Lymphoma

Question 1

What are lymphomas?

Answer 1

Lymphomas are solid tumours formed from the neoplastic proliferation of cells in the lymphatic system aka lymph nodes and spleen.

They are classified as Hodgkins or Non Hodgkins Lymphoma depending on the presence of Reed-Sternberg cells. Non Hodgkin’s Lymphoma can be further classified by whether it predominantly affects B or T cells.

Question 2

How does NH lymphoma’s present?

Answer 2

Non Hodgkins Lymphoma is much more common in childhood.

NHL predominantly affects lymph nodes and can present as localised lymph node disease in the head, neck or abdomen (pain and intussusception) (B cell) or as a mediastinal mass (T cell) and may also cause bone marrow infiltration.

Question 3

How does Hodgkins lymphoma present?

Answer 3

More common in adolescence. (rare pre-pubertally)

Usually presents as painless lymphadenopathy (larger and firmer than benign lymphadenopathy seen in children), frequently in the neck.

Clinical presentation is often long (slow growing) and systemic symptoms (anorexia, weight loss etc) are uncommon, even in advanced disease.

Note: is very responsive to chemo

Question 4

Outline the main differences between Hodgkins and Non Hodgkin’s lymphoma?

Answer 4

Hodgkins:

• presence of reed-sternburg cells
• adolescents
• B cells
• rare
• painless neck swelling

Non Hodgkins:

• no reed sternberg cells
• more common in children
• B or T cells (more commonly B)
• more common
• varied presentation (head/neck swelling, abdo pain, intussusception)

Question 5

What are the short term complications of chemotherapy?

Answer 5

Blood:
Anaemia
Neutropenia (infection risk)
Easy bleeding bruising
Mouth sores

GI:
Nausea and vomiting
Weight gain

General:
Hair loss
Irritability

Question 6

What are the long term implications of chemotherapy?

Answer 6

Delayed puberty, reduced fertility, reduced growth.

Chemotherapy can cause: neurotoxicity, hepatotoxicity, renal toxicity, cardiotoxicity, and pulmonary toxicity.

Psychological impact.