Lymphoma Flashcards
What are the malignant cells in lymphoma?
B lymphocytes
T lymphocytes
NK cells
What sites does lymphoma effect?
Lymph nodes
Spleen
Bone marrow
What are the types of lymphoma?
Hodgkin
Non-Hodgkin
How is Hodgkin lymphoma divided?
Classical
Non-classical
How is non-Hodgkin lymphoma divided?
By cell type
By grade
What is the classic histology of Hodgkin lymphoma?
Reed-Sternberg cells
What are the clinical features of Hodgkin lymphoma?
Painless lymphadenopathy B symptoms Hepatosplenomaegaly Alcohol induced LN pain Pel-Ebstein fever
What is Pel-Ebstein fever?
Fever that lasts a few days, goes away and comes back in cycles
What are the clinical features of non-Hodgkin lymphoma?
Painless lymphadenopathy
B symptoms
Hepatosplenomegaly
Who is effected by Hodgkin lymphoma?
15-35 years
> 60 years
Who is effected by non-Hodgkin lymphoma?
Elderly
What investigations are done for suspected lymphoma?
Bloods
- FBC
- blood film
- LDH
- ESR
CT CAP
Bone marrow biopsy
LN biopsy
How is low grade non-Hodgkin lymphoma managed?
Radiotherapy +/- chemo
chemo = R-CHOP/CHOP
How is high grade non-Hodgkin lymphoma managed?
Chemotherapy +/- radiotherapy
chemo = R-CHOP/CHOP
How is Hodgkin lymphoma managed?
Chemotherapy + radiotherapy
chemo = ABVD
What are the main types of non-Hodgkin lymphoma?
Follicular Marginal zone Mantle cell Burkitt Diffuse
Which non-Hodgkin lymphomas are low grade?
Follicular
Marginal zone
Mantle cell
Which non-Hodgkin lymphomas are high grade?
Burkitt
Diffuse
What is follicular lymphoma?
Proliferation of small B cells forming follicle like nodules
What is the translocation associated with follicular lymphoma?
t(14;18)
What is marginal zone lymphoma?
Proliferation of small B cells that expand the marginal zone
Where does marginal zone lymphoma effect?
LNs
Spleen
Extranodal sites
- gastric MALToma
- thyroid gland
- salivary gland
What causes extranodal involvement in marginal zone lymphoma?
Chronic inflammation
Gastric MALToma = H.pylori
Thyroid = Hashimoto’s thyroiditis
Salivary gland = Sjogren’s
What is mantle cell lymphoma?
Proliferation of small B cells in the mantle zone
What is the translocation associated with mantle cell lymphoma?
t(11;14)
What is Burkitt lymphoma?
Proliferation of intermediate B cells
What conditions are associated with Burkitt lymphoma?
EBV
HIV
What translocation is associated with Burkitt lymphoma?
t(8;14)
What is the appearance of Burkitt lymphoma on microscopy?
Starry-sky appearance
What are the types of Burkitt lymphoma?
Sporadic - arises in abdo/pelvis
Endemic - EBV associated and arises in jaw
What is diffuse lymphoma?
Proliferation of large B cells which grow in sheets
What is the pathophysiology of diffuse lymphoma?
Arise sporadically or from transformation of a low grade lymphoma
What are the classical types of Hodgkin lymphoma?
Nodular sclerosis
Mixed cellularity
Lymphocyte rich
Lymphocyte deplete
What is the non-classical type of Hodgkin lymphoma?
Nodular lymphocyte predominant
Who does nodular sclerosis Hodgkin lymphoma tend to affect?
Young women
Which lymph nodes are affected in nodular sclerosis Hodgkin lymphoma?
Cervical / mediastinal
What is associated with mixed cellularity Hodgkin lymphoma?
EBV
Which lymph nodes are affected in mixed cellularity Hodgkin lymphoma?
Abdominal
What lymph nodes are affected in lymphocyte rich Hodgkin lymphoma?
Cervical / axillary
What is associated with lymphocyte deplete Hodgkin lymphoma?
HIV
Which lymph nodes are affected in lymphocyte deplete Hodgkin lymphoma?
Below diaphragm
What cells are found in nodular lymphocyte predominant Hodgkin lymphoma?
Popcorn cells
What staging system is used in Hodgkin lymphoma?
Ann Arbor
What is the Ann Arbor staging?
1 = single LN region
2 = 2 or more on same side of diaphragm
3 = regions on both sides of the diaphragm
4 = extranodal involvement
