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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
anaplastic large cell
null phenotype very variable cells 2;5 alk-1
26
hodgkin lymphoma
more often localised to a signle nodal site
27
classic HL
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
nodular LP hodgkins
Cd20+ germinal centre b cells isolated
29
parotid marginal zone lymphoma and sjogren syndrome are linked?
SS - inflammation, dry mouth, dry eyes increases risk
30
MALT is associated with
h pylori infection
31
mantle cell lymphoma are associated which proto-oncogene?
IgH- cyclin d1
32
follicular NHL is associated with which translocation?
IgH-bcl2
33
burkitt lymphoma protooncogene
IGH-MYC
34
classical hodgkin lymphoma presents?
v few malignant cells reed sternberg cells reactive chronic inflammatory cells and eosinophils
35
how does lymphoma present?
painless progressive lymphadenopathy -palpable node extrinsic compression of any tube
36
steps of lymphoma
histo Ct/PET scan BM biopsy lumbar puncture blood tests LDH, albumin, kidney HIV, Hep B +/-HTLV1
37
hodgkin lymphoma presents b symptoms
fever night sweats weight loss
38
nodular scleroising HL
80% good prognosis
39
staging of lymphoma
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
HL treatment? side effects
ABVD adriamycin bleomycin vinblastine DTIC 2-6 cycles + radiotherapy pulmonary fibrosis cardiomyopathy
41
radiotherapy for HL?
long term consequence 1 in 4 risk of breast cancer
42
non hodgkin lymphoma what is the most aggressive?
burkitt lymphoma
43
prognostic markers of NHL
LDH performance status HIV serology hep B serology
44
high grade lymphoma
diffuse / mantle burkitt t/b cell lymphoblastic
45
how to treat lymphoma
rituximab chop- cyclophosphamide adriamycin vincristine prednisolone R- Rituximab - cd20 monoclonal antibody
46
follicular NHL
t(14,18) 12-15 years
47
marginal zone lymphoma -
comprise 8% NHL epigastric pain / ulceration / bleeding abx: h pylori
48
eatl
coeliac gluten avoidence
49
most common CHL women
nodular sclerosis
50
chronic lymphocytic leukaemia difference to lymphoma
bone marrow > leukaemia lymph node / early presentation > lymphoma
51
CLL
commonest leukaemia proliferation normal b cells abberant Cd5+ smear cells on
52
CLL prognosis
IgHV CLL FISH tp53
53
FISH
loss of 13q trisomy 12 11q deletion of 17p (really bad)
54
deletion of 17p
is loss of p53 - tumour suppressor gene
55
CLL supportive care
pneumocystis prophylaxis zoster IVIG replacement therapy vaccinate - pneumococcal sars cov 2 seasonal flu avoid live vaccine
56
targetted therapy in CLL
ibrutinib - BTK germline - primary immune no b cells drug target kill proliferating b cells
57
bcl2 inhibitors
apoptosis venetoclax
58
experimental cell based therapies
chimaeric antigen receptor t cells CAR-T
59
venetoclax
oral active agent peermits apoptosis of CLL main risk is TLS p53 mutated in 85% of CLL
60
immunophenotype of a normal b cell
cd3-, cd5- cd19+
61

Year 5 Haematology (10 decks)

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