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Module 5 - Haematology > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

A patients with Sjogren’s syndrome presents with asymmetrical salivary gland swelling. What is this suspicious of?

A

Lymphoma.

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2
Q

What is lymphoma?

A

CLINIC PROLIFERATIOn of LYMPHOCYTES arising in a LYMPH NODE or ASSOCIATED TISSUE.

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3
Q

Where is lymphoma found?

A
  • a SOLID tumor, some cells in the blood.
  • Found in SOMATIC TISSUES rather than in bone marrow.
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4
Q

What are the types of lymphoma?

A

2 types:
- Hodgkin and Non-Hodgkin.

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5
Q

Why type of lymphoma is most common?

A

Non Hodgkin, 6:1.

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6
Q

What is staging?

A

Determines the EXTENT of disease.

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7
Q

Why is cancer stage important?

A

It determines the PROGNOSIS and TREATMENT.

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8
Q

What determines lymphoma stage? How is the stage found (what diagnostic tools used)?

A
  • Whether disease is on BOTH SIDES OF THE DIAPHRAGM
  • number and site of lymph nodes involved.
  • extra nodal involvement.
  • systemic symptoms.
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9
Q

What is a typical cell seen in Hodgkin lymphoma?

A

Reed-sternberg cells are GIANT LYMPHOCYTIC CELL, seen in biopsies of affected Hodgkin tissues.

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10
Q

What is the clinical presentation of Hodgkin lymphoma? (8)

A
  • Lymphadenopathy - typically CERVICAL, can fluctuate in size.
  • Pain on DRINKING ALCOHOL
  • Fever, night sweats, weight loss, weakness, itching, infection
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11
Q

What is the cure prognosis for hodgkins lymphoma?

A

Stage I and II –> more than 90%

Stage III and IV –> cure prognosis 50-70%

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12
Q

When are reed-sternberg cells seen?

A

In tissues affected by HODGKINS lymphoma.

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13
Q

What cells are usually involved in non Hodgkins lymphoma?

A

B cells (85%) and T cells (15%)

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14
Q

What are the 3 common causes of non Hodgkins lymphoma?

A
  • Microbial factors.
  • Autoimmune disease (Sjogrens, peptic ulcer, rheumatoid).
  • Immunosuppression
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15
Q

What are the 3 mains presentations of Non-Hodgkins lymphoma?

A
  • DISSIMINATED lymphadenopathy.
  • Extra nodal involvent –> WELDEYERS RING, OROPHARYNHEAL INVOLVMENT
  • Noisy breathing and sore throat (due to above).
  • Marrow failure.
  • Constitutional symptoms less common (fever, sweats etc).
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16
Q

A patient presents with lymphoma and their symptoms are: lymphadenopathy, fever and sweating. Which type is it MORE LIKELY to be?

A

Hodgkins

(constitutional symptoms less common with Hodgkins).

17
Q

What is the prognosis for non hodgkins lymphoma?

A

50% will relapse - POOR PROGNOSIS.

18
Q

What cells are involved in multiple myeloma?

A

Malignant proliferation of PLASMA CELLS which produce an abundance of ANTIBODIES.

19
Q

What are plasma cells derived from?

A

B cells.

20
Q

What are 3 main features on multiple myeloma?

A
  • monoclonal paraprotein in blood and urine
  • lytic bone lesions (cause BONE PAIN AND FRACTURE).
  • excess plasma cells in bone marrow (cause MARROW FAILURE).
21
Q

Name 4 symptoms of multiple myeloma.

A
  1. infection
  2. bone pain/ fracture.
  3. renal failure.
  4. amyloidosis.
22
Q

How is multiple myeloma treated and why is this relevant to dentistry?

A

Patient may be taking BISPHOSPHONATES

23
Q

Name 5 different modes of treatment for hematological malignancies.

A
  1. chemotherapy.
  2. radiotherapy.
  3. monoclonal antibodies.
  4. Haemopoietic stem cell transplantation.
  5. supportive therapy.
24
Q

How does chemotherapy work? What are 2 drawbacks?

A
  • Targets cells with HIGH TURNOVER RATE.
  • Side effects: hair loss, nausea, vomiting, tiredness.
  • Long-term risk of oncogenesis.
25
Q

How does radiotherapy work? What are 2 drawbacks?

A
  • Uses CYTOTOXIC effect of IONIZING RADIATION on cells with high turnover.
  • Adjacent tissue also irradiated yet minimizing with positioning and dosing.
  • Risk of inducing late cancers.
26
Q

How do monoclonal antibodies work? What is their advantage?

A
  • Monoclonal antibodies to SPECIFIC CANCER CELL ANTIGENS are produced artificially. Gives TARGETED TREATMENT.
  • Use Cluster definition/ cell recognition antigens on white cells.
  • Target interleukin messaging.
  • Target growth factor.
27
Q

What are the 2 sources of haemopoietic stem cell transplantation?

A
  • Allogenic (stranger/ family member).
  • Autologus (from self).
28
Q

What are 3 risks with haemopoietic stem cell transplant? What is the mortality risk?

A
  • Life threatening infection.
  • Graft versus host disease.
  • Graft failure and total marrow failure.

10% mortality risk.

29
Q

What are the stages to haemopoietic cancer treatment?

A
  1. Induction.
  2. Remission.
  3. Maintenance and consolidation.
  4. Relapse.

Module 5 - Haematology (7 decks)

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