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3MB Haematology > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

What is Hodgkin’s lymphoma?

A

Most common specific type of lymphoma

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

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2
Q

Risk factors for Hodgkin’s lymphoma

A

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

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3
Q

Different types of NHL

A

Diffuse large B cell lymphoma
Burkitt lymphoma
MALT lymphoma

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4
Q

What is Diffuse large B cell lymphoma?

A

Rapidly growing painless mass in older patients

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5
Q

What is Burkitt lymphoma?

A

Associated with Epstein-Barr virus and HIV

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6
Q

What is MALT lymphoma?

A

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

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7
Q

Risk factors for non-Hodgkin’s lymphoma

A

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

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8
Q

Non-tender lymph nodes and feel firm or rubbery

A

Lymphoma

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9
Q

Patients with ____________ may experience lymph node pain after drinking alcohol

A

Hodgkin’s lymphoma

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10
Q

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

A

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

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11
Q

Ix for lymphoma

A

Lymph node biopsy
CT, MRI, and PET scans

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12
Q

What does the image show?

A

Reed-Sternberg cells - HL

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13
Q

Outline lugano’s classification

A

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

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14
Q

Tx for Hodgkin’s lymphoma

A

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

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15
Q

Side effects of chemotherapy

A

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

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16
Q

Side effects of radiotherapy

A

Tissue fibrosis, secondary cancers and infertility

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17
Q

What are the different types of HL?

A

Nodular sclerosing
Mixed cellularity
Lymphocyte predominant
Lymphocyte depleted

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18
Q

Which type of HL has the best prognosis?

A

Lymphocyte predominant

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19
Q

Which type of HL has the worse prognosis?

A

Lymphocyte depleted

20
Q

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

A

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

21
Q

Mixed cellularity is associated with a large number of _______ cells

A

Reed-Sternberg cells

22
Q

What are the FBC findings in HL?

A

Normocytic anaemia
Eosinophilia
LDH raised

23
Q

Complications of HL treatment

A

Secondary malignancies - breast and lung

24
Q

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

A

B

25
Q

What are the two forms of Burkitt’s lymphoma?

A

Endemic (African) form: typically involves maxilla or mandible

Sporadic form: abdominal (e.g. ileo-caecal) tumours in patients with HIV

26
Q

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

A

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

27
Q

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

A

EBV

28
Q

What does the image show?

A

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

29
Q

Mx of Burkitt’s lymphoma

A

Chemotherapy
Rasburicase beforehand to prevent ‘tumour lysis syndrome’

30
Q

Complications of tumour lysis syndrome include..

A

Hyperkalaemia
Hyperphosphataemia
Hypocalcaemia
Hyperuricaemia
Acute renal failure

31
Q

Tx for MALT lymphoma

A

H. pylori eradication

32
Q

Paraproteinaemia

A

MALT lymphoma

33
Q

Which one’s more common? HL or NHL?

A

NHL

34
Q

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

A

True

35
Q

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

A

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

36
Q

Ix for NHL/HL

A

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

37
Q

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

A

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

38
Q

Mx for NHL

A

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

39
Q

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

A

Viral

40
Q

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

A

Bacterial

41
Q

Rubbery/soft, smooth no skin inflammation/tethering

A

Lymphoma

42
Q

Non-tender, hard, irregular, tether lump

A

Metastatic carcinoma

43
Q

Assessing lymph node pathology

A

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

44
Q

________ cells in follicular B cell NHL

A

CD20 +ve cells

45
Q

__________ cells in Hodgkin’s Disease

A

CD30 +ve Reed Sternberg

3MB Haematology (23 decks)

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