Lymphoma Flashcards

1
Q

What is lymphoma?

A

disorders caused by malignant proliferation of lymphocytes

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2
Q

What causes lymphadenopathy in lymphoma?

A

accumulation of lymphocytes in nodes

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3
Q

How are lymphomas histologically classified?

A

Hodgkins

Non Hodgkins

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4
Q

What is the histology of Hodgkins lymphoma?

A

Reed-sternberg cells are found

cells with mirror image nuclei

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5
Q

What are the 2 peaks of incidence in hodgkins lymphoma?

A

young adults

elderly

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6
Q

What are risk factors for hodgkins lymphoma?

A
female sex 
western 
affected sibling 
EBV 
SLE
obesity 
post transplant
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7
Q

How does Hodgkins lymphoma present?

A

enlarged, painless, non tender ‘rubbery’ superficial lymph nodes (usually cervical, can be inguinal, axillary)
size of nodes may increase/decrease spontaneously
systemic symptoms: fever, weight loss, night sweats, lethargy, pruritus
alcohol induced node pain

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8
Q

What are the signs of Hodgkins lymphoma?

A

lymphadenopathy
cachexia
anaemia
spleno or hepatomegaly

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9
Q

What are the investigations for Hodgkins lymphoma?

A

node biopsy

bloods: FBC, film, ESR, LFTs, LDH, calcium, urate

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10
Q

What is stage 1 Hodgkins lymphoma?

A

single node region involved

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11
Q

What is stage 2 Hodgkins lymphoma?

A

2 or more nodal areas

same side of diaphragm

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12
Q

What is stage 3 Hodgkins lymphoma?

A

nodes on both sides of diaphragm

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13
Q

What is stage 4 Hodgkins lymphoma?

A

spread beyond nodes e.g. liver, bone marrow

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14
Q

What does the A and B mean in lymphoma staging?

A

A - no systemic symptoms except pruritus

B - presence of B symptoms e,g, weight loss, night sweats, fever

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15
Q

What is the treatment of Hodgkins lymphoma?

A

chemoradiotherapy

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16
Q

What are non-Hodgkins lymphomas?

A

all lymphomas without reed sternberg cells

17
Q

What cell are most non-Hodgkins lymphomas derived from?

A

B cells

can also be derived from T cells

18
Q

Apart from nodes, where else can non Hodgkins lymphoma affect?

A

extra nodal tissue
mucosa associated with lymphoid tissue
e.g. gastric MALT

19
Q

What indicates worse disease in lymphomas?

A

presence of B symptoms

20
Q

How does non Hodgkins lymphoma present?

A

systemic symptoms e.g. wt loss, night sweats, fever (less common than in Hodgkins)
nodal disease
extra nodal disease (25%)
- skin e.g. Sezary syndrome
- oropharynx e.g. waldeyers ring lymphoma
- gut e.g. gastric MALT (h pylori), non MALT
- small bowel

21
Q

What is gastric MALT?

A

gastric mucosa- associated lymphoid tissue

22
Q

What is the management of low grade non Hodgkins lymphoma?

A

chemo
radiotherapy - local disease
often incurable

23
Q

What is the management of high grade non Hodgkins lymphoma?

A

chemo - R-CHOP

aggressive but often curable