Lymphoma Flashcards
Define lymphoma
Cancer affecting the lymphocytes in the lymphatic system
Causes proliferation inside the lymph nodes -> lymphadenopathy
What are the two main categories of lymphoma?
Hodgkin lymphoma - specific disease
Non-hodgkins lymphoma - umbrella term for all other types.
What cell lineage is affected in lymphoma?
Lymphoid blast cells -» either B or T cell lineages
What is the key presentation of lymphoma?
Lymphadenopathy - non-tender, firm or rubbery.
‘B-cell metabolic symptoms’ : fever, weight loss, night sweats.
Additional non-specific: fatigue, itching, cough, SoB, abdo pain, recurrent infections, organomegaly.
What are the key risk factors for Hodgkins lymphoma?
Bimodal age distribution - peak 20-25yrs and 80yrs.
Risk: HIV, EBV, autoimmune conditions, family history.
What are the key diagnostic features of Hodgkin’s lymphoma?
Lymph node pain after drinking alcohol
Reed-Sternberg cells - large cancerous B-lymphocytes - hallmark biopsy.
What is shown on this cancer patient biopsy of lymph node?
Reed-sternberg cells
Large cancerous B-lymphocytes - looks like owls
What are some different types of Non-Hodgkins lymphoma?
Diffuse large B-cell lymphoma
Burkitt lymphoma
MALT lymphoma
What are the main risk factors for Non-Hodgkins lymphoma?
EBV
HIV
H.pylori (MALT)
Hepatitis B/C
Pesticides
Trichloroethylene
Family History
What are the typical features of Diffuse large B cell Lymphoma?
Non-hodgkins
Rapidly growing painless mass in older patients.
What is key to know about Burkitt lymphoma?
A type of non-Hodgkins lymphoma
Associated with HIV and EBV
What are the key features of MALT lymphoma?
Type of Non-Hodgkins lymphoma
Usually around the stomach.
What is the key difference between High-grade and Low-grade lymphomas?
Highgrade - faster proliferation, respond better to treatment, unlikely to reoccur
Low grade - slower proliferation, poorer response to treatment, can be incurable or require lots of treatment, watch and wait approach
What is meant by transformation of a lymphoma?
Changing from a slow growing to a faster growing type.
What are the key investigations for lymphoma?
Lymph node biospy - gold standard
CT, MRI and PET - for diagnosis and staging
What classification system is used for stages of Lymphoma?
Lugano
What are the different stages of lymphoma by the lugano system?
Stage 1 - confined to one node or group of nodes
Stage 2 - multiple groups of nodes on the same side of the diaphragm
stage 3 - lymph nodes above and below the diaphragm
Stage 4 - widespread including non-lymphatic organs such as the lung/liver.
What is the typical management for Hodgkin’s lymphoma?
Chemotherapy
Radiotherapy
Curative, often successful.
Risk of relapse
What are the typical management plans for Non-Hodgkins lymphoma?
Depends on type/stage
Watchful waiting
Chemotherapy
Monoclonal antibodies
Radiotherapy
Stem cell transplant
What are the potential side effects of chemotherapy?
Infections
Cognitive impairement
Secondary cancer (leukemia)
Infertility
What are the side effects of radiotherapy?
Tissue fibrosis.
Secondary cancers.
Infertility.
What is a monoclonal antibody?
A single type of antibody that targets a specific protein (antigen) - which is part of a harmful process (cancer, autoimmune disease)
Triggers immune response
What is rituximab?
Monoclonal antibody
Targets CD-20 protein on the surface of B-cells
Treat: autoimmune conditions, cancers related to B-cells (Non-hodkins lymphoma)
What are infliximab and adalimumab?
Blocks the effects of TNF-alpha.
Monoclonal antibody
