Lymphoma Flashcards by Alaa M.

What is Hodgkin’s lymphoma?

Most common specific type of lymphoma

Bimodal age distribution with peaks around 20-25 and 80 years

How well did you know this?

Not at all

Perfectly

Risk factors for Hodgkin’s lymphoma

HIV
Epstein-Barr virus
Autoimmune conditions, such as rheumatoid arthritis and sarcoidosis
Family history

How well did you know this?

Not at all

Perfectly

Different types of NHL

Diffuse large B cell lymphoma
Burkitt lymphoma
MALT lymphoma

How well did you know this?

Not at all

Perfectly

What is Diffuse large B cell lymphoma?

Rapidly growing painless mass in older patients

How well did you know this?

Not at all

Perfectly

What is Burkitt lymphoma?

Associated with Epstein-Barr virus and HIV

How well did you know this?

Not at all

Perfectly

What is MALT lymphoma?

Affects the mucosa-associated lymphoid tissue, usually around the stomach

How well did you know this?

Not at all

Perfectly

Risk factors for non-Hodgkin’s lymphoma

HIV
Epstein-Barr virus
H. pylori - MALT lymphoma
Hepatitis B or C
Exposure to pesticides/ trichloroethylene
Family history

How well did you know this?

Not at all

Perfectly

Non-tender lymph nodes and feel firm or rubbery

Lymphoma

How well did you know this?

Not at all

Perfectly

Patients with ____________ may experience lymph node pain after drinking alcohol

Hodgkin’s lymphoma

How well did you know this?

Not at all

Perfectly

B symptoms refer to systemic symptoms of lymphoma. These are..

Weight loss > 10% in last 6 months
Fever > 38ºC
Night sweats

How well did you know this?

Not at all

Perfectly

Ix for lymphoma

Lymph node biopsy
CT, MRI, and PET scans

How well did you know this?

Not at all

Perfectly

What does the image show?

Reed-Sternberg cells - HL

How well did you know this?

Not at all

Perfectly

Outline lugano’s classification

1: one node or group of nodes
2: more than one group of nodes but on the same side of the diaphragm (either above or below)
3: lymph nodes both above and below the diaphragm
4: widespread involvement, including non-lymphatic organs, such as the lungs or liver

A: no systemic symptoms other than pruritus
B: weight loss > 10% in last 6 months, fever > 38c, night sweats

How well did you know this?

Not at all

Perfectly

Tx for Hodgkin’s lymphoma

ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine)
BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone)
Radiotherapy
CMT
Hematopoietic cell transplantation - relapse/refractory

How well did you know this?

Not at all

Perfectly

Side effects of chemotherapy

Infections, cognitive impairment, secondary cancers (e.g., leukaemia) and infertility

How well did you know this?

Not at all

Perfectly

Side effects of radiotherapy

Tissue fibrosis, secondary cancers and infertility

How well did you know this?

Not at all

Perfectly

What are the different types of HL?

Nodular sclerosing
Mixed cellularity
Lymphocyte predominant
Lymphocyte depleted

How well did you know this?

Not at all

Perfectly

Which type of HL has the best prognosis?

Lymphocyte predominant

How well did you know this?

Not at all

Perfectly

Which type of HL has the worse prognosis?

Lymphocyte depleted

Nodular sclerosing is more common in __________ and is associated with __________ cells

Nodular sclerosing is more common in women and is associated with lacunar cells

Mixed cellularity is associated with a large number of _______ cells

Reed-Sternberg cells

What are the FBC findings in HL?

Normocytic anaemia
Eosinophilia
LDH raised

Complications of HL treatment

Secondary malignancies - breast and lung

Burkitt’s lymphoma is a high-grade ___-cell neoplasm

What are the two forms of Burkitt's lymphoma?

Endemic (African) form: typically involves maxilla or mandible Sporadic form: abdominal (e.g. ileo-caecal) tumours in patients with HIV

Burkitt's lymphoma is associated with the ________ translocation, usually ________

C-myc gene translocation, usually t(8:14)

_____ is strongly implicated in the development of the African form of Burkitt's lymphoma and to a lesser extent the sporadic form

EBV

What does the image show?

'Starry sky' appearance: lymphocyte sheets interspersed with macrophages containing dead apoptotic tumour cells

Mx of Burkitt's lymphoma

Chemotherapy Rasburicase beforehand to prevent 'tumour lysis syndrome'

Complications of tumour lysis syndrome include..

Hyperkalaemia Hyperphosphataemia Hypocalcaemia Hyperuricaemia Acute renal failure

Tx for MALT lymphoma

H. pylori eradication

Paraproteinaemia

MALT lymphoma

Which one's more common? HL or NHL?

NHL

T or F: B' symptoms typically occur earlier in Hodgkin's lymphoma and later in non-Hodgkin's lymphoma

True

T or F: Extra-nodal disease is much more common in Hodgkin's lymphoma than in non-Hodgkin's lymphoma

False - more common in non-Hodgkin's lymphoma than in Hodgkin's lymphoma

Ix for NHL/HL

Excisional node biopsy CT abdomen, chest and pelvis HIV test FBC and blood film ESR LDH

Which one has a worse prognosis? Low or high grade NHL?

Low-grade non-Hodgkin's lymphoma has a better prognosis High-grade non-Hodgkin's lymphoma has a worse prognosis but a higher cure rate

Mx for NHL

Rituximab in combination with conventional chemotherapy regimes (e.g. CHOP) All patients will receive flu/pneumococcal vaccines Patients with neutropenia may require antibiotic prophylaxis

Tender, hard, smooth lump with no tethering or skin inflammation

Viral

Tender, hard, smooth lump with skin inflammation +/- tethering

Bacterial

Rubbery/soft, smooth no skin inflammation/tethering

Lymphoma

Non-tender, hard, irregular, tether lump

Metastatic carcinoma

Assessing lymph node pathology

Histology-microscopic appearances Immunohistochemistry of solid node (Brown= positive) Immunophenotyping of blood/marrow Genetic analysis Molecular analysis

________ cells in follicular B cell NHL

CD20 +ve cells

__________ cells in Hodgkin’s Disease

CD30 +ve Reed Sternberg