Lymphoma Flashcards by Ella Knight

What are the malignant cells in lymphoma?

B lymphocytes
T lymphocytes
NK cells

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What sites does lymphoma effect?

Lymph nodes
Spleen
Bone marrow

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What are the types of lymphoma?

Hodgkin

Non-Hodgkin

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How is Hodgkin lymphoma divided?

Classical

Non-classical

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How is non-Hodgkin lymphoma divided?

By cell type

By grade

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What is the classic histology of Hodgkin lymphoma?

Reed-Sternberg cells

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What are the clinical features of Hodgkin lymphoma?

Painless lymphadenopathy 
B symptoms 
Hepatosplenomaegaly 
Alcohol induced LN pain 
Pel-Ebstein fever

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What is Pel-Ebstein fever?

Fever that lasts a few days, goes away and comes back in cycles

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What are the clinical features of non-Hodgkin lymphoma?

Painless lymphadenopathy
B symptoms
Hepatosplenomegaly

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Who is effected by Hodgkin lymphoma?

15-35 years

> 60 years

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Who is effected by non-Hodgkin lymphoma?

Elderly

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What investigations are done for suspected lymphoma?

Bloods

FBC
blood film
LDH
ESR

CT CAP

Bone marrow biopsy
LN biopsy

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How is low grade non-Hodgkin lymphoma managed?

Radiotherapy +/- chemo

chemo = R-CHOP/CHOP

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How is high grade non-Hodgkin lymphoma managed?

Chemotherapy +/- radiotherapy

chemo = R-CHOP/CHOP

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How is Hodgkin lymphoma managed?

Chemotherapy + radiotherapy

chemo = ABVD

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What are the main types of non-Hodgkin lymphoma?

Follicular 
Marginal zone 
Mantle cell 
Burkitt 
Diffuse

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Which non-Hodgkin lymphomas are low grade?

Follicular
Marginal zone
Mantle cell

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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