Lymphoma Flashcards
What is the most common presentation of lymphoma?
A painless, enlarged lymph node
What are some symptoms other than lymphadenopathy that both HL and NHL can present with?
Night sweats, weight loss, fever, fatigue
What are some features other than lymphadenopathy that a HL may be more likely to present with?
Itch without rash, alcohol induced pain (where the affected lymph node is)
Which people suffering from lymphoma tend to present with more generalised symptoms rather than a specific lump?
People whose lymphoma affects deep nodes which cannot be felt
What investigation is required to diagnose a lymphoma?
Lymph node biopsy (ideally a whole sample)
What investigation can be useful to determine the spread of a lymphoma?
CT scan
How will the consistency of a lymphoma lymphadenopathy be different from that of an infection or metastatic disease?
It will be rubbery/smooth (not hard)
What type of lymphoma can be described as ‘nodular sclerosing’?
Hodgkin’s
What cells present on histology are characteristic of Hodgkin’s lymphoma?
Reed-Sternberg cells
After taking a biopsy for histology, what investigation is used to confirm a lymphoma and help to sub-classify it?
Immunohistochemistry
On immunohistochemistry, CD20+ cells are seen in what type of lymphoma?
Follicular NHL
On immunohistochemistry, CD30+ Reed Sternberg cells are seen in what type of lymphoma?
HL
Immunophenotyping is useful in the diagnosis of what type of lymphomas? Give an example.
Lymphomas present in the marrow e.g. Burkitt’s
Specific patterns of chromosomal abnormalities are seen in certain lymphomas. What cytogenetic analysis can be used to assess these?
G banding or FISH
A translocation between chromosomes 14 and 18 is seen in which type of lymphoma?
Follicular NHL
A translocation between chromosomes 11 and 14 is seen in which type of lymphoma?
Mantle cell NHL
Non-Hodgkin’s lymphoma can be split into what two types? Which is the most common? Which has a poorer prognosis?
B cell and T cell / B cell / T cell
The B cell subtype of non-Hodgkin’s lymphoma can be further divided into what two types? Describe the difference between the two?
High grade - fast growing but very responsive to treatment / low grade -slow growing but not curable
Burkitt’s lymphoma is a subtype of which class of lymphoma? What is clinically significant about this type?
B cell NHL - it is very aggressive and grows very rapidly, it requires more intensive treatment
Mantle cell lymphoma is a subtype of which class of lymphoma? What is clinically significant about this type?
B cell NHL - under the microscope cells are mature and look low grade however they actually behave badly and are incurable
Marginal zone lymphoma is a subtype of which class of lymphoma? What is clinically significant about this type?
NHL - very slowly changing, can live for years without treatment
The aetiology of Hodgkin’s lymphoma can be associated with what?
EBV infection
When does Hodgkin’s lymphoma tend to present?
Has two main peaks of incidence in the 3rd and 7th decades
What are some potential signs of Hodgkin’s lymphoma?
Anaemia and splenomegaly
How should Hodgkin’s lymphoma be treated? What is its prognosis like?
Chemotherapy/radiotherapy or both / good prognosis, cures around 80% of patients
The aetiology of NHL can be associated with what?
Immunodeficiency (congenital or acquired)
Which type of lymphoma is most likely to present with extranodal disease?
NHL
What is the treatment for low grade NHLs?
May not require any treatment if not symptomatic, radiotherapy can be used in localised disease
What is the treatment for high grade NHLs?
RCHOP chemotherapy or rituximab if CD20+
Burkitt’s lymphoma is a subtype of NHL which is more likely to present with extranodal disease. Where is disease likely to occur in a) endemic disease in Africa? b) sporadic form?
a) Jaw b) Abdomen
How is Burkitt’s lymphoma treated?
Chemotherapy
What is significant about chemotherapy treatment for Burkitt’s lymphoma?
It tends to produce a rapid response which can result in tumour lysis syndrome
What actually is a lymphoma?
A solid tumour of lymphoid tissue
What is the median age of onset for NHL?
55-60
What type of lymphoma can be described as having a ‘starry sky’ appearance on blood film?
Burkitt’s lymohoma
A translocation between chromosomes 8 and 14 is seen in which type of lymphoma?
Burkitt’s lymphoma