Lymphoma

Question 1

2 main types

Answer 1

hodgkins and non-hodgkins

Question 2

epi of hodgkins

Answer 2

bimodal 15-30 andover 50

Question 3

4 subtypes of hodgkins based on lymph node histo

Answer 3

1. lymphocyte predom
   - few reed sternberg and many lymphocytes
2. nodular (most common)
   - bands of collagen envelop reed-sternberg cells
3. mixed cellularity
4. lymphocyte depletion
   - worst prognosis

Question 4

what is staging based on (3)

Answer 4

1. Phx
2. CT
3. bone marrow biopsy

Question 5

clinical features

Answer 5

1. painless lymphadenopathy most common
2. spreads by continuity from one to the next
3. B sx

Question 6

5 things needed for Dx

Answer 6

1. node biopsy - reed sternberg cells
2. inflammatory cell infiltrates
3. CXR and chest CT for nodes
4. bone marrow biopsy
5. labs
   - leukocytosis
   - ESR

Question 7

Tx 2

Answer 7

1. chemo

2. rads

Question 8

patho of NHL

Answer 8

malig. tranformation of B or T cells or their precursors in lymph system

Question 9

main types

Answer 9

B cell - 85%

T cell - 15%

Question 10

5 risk factors for NHL

Answer 10

1. HIV
2. immunosuppression
3. EBV and HTLV-1
4. Hx of Hpylori
5. autoimmune disease - esp MALT

Question 11

clinical manifestations

Answer 11

1. lymphadenopathy
2. B Sx
3. hepatosplenmeg
4. recurent infectipns/ anemia

Question 12

main Dx nor NHL

Answer 12

biopsy of node

- any node over 1cm >4 weeks should be Bx

Question 13

see tables P 342 for types

Answer 13

do it

Question 14

Tx of NHL

Answer 14

indolent
- non curable, but good survival
- obs/chemo/rads
high grade
- can sometime get remission with chemo