Lymphoma

Question 1

Ann Arbor stage 1

Answer 1

One group LN ONE SIDE diaphragm

Question 2

Classical HODGKINS picture

Answer 2

Young patients present with a lymph node

Question 3

Ann Arbor stage 2

Answer 3

Same side diaphragm more than one group LN

Question 4

Ann Arbor stage 3

Answer 4

Both sides of diaphragm

Question 5

Ann arbor stage 4

Answer 5

disease outside LN- bone marrow, liver, lungs

Question 6

ABVD

Answer 6

adriamycin, bleomycin, vinblastine, dacarbazine

Question 7

ABVD side effects

Answer 7

hair loss
neutropaenia
cardiotoxicity adriamycin
lung toxicity bleomycin
low risk infertility

Question 8

Long term management issues in HL

Answer 8

Infertility - men worse, older worse
Second cancers- breast, lung, colon, leukaemia (2-10% AML at 10 years), NHL
damage to organs- heart, thyroid, lung- coronary disease

Question 9

DLBCL - factors in international prognostic index (5)

Answer 9

Performance status 2 or more (ecog)
Age 60 or more
Ann Arbor 3 or 4
LDH above normal
2 or more extranodal sites of disease

Question 10

Viruses in lymphoma

Answer 10

Hcv HIV htlv 1 cause noth NHL and HL

EBV just causes NHL

Question 11

Diagnosis

Answer 11

Excisional

Not fna

Question 12

What is the most common oncogene in follicular lymphoma

Answer 12

Rearrangement of bcl-2 oncogene in over 90%

Cytogenetic show T14;18

Question 13

Treat follicular lymphoma

Answer 13

Single rituximab or R-CVP or R-CHOP

Question 14

What are the four stages of CLL

Answer 14

0 no symptoms. 
1 ly,phadenoop
2 splenomegaly 
3 anaemia 
4 THROMBOCYTOPAENIA

Question 15

In CLL which fish is bad?

Answer 15

Zap 70

17 p 13 del is bad cytogenetic

Cd 38 bad

Unmutated igH

13 q del good in CLL
BAD IN MYELOMA

Question 16

CLL complications

Answer 16

Hypogammaglobulinaemia
Infection
Richter transformation to large cell lymphoma 
Monoclonal gammopathy
ITP
Autoimmune haemolytis

Question 17

DLBCL treat or delay?

Answer 17

Treat immediately

Rchop and radiation if bulky

Question 18

Diagnostic of mantle cell lymphoma?

Answer 18

T11;14
Over expression cyclin D

Tx is r hypercvad

Question 19

What markers on B cells

Answer 19

CD 19 20 22

Follicular and lymphoblastic lymphomas often CD 10

Question 20

T cells markers

Answer 20

CD 2 3 5 7

Question 21

Leukocyte common ag

Answer 21

Cd 45

Question 22

NK cell markers

Answer 22

Cd 16 56 57

Question 23

B cell CLL

Answer 23

Cd 5 19 23

Question 24

Fancy new drug in treatment of relapsed CLL?

Answer 24

Ibrutinib
BCL-2 inhibitor
Brutons TK inhibitor

Question 25

What is the main defect in burkitts lymphoma

Answer 25

c-myc gene translocation on t(8;14)

EBV strongly implicated in endemic African burkitts

Sporadic most common at ileocEcal valve