Lymphoma

Question 1

Lymphomas are malignant proliferation of ? , which most commonly accumulate in ? lymph nodes, but can accumulate in the peripheral ? or infiltrate ?. Most are derived from ? cells.

Answer 1

lymphocytes
peripheral
blood
organs
B

Question 2

Hodgkin’s lymphoma;

Make up ?%, characterised by ?-? cells.
o ? ‘? cells’ on biopsy.
The largest peak of incidence is in ? adults
o There is a second peak in ?-? year olds.

Answer 2

15
reed-sternberg
binucleate
mirror
young 25-30
50-70

Question 3

Hodgkins

It is twice as common in ? .
Risk factors are having an affected ?, ?, ?or being ?.
Hodgkin’s disease is ? growing, usually ? and ? fatal.

Answer 3

males
sibling
ebv
sle
obese
slow
local
rarely

Question 4

Hodgkin’s Symptoms;

Enlarged, non-?, ‘?’ lymph nodes, typically ? LNs.
25% will have B symptoms, with profuse ? ?.
? can induce lymph node pain.
? lymph nodes can have mass effects (?/? obstruction) or effects of direct extension (? ?).
On examination, there will be lymphadenopathy, with ? in 50%, and potentially signs of cachexia / ?.

Answer 4

tender
rubbery
cervical
night sweats
alcohol
mediastinal
SVC, bronchial
pleural effusion
hepatosplenomegaly
anaemia

Question 5

Prognosis;

Prognosis is better in ? predominant disease

Answer 5

lymphocyte

Question 6

Non-Hodgkin’ s lymphoma;

Includes all lymphomas without the presence of ?-? cells.
The peak incidence is at ? years.
They can be further classified into high or low ?;

Answer 6

reed-sternberg
70
grade

Question 7

Non-H

o High grade tumours: divide ?, typically present with ? onset lymphadenopathy. They are more ?, + have a ? prognosis if identified and treated.
o Low grade tumours: divide ?, typically present more ? and thus tend to be ?disseminated at diagnosis, often ?.

Answer 7

rapidly
rapid
aggressive
better
slowly
insidiously
widely
incurable

Question 8

Non-H Sx

Nodal disease: ?% have superficial lymphadenopathy at presentation.
Extranodal disease: 25% at presentation, can affect the ?, ?, ???, ? or ?.
B symptoms: ? ? indicates disseminated disease.
Bone marrow ?

Answer 8

75
gut, lung, CNS, oropharynx, skin
wt loss
failure

Question 9

Investigations;

FBC, ?, ?, ?, ?, ?, ?.
? ? ? biopsy if possible.
Image guided ?, laparotomy or ? may be required to get a sample.
? CT.

Answer 9

film,lft, u+e, calcium, esr, LDH
L N excision
biopsy
mediastinoscopy
staging

Question 10

Management;
?, ? or Chemo-Radiotherapy.

Staging with ? ? system not TNM

Answer 10

Ann arbor

Question 11

Prognosis;
Poor prognostic signs are age >? at presentation, ? disease, and raised ?.
Survival is very variable.

Answer 11

60
disseminated
LDH