Lymphoma

Question 1

viral infection lymph nodes

Answer 1

tender
hard
smooth

Question 2

bacterial infection lymph nodes

Answer 2

tender 
hard
smooth 
inflammation of skin
tethering of skin

Question 3

lymphoma lymph nodes

Answer 3

non-tender
rubbery/soft
smooth

Question 4

metastatic cancer lymph nodes

Answer 4

non-tender
hard
irregular
tethered

Question 5

lymphadenopathy and suspect malignancy, what is the best diagnostic test

Answer 5

biopsy (FNA and core biopsy often insufficient)

Question 6

what is lymphoma

Answer 6

malignant proliferation of lymphocytes usually in lymph nodes

Question 7

what are the 2 categories of lymphoma

Answer 7

hodgkins

non-hodgkins

Question 8

what type of lymphoma gets reed Sternberg cells (B cells)

Answer 8

hodgkins lymphoma

Question 9

how does hodgkins usually present

Answer 9

lymph nodes which become painful with alcohol
systemic symptoms - night sweats, fever, weight loss (B symptoms)
invasion - hepatosplenomegaly, anaemia (invasion of bone marrow)

Question 10

what kind of cells usually causes non-hodgkins lymphoma

Answer 10

B cells

Question 11

how does non-hodgkins usually present

Answer 11

nodes 
extranodal disease (skin, oropharynx, gut, bone, CNS, lung)

Question 12

what type of cell causes non-hodgkins extra-nodal disease

Answer 12

T cells

Question 13

systemic symptoms are more common with hodgkins/non-hodgkins?

Answer 13

hodgkins

Question 14

what do systemic symptoms in non-hodgkins indicate

Answer 14

disseminated disease

Question 15

who gets hodgkins lymphoma

Answer 15

young adults and the elderly

Question 16

associations with hodgkins

Answer 16

EBV
SLE
transplant
obesity

Question 17

what is burkitts lymphoma

Answer 17

high grade B cell NHL

Question 18

where does the African form of burkitts present

Answer 18

mandibular/maxilla

Question 19

associations with burkitts lymphoma

Answer 19

children

EBV

Question 20

what translocation causes follicular NHL

Answer 20

14:18 - produces Bcl-2

Question 21

what translocation causes mantle cell NHL

Answer 21

11:14

Question 22

staging of lymphoma

Answer 22

1 - restricted to single lymph node region
2 - 2+ regions on same side
3 - 2+ regions on different sides
4 - extra-nodal tissues

A - itch only
B - weight loss >10% in 6 months, fever >38, drenching night sweats

Question 23

investigations for lymphoma

Answer 23

biopsy:
histology - nodular sclerosing in hodgkins
immunohistochemistry - brown if positive
immunophenotyping - bone marrow disease
genetics

Question 24

what is used as a prognostic marker in non-hodgkins lymphoma

Answer 24

LDH

Question 25

treatment for hodgkins

Answer 25

radio and chemo

Question 26

treatment for low grade non-hodgkins

Answer 26

indolent and incurable

if local, can do radio

Question 27

treatment for high grade NHL

Answer 27

chemo
immunotherapy
steroids

Question 28

Burkitts has good/bad response to chemo

Answer 28

responds rapidly

Question 29

risk with chemo (especially in burkitts)

Answer 29

tumour lysis syndrome during the first course

Question 30

what is tumour lysis syndrome

Answer 30

rapid breakdown of tumour causing a surge in electrolytes
imbalance can cause AKI
hyperrehydration

Question 31

what translocation is present in burkitts lymphoma and what protein is produced

Answer 31

8:14 - produces c-myc