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Haematology > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

Lymphoma risk factors

A

Constant antigenic stimulation (e.g. Coeliac disease in EATL)
Infection (e.g. EBV in Burkitts, HTLV1 in ATLL)
Loss of T cell function (normally controls B cell proliferation - e.g. in HIV)

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2
Q

Is Hodgkin’s or non-Hodgkin’s more common?

A

Non-Hodgkin’s (80%)

Hodgkin’s (20%)

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3
Q

Hodgkin’s vs. non-Hodgkin’s

A

Single site vs. multiple sites
Pain after alcohol vs. no pain after alcohol
Reed-Sternberg cells, Pal Ebstein fever (Hodgkin’s)
B cells vs. B and T cells
Contiguous spread between nodes vs. random spread between nodes
Classical / non-classical vs. B cell / T cell

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4
Q

Hodgkin’s sub-types

A

Classical: Nodular sclerosing (80%), mixed cellularity, lymphocyte rich, lymphocyte depleted
Non-classical: Nodular lymphocyte predominant

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5
Q

Most common Hodgkin’s

A

Nodular sclerosing

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6
Q

Pain in nodes after alcohol

A

Hodgkin’s

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7
Q

Owl eyed cells

CD15 and CD30 positive

A

Reed Sternberg cells

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8
Q

Cyclical fever lasting 1-2w

Hodgkin’s lymphoma

A

Pal Ebstein fever

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9
Q

Hodgkin’s bad prognosis

A

Lymphocyte depleted

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10
Q 
Single site painless lymphadenopathy
Pain after alcohol
Contiguous spread between LN
Reed-Sternberg cells
Pal Ebstein fever
B cells only
A

Hodgkin’s

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11
Q

Multiple sites painless lymphadenopathy
Random spread between LNs
B and T cells

A

Non-Hodgkin’s

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12
Q

B symptoms

A

Fever >38
Night sweats
Weight loss >10% in 6m

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13
Q

EBV in lymphoma

A

Hodgkins lymphoma

Non-Hodgkins Burkitts

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14
Q

Ann Arbor lymphoma staging

A 
1 = 1 LN region
2 = 2 LN regions same side of diaphragm
3 = 2 LN regions opposite sides of diaphragm
4 = Extranodal spread (e.g. Liver, BM)
A = No B symptoms
B = B symptoms
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15
Q

Causes of death lymphoma
<5y
>5y

A

<5y relapse

>5y secondary malignancy

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16
Q

Hodgkins lymphoma treatment

A
  1. Combination chemo ABVD given to all
  2. Radio if small targetable area but radiation can = secondary malignancy
  3. Intensive chemo, autologous SCT if resistant

Balance risk of relapse (give chemo and radio) vs risk of secondary malignancy (give chemo only)

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17
Q

ABVD

A

Hodgkin’s chemo

Adriamycin, bleomycin, vinblastine, dacarbazine

18
Q

Are B cell or T cell non-Hodgkin’s lymphomas more common?

A

B cell

19
Q

Non-Hodgkins lymphoma sub-types

A

B / T cell

B cell then divided into: Very aggressive, aggressive, indolent

20
Q

Very aggressive NHL

A

Burkitt’s
2-5w survival without treatment
Curable

21
Q

Aggressive NHL

A

DLBC, mantle cell
3-12m survival without treatment
Less curable

22
Q

Indolent NHL

A

Follicular, CLL/SLL, MALTs
10-15y survival
Mostly incurable

23
Q

5 main B cell NHL

A

Burkitts, DLBC, Mantle, Follicular, MALTs

24
Q

What happens to curability and survival without Tx as aggression decreases?

A

Curability decreases

Survival increases

25
Q

t(8;14)
Over-expression of c-myc on chromosome 8
Starry sky appearance
EBV

A

Burkitt’s

26
Q

t(11;14)
Cyclin D1 over-expression
Middle aged man with GI involvement
Angular nuclei

A

Mantle cell

27
Q

Lymphoma incidence

A

Bimodal peak
Most common 20-29yo
Second smaller peak >60

28
Q

t(14;18)

BCL2 over-expression

A

Follicular (four)

29
Q

Sjogren’s (parotid), Hashimoto’s (thyroid), H pylori (gastric)

A

MALT ‘marginal zone’

30
Q

5 main T cell NHL

A

Anaplastic large cell, peripheral, ATLL, EATL, CTCL

31
Q

Mycosis fungoides

Cutaneous T cells

A

CTCL

32
Q

Coeliac disease

A

EATL

33
Q

Cloverleaf / flower appearance
Japanese
HTLV1
Hypercalcaemia

A

ATLL

34
Q

Large epithelioid T lymphocytes

A

Anaplastic large cell

35
Q

Key transformations in lymphoma

A

CLL to DLBC (Richters)

Follicular to DLBC

36
Q

t(14;18)
Large B cells
Elderly men

A

DLBC

37
Q

Tartrate resistant acid phosphatase (TRAP)

A

Hairy cell leukaemia (type of NHL)

38
Q

CLL patient with recurrent pneumonia + haemoptysis

Found to have endobronchial mass

A

Richter’s transformation

CLL -> DLBC

39
Q

HL - fibrous bands separate nodules

A

Nodular sclerosis

40
Q

HL - atypical popcorn cells

Lymphocytic + histiocytic variant

A

Nodular lymphocytic

41
Q

HL - many lymphocytes

Good prognosis

A

Lymphocyte rich

42
Q

HL - few lymphocytes

Bad prognosis

A

Lymphocyte depleted

Haematology (17 decks)

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