Lymphoma Flashcards
viral infection lymph nodes
tender
hard
smooth
bacterial infection lymph nodes
tender hard smooth inflammation of skin tethering of skin
lymphoma lymph nodes
non-tender
rubbery/soft
smooth
metastatic cancer lymph nodes
non-tender
hard
irregular
tethered
lymphadenopathy and suspect malignancy, what is the best diagnostic test
biopsy (FNA and core biopsy often insufficient)
what is lymphoma
malignant proliferation of lymphocytes usually in lymph nodes
what are the 2 categories of lymphoma
hodgkins
non-hodgkins
what type of lymphoma gets reed Sternberg cells (B cells)
hodgkins lymphoma
how does hodgkins usually present
lymph nodes which become painful with alcohol
systemic symptoms - night sweats, fever, weight loss (B symptoms)
invasion - hepatosplenomegaly, anaemia (invasion of bone marrow)
what kind of cells usually causes non-hodgkins lymphoma
B cells
how does non-hodgkins usually present
nodes extranodal disease (skin, oropharynx, gut, bone, CNS, lung)
what type of cell causes non-hodgkins extra-nodal disease
T cells
systemic symptoms are more common with hodgkins/non-hodgkins?
hodgkins
what do systemic symptoms in non-hodgkins indicate
disseminated disease
who gets hodgkins lymphoma
young adults and the elderly
associations with hodgkins
EBV
SLE
transplant
obesity
what is burkitts lymphoma
high grade B cell NHL
where does the African form of burkitts present
mandibular/maxilla
associations with burkitts lymphoma
children
EBV
what translocation causes follicular NHL
14:18 - produces Bcl-2
what translocation causes mantle cell NHL
11:14
staging of lymphoma
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
investigations for lymphoma
biopsy:
histology - nodular sclerosing in hodgkins
immunohistochemistry - brown if positive
immunophenotyping - bone marrow disease
genetics
what is used as a prognostic marker in non-hodgkins lymphoma
LDH
treatment for hodgkins
radio and chemo
treatment for low grade non-hodgkins
indolent and incurable
if local, can do radio
treatment for high grade NHL
chemo
immunotherapy
steroids
Burkitts has good/bad response to chemo
responds rapidly
risk with chemo (especially in burkitts)
tumour lysis syndrome during the first course
what is tumour lysis syndrome
rapid breakdown of tumour causing a surge in electrolytes
imbalance can cause AKI
hyperrehydration
what translocation is present in burkitts lymphoma and what protein is produced
8:14 - produces c-myc
