Lymphoma Flashcards
Define lymphoma
Malignant tumour (of the lymphatic system) Causing proliferation of lymphocytes mainly in lymph nodes
2 types of lymphoma
Hodgkin’s
Non-Hodgkin’s
Clinical presentation of Hodgkin’s lymphoma
Painless rubbery lymph node enlargement
Hepatosplenomegaly
Systemic ‘B symptoms’ (fever, drenching night sweats, weight loss)
Pruritus, fatigue, anorexia and alcohol-induced pain in affected nodes.
Extranodal involvement is possible
Pathophysiology of Hodgkins lymphoma
Malignant transformation of normal T or B cell in lymph nodes.
Reed-Sternberg cells seen on histology.
Aetiology of Hodgkins lymphoma
Previous Epstein-Barr virus in some cases
Epidemiology of Hodgkin’s lymphoma
More common in young adults
Diagnosis of Hodgkins lymphoma
Lymph node biopsy = showing Reed-Sternberg cells
CT = Staging
ESR is raised
Staging of Hodgkins lymphoma (Ann Arbor)
1: Single lymph node or site
2: Two or more nodes/sites, same side of the diaphragm
3: Lymph nodes either side of the diaphragm
a - without B symptoms
b - with B symptoms
4: Diffuse or disseminated of one or more extralymphatic tissue
Treatment of Hodgkins lymphoma
Early stage disease = Brief chemo (ABVD) and irradiation
Advanced = Cyclical chemo (ABVD) and irradiation
Clinical presentation of Non-Hodgkins lymphoma
Same as Hodgkins
Can be indolent or aggressive (depending on origin cell).
Extranodal involvement is more common (than in Hodgkins)
Pathophysiology of Non-Hodgkins lymphoma
70% B cell 30% T cell by origin Clonal expansion of lymphocytes Nature lymphocyte transformation: Indolent course Proliferating cell: Aggressive
Aetiology of Non-Hodgkins lymphoma
Usually unknown
H.pylori infection in MALT lymphoma
EBV infection in Burkitt’s lymphoma
Epidemiology of Non-Hodgkins lymphoma
Rare before 40
Specific varieties more common in children
Diagnosis of Non-Hodgkins lymphoma
FBC - possible anaemia
Lymph node biopsy - needed for diagnosis
CT - staging
Treatment of Non-Hodgkins lymphoma - Diffuse Large B cell lymphoma
Cyclical combination chemo and field irradiation
Treatment of Non-Hodgkins lymphoma - Primary gastric lymphoma
H.pylori eradication
Treatment of Non-Hodgkins lymphoma - Burkitt’s
Cyclical combo chemo
Cells seen on histology
Reed-Steinberg cells
Symptoms of lymphoma
General B symptoms - Fatigue, fever, weight loss Hepato/splenomegaly Anaemia (more a sign) Enlarged lymph nodes Easy bruising Frequent infections
Radiotherapy drugs for Hodgkins lymphoma
AVBD Doxorubicin Vincristine Bleomycin Dacarbazine
Give a side effect of each of these drugs used in Hodgkins lymphoma chemotherapy Doxorubicin Vincristine Bleomycin Dacarbazine
Doxorubicin - n/v
Vincristine - headache, hair loss
Bleomycin - weight loss
Dacarbazine - diarrhoea
Radiotherapy drugs for Non-Hodgkins lymphoma
R-CHOP Rituximab Cyclophosphamide *Hydroxydaunomycin Vincristine Prednisolone
Give a side effect for each of these drugs used in Non-Hodgkins lymphoma chemotherapy Rituximab Cyclophosphamide Hydroxydaunomycin Vincristine Prednisolone
Rituximab - headache Cyclophosphamide - diarrhoea Hydroxydaunomycin - hair loss Vincristine - headache, hair loss Prednisolone - weight gain
Give 5 side effects of prednisolone
Cushings Weight gain Osteoporosis Hypertension Headache
What cells do rituximab inhibit
CD20
Complications of Non-Hodgkins lymphoma
Immunosuppression
Headache
Diarrhoea
Complications of Hodgkins Lymphoma
Immunosuppression
Infertility
Headache
Difference in presentation between Hodgkins and Non-Hodgkins
No night sweats in Non-Hodgkins
Types of Hodgkins lymphoma
Lymphocyte predominant
Nodular sclerosing
Mixed cellularity
Lymphocyte depleted
