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Y3 - Clinical Haematology > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

What is lymphoma?

A

A type of cancer affecting the lymphocytes inside the lymphatic system causing abnormally large lymph nodes

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2
Q

What are the two main groups of lymphoma?

A

1) Hodgkin’s lymphoma
2) Non-Hodgkin’s lymphoma

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3
Q

What is the classical histological finding associated with Hodgkin’s lymphoma?

A

Reed-Sternberg cells

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4
Q

Describe the appearance of Reed-Sternberg cells:

A

giant bilobed nucleus giving a cartoon owl eye appearance

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5
Q

What are the two peak age groups for Hodgkin’s lymphoma?

A

1) 20-25
2) 80+

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6
Q

Give 4 risk factors for Hodgkin’s lymphoma:

A

1) HIV
2) Epstein-Barr virus
3) autoimmune conditions such as RA and sarcoidosis
4) family history

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7
Q

What is the most common cause of Hodgkin’s lymphoma?

A

Epstein-Barr virus

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8
Q

Give 3 examples of non-Hodgkin lymphomas:

A

1) diffuse large B cell lymphoma
2) Burkitt lymphoma
3) MALT lymphoma

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9
Q

What is the most common type of non-Hodgkin’s lymphoma?

A

Diffuse large B cell lymphoma

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10
Q

How does diffuse large B cell lymphoma present?

A

rapidly growing painless mass, seen typically in older patients

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11
Q

What two viruses are major risk factors for Burkitt lymphoma?

A

1) HIV
2) EBV

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12
Q

What are MALT lymphomas?

A

tumours of the mucosa-associated lymphoid tissue, particularly the stomach

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13
Q

Give 7 risk factors for non-Hodgkin lymphomas:

A

1) HIV
2) EBV
3) Hepatitis B and C
4) H. pylori (specifically for MALT lymphoma)
5) family history
6) exposure to pesticides
7) exposure to trichloroethylene

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14
Q

What is the key presentation associated with lymphoma?

A

lymphadenopathy found in the neck, axilla or groin

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15
Q

Give 3 features of the lymphadenopathy seen in lymphoma:

A

1) non-tender
2) firm
3) rubbery

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16
Q

What symptom may be elicited by drinking alcohol in Hodgkin’s lymphoma?

A

lymph node pain

17
Q

Other than lymphadenopathy, give 9 presentations associated with lymphoma:

A

1) fever
2) weight loss
3) night sweats
4) fatigue
5) recurrent infections
6) itching
7) cough
8) shortness of breath
9) abdominal pain

18
Q

What is the gold standard investigation for lymphoma?

A

lymph node biopsy

19
Q

What 3 scans can be used to stage lymphoma?

A

1) CT
2) MRI
3) PET

20
Q

What classification system is used to stage lymphoma?

A

1) Lugano classification

21
Q

Summarise the Lugano classification:

A

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

22
Q

What are the 2 management options used for Hodgkin’s lymphoma?

A

1) chemotherapy
2) radiotherapy

23
Q

Give 3 side effects associated with lymphoma chemotherapy:

A

1) susceptibility to infections
2) cognitive impairment
3) infertility

24
Q

Give 3 side effects associated with radiotherapy chemotherapy:

A

1) increased risk of tissue fibrosis
2) secondary cancers
3) infertility

25
Q

What monoclonal antibody targets B cells and can therefore be used to treat Non-Hodgkin’s lymphoma?

26
Q

Give 4 managements for non-Hodgkin’s lymphoma:

A

1) chemotherapy
2) monoclonal antibodies like rituximab
3) radiotherapy
4) stem cell transplantation

27
Q

what are the investigations for Hodgkin’s lymphoma?

A
  • blood tests = normocytic anaemia, eosinophilia, raised LDH
  • lymph node biopsy = reed sternberg cells
  • CT and PET scan for stagins
28
Q

is hodkin’s or non-hodgkin’s lymphoma more common?

A

non-hodgkin’s

29
Q

what is the epidemiology of non-hodgkin’s lymphoma?

A
  • > 75yrs
  • M>F
  • common haematological malignancy
30
Q

what are the risk factors for non-hodgkin’s lymphoma?

A
  • elderly
  • caucasians
  • viral infection
  • FH
  • immunosuppression eg HIV, DM
  • autoimmine disease eg SLE, sjogren’s and coeliac
31
Q

what are the clinical features of non-hodgkin’s lymphoma?

A

painless lymphadenopathy (more likely to be symmetrical non Hodgkin’s)

  • B symptoms eg fever, weight loss, night sweats and fatigue
  • extranodal disease = cutaneous and oropharyngeal involvement
32
Q

what are the investigations for non-hodgkin’s lymphoma?

A

bloods = LDH, normocytic anaemia and paraprotein

  • blood film = nucleated RBCs and left shift (early WBC precursors)
  • biopsy = diagnostic
  • bone marrow biopsy
  • staging = CT and PET

Y3 - Clinical Haematology (5 decks)

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