Lymphoma Flashcards
how can a lymphoma present?
a lump
what should you ask in a history of a lump?
- site
- has this enlarged, got smaller or remained the same
- over what time period
- pain or redness
which are the B symptoms?
- fever
- night sweat
- weight loss
which systems should be covered in the systemic enquiry?
- neurological
- musculoskeletal
- cardiorespiratory
- gastrointestinal
- genitourinary
what should you note in a lump examination?
- size
- consistency
- tenderness
- overlying erythema or skin changes
radiological investigations to confirm a lymphadenopathy
- ultrasound
- CT scan
- PET-CT
differential diagnosis for lymphadenopathy
- infection
- solid tumour
- lymphoma
blood investigations
- CBC
- ESR and CRP
- U&E and Creatinine
- LFTs
- serum Ca, albumin, LDH, uric acid
- serum protein electrophoresis and Igs
- ANA
- HIV, TORCH, EBV, HBV, HCV
histological investigation
- biopsy with H&E and immunology
what are the stages of lymphoma?
Stage 1: involvement of a single node region or lymphoid structure
Stage 2: involvement of 2 or more node regions on the same side of the diaphragm
Stage 3: involvement of lymph regions or structures on both sides of the diaphragm
Stage 4: involvement of extranodal site(s) beyond that designated E
types of B-cell lymphoma
- high-grade
- low-grade
types of high-grade B-cell lymphoma
- Hodgkin’s lymphoma
- diffuse large B-cell lymphoma
features of Hodgkin’s lymphoma
- can be nodular
- nodular sclerosing
- mixed cellularity
- lymphocyte rich
- lymphocyte depleted
what are the subtypes of diffuse large B-cell lymphoma based on?
- morphology (centroblastic, immunoblastic, anaplastic, plasmablastic)
- genetic (germinal centre vs activated phenotype)
- immunological
- disease characteristics (CNS, cutaneous leg type, mediastinal, intravascular, effusion)
- infections
types of low-grade B-cell lymphoma
- Small Lymphocytic Lymphoma
- Mantle Cell Lymphoma
- B-Prolymphocytic Leukaemia
- Follicular Lymphoma
- Splenic Marginal Zone Lymphoma
- Marginal Zone Lymphoma (Nodal vs Extranodal)
- Hairy Cell Leukaemia
- Lymphoplasmacytoid Lymphoma