Lymphoma

Question 1

What is lymphadenopathy?

Answer 1

Lymph nodes enlargement

Question 2

What is MALT lymphoma?

Answer 2

It is a non-hodgkin lymphoma that originates from B lymphocytes in the marginal zone. It usually occurs in the stomach.

Question 3

What can cause MALT lymphoma?

Answer 3

H.pylori infection
Chronic inflammation

Question 4

What would someone with MALT lymphoma present with?

Answer 4

Abdominal pain

Nausea and vomiting

Symptoms of anaemia

Weight loss

Question 5

What investigations do you do if you susepct MALT lymphoma in a patient?

Answer 5

Endoscopy and biospy
Immunohistochemistry
CT and PET scans

Question 6

What is the management plan for somone with MALT lymphoma?

Answer 6

H.pylori eradication therapy (is the INITIAL treatment)

Chemotherapy and radiotherapy (if H.pylori eradication therapy fails)

Question 7

What are risk factors for Hodgkin’s lymphoma?

Answer 7

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

Question 8

How are hodgkin’s and non-hodgkin’s lymphoma different?

Answer 8

Hodgkin’s is a SPECIFIC type of lymphoma.
Whereas Non-Hodgkin’s lymphoma includes many types like diffuse large B cell lymphoma, Burkitt lymphoma, MALT lymphoma and Waldenström macroglobulinaemia

Question 9

What are the risk factors for Non-Hodgkin’s lymphoma?

Answer 9

• HIV
• Epstein-Barr virus
• Helicobacter pylori(H.pylori)infection is associated with MALT lymphoma
• Hepatitis B or C infection
• Exposure topesticides
• Exposure to trichloroethylene (a chemical with a variety of industrial uses)
• Family history

Question 10

What infections are Burkitt lymphoma usually associated with?

Answer 10

EBV and HIV

Question 11

How does diffuse large B cell lymphoma usually present and in who (what demographic is it likely to present in)?

Answer 11

Uusally presents in older patients as a growing painless mass

Question 12

What antibody does Waldenstrom macroglobulinaemia cause an excess of?

Answer 12

IgM antibodies

Question 13

When can patients experience lymph node pain in Hodgkin’s lymphoma?

Answer 13

After drinking alcohol

Question 14

What are B symptoms?

Answer 14

B symptoms is the termed used for these 3 symptoms :
Fever
Night sweats
Weight loss

Question 15

What investigations do you do for a suspected Hodgkin’s lymphoma?

Answer 15

Lymph node biopsy
(Would see Reed-Sternberg cells)
CT, MRI and PET scans

Question 16

What classification system is used for assessing a Hodgkin AND Non-Hodgkin lymphoma? What does it look at?

Answer 16

The Lugano classification

It emphasises whether the affected nodes are above or below the diaphragm.

Question 17

What is stage 1 of the Lugano classification?

Answer 17

When there is only one node or groups of nodes

Question 18

What is stage 2 of the Lugano classification?

Answer 18

When there is more than one group of nodes they are all either above the diaphragm or are all below the diaphragm

Question 19

What is stage 3 of the Lugano classification?

Answer 19

Lymph nodes above and below the diahpragm are affected.

Question 20

What is stage 4 of the Lugano classification?

Answer 20

Widespread involvement of the lymph nodes including non-lymphatic organs such as the lungs or liver.

Question 21

What is the management for someone with Hodgkin’s lymphoma?

Answer 21

Chemotherapy and radiotherapy

Question 22

What risks are there with chemotherapy and radiotherapy?

Answer 22

Chemotherapy —-> Infections,cognitive impairment, secondary cancers (e.g. leukaemia) and infertility

Radiotherapy —-> risk of tissue fobrosis, secondary cancers and infertility

Question 23

Which B cell lymphoma is aggressive and which is indolent: Margin B-cell lymphoma OR Mantle B-cell lymphoma?

Answer 23

Margin B cell lymphoma —> is indolent

Mantle B-cell lymphoma is aggressive

From outer layer to inner layer (margin —>mantle—>germinal centre (in the middle)

These are all part of the cortex. This is where B-cells reside which is why both mantle and margin lymphomas are B-cell lymphomas.