Lymphoma Flashcards
What are signs and symptoms of lymphoma?
Cough, fever, fatigue, night sweats, weight loss, lymphadenopathy, discomfort after drinking alcohol
What are the signs of hilar lymphadenopathy?
Chest pain, peri-hilar shadows on CXR
What are the features of a malignant node?
hard, painless and adherent to the surrounding tissues and hence they do not move freely
What causes Tuberculous Lymphadenopathy?
result of infection of the lymph nodes by the TB bacillus. Most commonly observed in immunocompromised.
What are the clinical features of Tuberculous Lymphadenopathy?
chronic, painless mass in neck. Mass may become adherent to skin and form a chronic discharging sinus.
What causes cervical lymphadenopathy?
Inflammatory
Malignant
What are the signs of an inflammatory lymph node?
Preceding infection, node gets bigger and small over time, can be painful
What are the signs of a malignant node?
Continued progressive growth. Often have associated head and neck symptoms. Glands often painless. Fixed and irregular.
What are the features of lymph nodes in lymphoma?
presents with multiple often smooth and firm rather than hard irregular
How do you investigate cervical lymphadenopathy?
Full head and neck exam - fibreoptic endoscopy in ENT neck lump clinic
Imaging - USS, CT, MRI, PET
Biopsy - fine-needle aspiration
What are features of mucosal squamous cancer?
Odynophagia with associate otalgia, hoarseness, dysphagia, neck lump
What are risk factors for mucosal squamous cancer?
Smoking, alcohol, HPV, cannabis
What are two types of lymphoma?
Hodgkin or non-hodgkin
What are the classifications of non-hodgkin lymphoma
High-Grade or low-grade
What is a high-grade tumour?
tumours divide rapidly, are typically present for a matter of weeks before diagnosis, may be life-threatening. Potentially curable.
What is a low-grade tumour?
divide slowly, may be present for many months before diagnosis, and typically behave in an indolent fashion. Non-curable by conventional therapy.
What is a lymphoma?
A malignancy that involves the lymphocytes and present as solid tumours involving the lymph nodes
What increases risk of NHL?
autoimmune disease, HIV/AIDs, eating a large amount of meat and fat
What increases risk of HL?
infection with Epstein Barr Virus
What is the histological hallmark of HL?
Reed-Sternberg cells. They have an owl’s eye appearance.
What are the clinical features of HL?
painless, rubbery lymphadenopathy which may fluctuate in size
hepatosplenomegaly
What type of HL is more common in young patients and woman?
nodular sclerosing type
How is HL staged?
Stage 1 : One group of lymph nodes is affected.
Stage 2: Two or more groups of nodes are affected, but the lymphoma is restricted to one side of the diaphragm only
Stage 3: Lymphadenopathy is evident on both sides (above and below) of the diaphragm.
Stage 4: The lymphoma has spread beyond the lymph nodes to other organs such as the spleen, bone marrow, liver or lungs.
As well as giving each stage a number, a letter code – A or B, is added to each of the above stages to indicate whether or not the patient has systemic symptoms (such as weight loss, fevers or night sweats).
What investigations would you carry out in suspected HL?
FBC, ESR, Renal function test, Liver function test, LDH measurements, CXR, CT TAP, PET, lymph node biopsy
