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Haematology > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

Definition of Lymphoma

A

Neoplastic tumor of lymphoid tissue

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2
Q

Where can lymphoma affect

A

Often lymph nodes + BM +/- spill out to blood
Sometimes other lymphoid tissue - spleen, MALT (mucosal associated lymphoid tissue)
Rarely ‘anywhere’ - skin (T-cell), CNS, testes, breast

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3
Q

Incidence of Hodgkins lymphoma

A 
M>F
Bimodal age 20-29 and >60
EBV associated
Spreads to adjacent LNs, often only single group affected
20% of lymphoma
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4
Q

Presentation of Hodgkins Lymphoma

A

Assymmetrical painless lymphadenopathy +/- obstructive symptoms
+/- Consitutional symptoms - wt loss, low grade fever, night sweats, pruritus, fatigue
Pel-Ebstein fever (cyclical 1-2 week) in majority
Pain in affected nodes after alcohol

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5
Q

Investigations of Hodgkins Lymphoma

A

CT/PET
LN or BM biopsy - cells stain with CD15 and CD30
Reed-Sternberg cell - ni/multinucleate ‘owl-eyed’ cell on lymphocytes and reactive cells
Subtypes: nodular sclerosing, mixed cellularity, lymphocyte rich, lymphocyte depleted, nodular lymphocyte predominant

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6
Q

Staging of Lymphoma

A

Stage 1 - one LN region (can be spleen)
Stage 2 - 2 or more on same side of diaphragm
Stage 3 - 2 or more on opposite sides of diaphragm
Stage 4 - extranodal sites (liver, BM)
A: no constitutional symptoms B: symptoms

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7
Q

Treatment of Hodgkins Lymphoma

A

Prognosis excellent esp in young
Combination Chemo - most cases
- ABVD Adriamycin, bleomycin, vinblastine, dacarbazine
- 2-4 cycles in stage 1/2, 6-8 cycles in stage 3
Radiotherapy - alongside chemo
Intensive chemo and autologous SCT
- Relapsed patients

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8
Q

Autologous SCTs are used more often in the treatment in which disease?

A

Multiple myeloma and lymphoma particularly in relapse

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9
Q

Classification of Non-Hodgkins

A

Mature/immature
High grade - very aggressive, aggressive
Low Grade - indolent
Lineage - B cell, T cell

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10
Q

Common features of Non-Hodgkins

A

Painless lymphadenopathy often multiple sites
Consititutional symptoms
No pain after alcohol
Staging as per Hodgkins

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11
Q

Aggressive T CEll lympoma affaecting children and YAs
Large ‘epitelioid’ lymphocytes
t(2;5)
Alk-1 protein expression

A

Anaplastic large cell lymphoma

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12
Q

Aggressive T cell lymphoma affecting the middle-aged and elderly with large T-cells

A

Peripheral T cell lymphoma

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13
Q

Aggressive T cell lymphoma attacking the carribean and japanese with an association with HTLV-! infection

A

Adult T cell leukaemia/lymphoma

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14
Q

T cell lymphoma assoc with long standing coeliac

A

Enteropathy associated T cell lymphoma

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15
Q

T cell lymphoma associated with mycosis fungoides

A

Cutaneous T cell lymphoma

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16
Q

Aggressive B cell lymphoma with t(8;14)

C-myc oncogene overexpression and rapid response to Rx

A

Burkitt’s lymphoma

17
Q

Histological finding of Burkitt’s lymphoma

A

Starry sky appearance

18
Q

Treatment of Burkitt’s lymphoma

A

Chemo - Rituximab and leukaemia protocol

or SCT

19
Q

Three types of Burkitt’s

A 
Endemic - most common malignancy in equatorial africe
 - EBV-assoc
 - Characteristic jaw involvement with abdo masses
Sporadic - FOund outisde AFrica
 - EBV associated
 - Jaw less common
Immuno deficiency - Non-EBV
 - HIV/post-transplant
20
Q

Aggressive B Cell affaecting middle aged and elderly. COmmonly from Richter’s transformation and assoc with other secondary lymphomas

A

Diffuse Large B-cell

21
Q

Histology Finding in DLBC

A

Sheets of large lymphoid cells

22
Q

Treatment for DLBC

A

RItuximab CHOP

Auto-SCT for relapse

23
Q

Aggressive B cell lymphoma affecting middle aged men. Disseminated at presentation with a median survival of 3-5 years
t(11;14), Cyclin D1 deregulation

A

Mantle cell lymphoma

24
Q

Histology finding of mantle cell lymphoma

A

Angular nuclei

25
Q

Treatment for mantle cell lymphoma

A

RItuximab CHOP

Auto-SCT for relapse

26
Q

Indolent, incurable B cell lymphoma with a survival of 12-15 years
t(14;18)

A

Follicular

27
Q

Histology for FOllicular lymphoma

A

Follicular pattern and nodular appearance

28
Q

Treatment for Follicular Lymphoma

A

Watch and Wait

Rituximab CVP

29
Q

B cell lymphoma affecting the Marginal zone in middle aged patients caused by chronic antigen stimulation

A

Mucosal associated lymphoid tissue
H. pylori - gastric MALT
Sjogren’s - parotid lymphoma

30
Q

Treatment for MALT

A

Remove antigenic stimulus
eg H. pylori triple therapy
Chemo

Haematology (17 decks)

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