answer 1

NONHodg- Non contiguous, all over the body.

HOdg- Better overall prognosis, spreads contiguously

Question 2

What is the Dx for Hodgkin’s Lymphoma

Answer 2

Reed-Sternberg Cells

Question 3

What are the 4 groups of lymphoid malignancies

Answer 3

1. Precursor B- and T-cell neoplasms
2. Mature B-cell neoplasms
3. Mature T- and natural killer (NK)-cell neoplasms
4. Hodgkin lymphomas

Question 4

What is the majority of origin for NONHodg.

Answer 4

B cell origin

Question 5

What is the most common indolent and most common aggressive NONHodg

Answer 5

Follicular lymphoma (low grade) 
-Most common indolent NHL

Diffuse Large B-Cell Lymphoma (DLBCL) (High cell)
-Most common aggressive NHL

Question 6

What lymphoma is assoc. with H. Pylori

Answer 6

MALT

Question 7

EBV is associated with what lymphoma

Answer 7

Burkitt

Question 8

MALT

Answer 8

Most common site of the gastric antrum

2/2 chronic H. Pylori infection

Only appears outside lymph nodes (extranodal)
-Most often arises in stomach
Also appears in non-gastric sites (thyroid, salivary gland)

Treat this cancer by treating the H. Pylori
(Quad/ Triple therapy)

Question 9

What is the most common pediatric cancer in sub Saharan africa

Answer 9

Endemic Burkitt Lymphoma

MC to the mandible/ Maxilla

Assoc with EBV infection at an early age

Question 10

What is the clinical presentation of sporadic Burkitt Lymphoma

Answer 10

Commonly (~65%) presents with abdominal mass, often with ascites

Question 11

What is the single most important test in a lymphoma pt

Answer 11

Bx!

gold standard is an excisional lymph node biopsy of one of the largest nodes available

Immunophenotyping - crucial for the diagnosis and subclassification

Question 12

What is the International Prognostic Index for NONHodg

Answer 12

Factors that confer poor prognosis
-Age > 60-years-old

• Elevated serum LDH for Non-Hodgkin Lymphoma
• Stage III or Stage IV

> 1 extranodal site

-Poor performance status

Cure rates
Low-risk , 0 factors, 80%
High-risk, 4 or more factors, 50%

Question 13

What is the hallmark of Hodgkin’s

Answer 13

Reed Sternberg Cells

Question 14

What is the Hallmark S/s of Hodgkin Lymphoma

Answer 14

Painless Lymphadenopathy

Question 15

What are the major infections assoc with Hodgkin’s Lymphoma

Answer 15

EBV, HIV, and Autoimmun D/o

Question 16

A pt that presents with painless single lymphadenopathy, with pain in the node after ingestion of alcohol

Think

Answer 16

Hodgkin Lymphoma

Question 17

Hodgkin’s on CXR

Answer 17

Incidental discovery of mediastinal mass on routine CXR is another common presentation

Likely asymptomatic but may be associated with cough, shortness of breath, or retrosternal chest pain

Question 18

What is the 1st line treatment for Hodgkin’s

Answer 18

Chemotherapy is the mainstay of therapy for HL

ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) remains the standard first-line regimen

Question 19

What is the international prognostic score for Hodgkin’s

Answer 19

Risk factors that confer poor prognosis

• Stage IV
• Age (>45)
• Gender (M)
• Hemoglobin (<10.5 g/dL)
• Albumin (<4 g/dL)
• WBC (>15,000/µL)
• Lymphocyte count (<0.6 × 109/L)

Cure rate:
0-2 factors: 98-80%
3-7 factors: 74-62%