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Haematology > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

what is lymphoma

A

clonal neoplastic prolilferation of lymphoid cells- Hodgkin and non hodgkin

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2
Q

what is the % B cell and T cell lymphomas in NHL

A

85% B cell, 15% T cell

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3
Q

what is present in histology HL

A

Reed Sternberg cells

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4
Q

which is more common HL or NHL

A

NHL is 7x more common

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5
Q

most freq NHL B cell cancers

A

diffuse large B cell, follicular lymphoma

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6
Q

presentation patient

A

enlargement lymph nodes, systemic symptoms- weight loss, night sweats, local mass.

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7
Q

what are NHL split into

A

B cell and T cell

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8
Q

examples T cell NHL

A

T cell prolymphocytic leukaemia; mycosis fungoides; sezary syndrome

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9
Q

examples low grade B cell NHL

A

small lymphocytic leukaemia, follicular lymphoma, mantle cell, marginal cell

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10
Q

examples high grade B cell NHL

A

diffuse large B cell, burkitts

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11
Q

what are the types of Burkitts

A

spontaneous, endemic, immunodeficiency associated

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12
Q

what can patient with sporadic Burkitts present with

A

abdominal mass

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13
Q

what do patients have with immunodeficiency associated BL

A

HIV

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14
Q

do less or more aggressive tumours respond better to treatment

A

more aggressive. low grade tend to relapse

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15
Q

what is the cell origin of hodgkins

A

B cell

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16
Q

which type of HL has the best prognosis

A

lymphocyte rich

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17
Q

classifications classic hodgkins

A

nodular sclerosis, lymphocyte rich, mixed cellularity, lymphocyte depleted

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18
Q

classification HL

A

nodular lymphocyte predominant HL, Classic HL

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19
Q

what are reed Sternberg cells

A

multinucleate cells- mirror image nuclei

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20
Q

worst prognosis in classical HL

A

lymphocyte deplete

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21
Q

features HL

A

lymphadenopathy- cervical and painless; nodes fluctuate in size; 25% systemic upset- weight lo;ss, sweats, pruritus, lethargy

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22
Q

signs HL

A

lymph node enlargement. cachexia, anaemia, spleno/hepatomegaly

23
Q

lab features HL

A

anaemia (normochromic, normocytic) leucocytosis, raised ESR, abnormal LFTs

24
Q

diagnosis

A

biopsy of lymph node. FBC, film, ESR, LFT, LDH, urate, Ca

25
Q

what indicates a worse prognosis on bloods in HL

A

incr ESR or decr Hb

26
Q

what system is used for staging in HL

A

ann arbor staging

27
Q

staging of HL

A

1- single lymph node area; 2- >2 lymph node areas above diaphragm; 3-above and below diaphragm; 4- involvement of other organs- A- no systemic symptoms, B- presence systemic syptoms

28
Q

what diagnostic tool is used for staging

A

PET/CT

29
Q

what treatment for early disease HL- stage 1A or 2A

A

radiotherapy

30
Q

what treatment for advanced disease HL- stage 1B,2B,3,4

A

chemo- combination- 6 cycles ABVD

31
Q

what does ABVD stand for- chemo

A

Adriamycin, bleomycin, vinblastine, dacarbzine

32
Q

if pt relapses following radiotherapy alone in HL what is the prognosis following CCT

A

very good, >80% complete remission

33
Q

if HL patient relapses

A

poor, consider stem cell transplantation

34
Q

what is the prognosis HL

A

stage 1-2: >90%; 4: 50-70%

35
Q

poor prognostic factors for HL

A

increasing age, male, anaemia, leucocytosis, stage 4, B symptoms, bulky tumour, incr sites disease, early relapse, high ESR, lymphopenia

36
Q

what happens in NHL

A

clonal expansion of an abnormal cell

37
Q

risk factors NHL

A

EBV- Burkitts; bacterial infection, radiation, drugs, autoimmune disease, immune suppression

38
Q

clinical features NHL

A

lymphadenopathy- widely disseminated at presentation, splenomeg, extranodal disease, extranodal disease more common than in HL

39
Q

lab features NHL

A

anaemia, pancytopenia, lymphocytosis, paraprotein, LDH raised

40
Q

diagnosis NHL

A

tissue biopsy, immunophenotyping to see if B or T cell origin, antigenic markers, CT, MRI, PET, bone marrow aspirate, trephine

41
Q

how is NHL staged

A

same as for HL

42
Q

management- what can be given to patient with follicular lymphoma

A

rituximab

43
Q

what can diffuse large B cell be treated with

A

full course chemo

44
Q

clinical course follicular lymphoma

A

indolent for many years, transforms to a more aggressive large cell lymphoma in 1/3

45
Q

what does splenic marginal cell lymphoma present with

A

enlarged spleen, AIHA, paraprotein, monoclonal B lymphocytes

46
Q

where does MALT occur

A

mucosa associated lymphoid tissue in stomach assoc with H pylori

47
Q

what is the prognosis of mantle cell

A

poor- only a few years

48
Q

what is the most common NHL T cell

A

peripheral T cell lymphoma

49
Q

how can aggressive lymphoma be treated

A

deep x ray therapy (DXT) with adjuvant CCT

50
Q

difference in treatment for B and T cell tumours

A

rituximab is not used in T cell

51
Q

what can be used for indolent tumours NH if they need treatment

A

single agent chemo or CCT

52
Q

how is mycosis fungoides treated

A

skin targeted therapies- PUVA, topical steroids, vit D

53
Q

what does rituximab do

A

monoclonal antibody for CD20 protein (antigen), which is found on the surface of B cell.

Haematology (12 decks)

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