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Year 5 Haematology > lymphoma > Flashcards

lymphoma Flashcards

1
Q

adaptive immune system required ‘____’ DNA sensibility

A

limited
generation of diversity

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2
Q

in germinal centre there is a very ____ response?

A

rapid
but increases chance of DNa
90% of cells into germinal centre die

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3
Q

errors in recombination can cause?

A

oncogene
> lymphoma

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4
Q

3 mechanism for risk factors of NHL

A

constant antigenic stimulation

viral infection

loss of t cell function +EBV amd EBV infection of b cells - drive up b cells

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5
Q

chronic antigenic stim

A

h.Pylorti> Gastric malt

sjogren syndrome : parotid
hashimotos: MZL of thyroid

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6
Q

coeliac lymphoma

A

EATL
t cell non hodgkin lymphoma

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7
Q

direct integration of virus in genome

A

HTLV1
Adult t cell leukaemia lyphoma
ATLL

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8
Q

EBv and lymphoma

A

ebv infection
loss of t cell function - HIV

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9
Q

b cells - function

A

express surface IG
antibody

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10
Q

t lymphocyte

A

express surface T cell
regulate B cell / macrohphage function
cytotoxic function

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11
Q

b non- hodgkin lymphoma

A

most common type of lymphoma

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12
Q

cd3/ cd5

A

t cell

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13
Q

clonality of b cells

A

light chain expression
if all are kapp/lambda then it is a lymphoma

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14
Q

FISH

A

identify chromosome translocations

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15
Q

PCR- identifies translocations and clonal t cell receptor

A

11:14 mantle cell lymphoma

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16
Q

b cell NHL

low grade
high grade

A

low grade: follicular lyphoma
small lymphocytic lymphoma
marginal zone lymphoma

high grade
diffuse large b cell
burkitts

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17
Q

is mantle cell lymphoma aggressive?

A

yes

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18
Q

neoplastic follucilar lymphoma

A

form abnormal follicles
germinal centre cell marlers stained CD10, bcl-6

clinical signs
lymphadenopathy

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19
Q

CLL / small lympocytic lymphoma

shows expression

A

abnormal b cells - uniform, small

of abnronal Cd5, CD23

richter transformation

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20
Q

mantle cell lymphoma

A

small lymphcotes
cyclin d1
CD5

11;14 trabnslocation - FISH
cyclin d1 confirms diagnosis

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21
Q

burkitts

histopath

A

jaw /abdo mass
EBV associated
HIV

starry sky appearance
macrophages- medium sized, germinal centre cell origin

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22
Q

t non hodgkin lymphoma

histopath

A

tend to be more aggressive

infiltartes are more mixed
- eosinophils,

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23
Q

Enteropathy associated t cell lymphoma

A

long standing coeliac disease
aggressive

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24
Q

cutaneous t cell

A

mycosis fungoides - sun protecxted areas
cd4 + t cell > large nodules

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25
Q

anaplastic large cell

A

null phenotype

very variable cells
2;5
alk-1

26
Q

hodgkin lymphoma

A

more often localised to a signle nodal site

27
Q

classic HL

A

nodular sclerosing
singly scattered

ebv

large prominent nuclei ; bi nucleat

b cell in origin but negative for b cell marker

CD30 and
CD15 is positive

28
Q

nodular LP hodgkins

A

Cd20+

germinal centre b cells
isolated

29
Q

parotid marginal zone lymphoma and sjogren syndrome are linked?

A

SS - inflammation, dry mouth, dry eyes
increases risk

30
Q

MALT is associated with

A

h pylori infection

31
Q

mantle cell lymphoma are associated which proto-oncogene?

A

IgH- cyclin d1

32
Q

follicular NHL is associated with which translocation?

A

IgH-bcl2

33
Q

burkitt lymphoma protooncogene

A

IGH-MYC

34
Q

classical hodgkin lymphoma presents?

A

v few malignant cells
reed sternberg cells

reactive
chronic inflammatory cells and eosinophils

35
Q

how does lymphoma present?

A

painless progressive lymphadenopathy
-palpable node
extrinsic compression of any tube

36
Q

steps of lymphoma

A

histo
Ct/PET scan
BM biopsy
lumbar puncture

blood tests
LDH, albumin, kidney

HIV, Hep B
+/-HTLV1

37
Q

hodgkin lymphoma presents b symptoms

A

fever
night sweats
weight loss

38
Q

nodular scleroising HL

A

80% good prognosis

39
Q

staging of lymphoma

A

single group of lymph

2: >1 same side of diaphragm
3: nodes above and below diaphragm
4: extra nodal spread

B symptoms
suffix Aif absent /B if present
fever
night sweats
weight loss >10%

40
Q

HL treatment?

side effects

A

ABVD

adriamycin
bleomycin
vinblastine
DTIC

2-6 cycles
+ radiotherapy

pulmonary fibrosis
cardiomyopathy

41
Q

radiotherapy for HL?

A

long term consequence
1 in 4 risk of breast cancer

42
Q

non hodgkin lymphoma
what is the most aggressive?

A

burkitt lymphoma

43
Q

prognostic markers of NHL

A

LDH
performance status
HIV serology
hep B serology

44
Q

high grade lymphoma

A

diffuse / mantle
burkitt
t/b cell lymphoblastic

45
Q

how to treat lymphoma

A

rituximab
chop- cyclophosphamide
adriamycin
vincristine
prednisolone

R- Rituximab - cd20 monoclonal antibody

46
Q

follicular NHL

A

t(14,18)
12-15 years

47
Q

marginal zone lymphoma -

A

comprise 8% NHL
epigastric pain / ulceration / bleeding

abx: h pylori

48
Q

eatl

A

coeliac
gluten avoidence

49
Q

most common CHL
women

A

nodular sclerosis

50
Q

chronic lymphocytic leukaemia

difference to lymphoma

A

bone marrow > leukaemia

lymph node / early presentation > lymphoma

51
Q

CLL

A

commonest leukaemia
proliferation

normal b cells abberant
Cd5+
smear cells on

52
Q

CLL prognosis

A

IgHV
CLL FISH
tp53

53
Q

FISH

A

loss of 13q
trisomy 12
11q
deletion of 17p (really bad)

54
Q

deletion of 17p

A

is loss of p53 - tumour suppressor gene

55
Q

CLL supportive care

A

pneumocystis prophylaxis
zoster

IVIG replacement therapy
vaccinate -
pneumococcal
sars cov 2
seasonal flu
avoid live vaccine

56
Q

targetted therapy in CLL

A

ibrutinib - BTK
germline - primary immune

no b cells
drug target
kill proliferating b cells

57
Q

bcl2 inhibitors

A

apoptosis venetoclax

58
Q

experimental cell based therapies

A

chimaeric antigen receptor t cells

CAR-T

59
Q

venetoclax

A

oral active agent
peermits apoptosis of CLL
main risk is TLS
p53 mutated in 85% of CLL

60
Q

immunophenotype of a normal b cell

A

cd3-, cd5-

cd19+

61
Q
A

Year 5 Haematology (10 decks)

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