Lymphoma Flashcards
How is Hodgkin’s lymphoma staged?
Ann-abour staging
(via CT-PET)

If a child presents with a burning chest pain, what severe condition must be considered?
Hodgkin’s lymphoma
Which part of lymphoid cells does lymphoma affect?
Germline centre
What are the 2 different types of lymphoma?
Hodgkins
Non-hodgkins
What are the 2 different subtypes of non-hodkgins lymphoma?
Low grade
High grade
What is the main type of low grade non-hodgkins lymphoma?
Follicular lymphoma
What is the main type of high grade non-hodgkins lymphoma?
Diffuse large B-cell lymphpma
What type of lymphpoma is associated with IgM paraproteins?
Low-grade non-hodgkins lymphoma
(follicular lymphpma)
What type of lymphoma is the commonest?
Non-hodgkins
What type of lymphoma is most comon in children?
Hodgkins
What are the clinical featires of lymphoma?
Painless lymphadenopathy
B-symtpoms
Hepatosplenomeagly
Bone marrow failure
Which extra-nodal disease is most commonly associated with hodgkins and non-hodgkins lymphoma?
Hodgkins -> lung disease
Non-hodgkins -> GI disease
What lymph nodes does non-hodkins lymphoma mainly affect?
Those of the upper airway
Which sex is most at risk of hodgkins lymphoma?
Men
What are the investigations for lymphoma?
Lympho node core biopsy
Trephine biopsy
Bone marrow aspirate
PET-CT
Immunophenotyping
What is the 1st line investigation for lymphpma, and how is it done?
Lymph node core biopsy
Done via -> Trephine biopsy
What cells do you look for on a histology of a sample from a lymph node core biopsy to diagnose hodgkins lymphoma?
Reed- Stelenberg cells

Screening for which gene is a good prognostic indicator for lymphoma and other cancers?
p53 gene screening
What are the B-symptoms that are present in lymphoma?
Weight loss (>10% of TBW)
Fever
Drenching night sweats
Puritis
Fatigue
How does Ann-Arbour staging work?
Stage number followed by an A (no B-symptoms) or B (with B-symptoms)
Stage 1: LN in one area affected
Stage 2: >2 areas of LNs above or below the diaphragm affectd
Stage 3: >2 areas of LN above & below the diaphragm affeectd
Stage 4: Everywhere is buggered and extra-nodal disease
How is lymphoma treated?
Combo of chemo and monoclonal antibodies
Bone marrow transplant
Immunotherapy
Radiotherapy
What is the main treatment for lymphoma?
Combo of chemo and monoclonal antibodies
What antibodies are associated with hodgkins and non-hodgkins lymphoma?
Hodgkins -> CD-20
Non hodgkins -> CD-30
Is surgical resection and appropriate treatment for lymphoma?
Absolutley not
If you get hodgkins lymphoma once, will you get it again?
Yeah, it peaks again later in life
What 3 things do you test for to determine the prognosis of lymphoma?
p53 gene
LDL
R-IPI
In lymphoma, what is R-IPI?
Prognosis index
What type of lymphadenopathy does lymphoma cause?
Painless generalised lymphadenopathy
What is one of the main presenting features of hodgkins lymphoma?
Burning chest pain

What is the difference between hodgkins and non-hodgkins lymphoma regarding age?
Non-H -> Old
H -> Young
What is the difference between hodgkins and non-hodgkins lymphoma regarding how commonlly B-symptoms occur?
Non-H -> Less common
H -> Common
What is the difference between hodgkins and non-hodgkins lymphoma regarding the Ann-Arbour stage at which it often presents as?
Non-H -> Late (3 or 4)
H -> Early (1 or 2)
What is the difference between hodgkins and non-hodgkins lymphoma regarding which extra-nodal disease it’s associated with?
(obvs they’re both associated with bone marrow disease)
Non-H -> GI disease
H -> Lung disease
What is the difference between hodgkins and non-hodgkins lymphoma regarding where is commolny spreads?
Non-H -> Remote LN groups
H -> Nearby LN groups (neck & axilla)
What is the difference between hodgkins and non-hodgkins lymphoma regarding what are the findings on a lymph node biopsy?
Non-H -> follicle-like cells
H -> Reed stelenberg cells
Which group of LNs are both types of lymphoma associated with?
Para-aortic
When is an autologous stem cell transplant used for lymphoma?
When the patient is young
What is a potential curative treatment for Hodgkins lymphoma when the patient is young?
Autologous stem cell transplant
What is the difference between high-grade and low-grade non-hodgkins lymphoma regarding the speed of growth?
High -> rapid (aggresive yall)
Low -> slow (indolent)
What is the difference between high-grade and low-grade non-hodgkins lymphoma regarding if it’s curable?
High -> Yes
Low -> No
(kinda the opposite to what you think)
What is the difference between high-grade and low-grade non-hodgkins lymphoma regarding if treatment is needed at the time of diagnosis?
High -> Yes
Low -> No
What is the difference between high-grade and low-grade non-hodgkins lymphoma regarding the size of the cells on histology?
High -> Big
Low -> Small
What is the difference between high-grade and low-grade non-hodgkins lymphoma regarding how the cells look on histology?
High -> Abnormal
Low -> Normal
What is the difference between high-grade and low-grade non-hodgkins lymphoma regarding if it’s associated with IgM paraproteins?
High -> No
Low -> Yes
What is the difference between high-grade and low-grade non-hodgkins lymphoma regarding
What is the difference between high-grade and low-grade non-hodgkins lymphoma regarding
What virus can cause post-transplant lymphoma?
EBV
Why is PET is good for looking at lymphoma?
As PET picks up areas of high metabolic activity, which is obvs what occurs in lymphoma
What heart scan should be done prior to kicking off chemotherapy, and why?
MUGA
As chemo can cause cardiomyopathy
A MUGA scan should be done prior to kicking off chemotherapy, what does it look at?
The heart’s ejection fraction
What are scoring systems used for:
A: DLBCL
B: Follicular lymphoma
A: D-IPI
B: FLIPI
High-grade lymphoma can increase the risk of CNS damage, what is given to prevent this?
Methotrexate
What is the most common type of chemo used in NHL lymphoma, and how many courses of it do you usually give?
R-CHOP
Give 6 courses
Would you use chemo or radiotherapy for:
A- Wide-spread lymphoma
B- localised lymphoma
A- chemo
B- radiotherapy
Why can you get lower leg ischemia in lymphoma?
As the swollen LNs can compress the arteries/veins
What can follicular lymphoma progress to?
DLBCL
What does DLBCL stand for?
Diffuse large B-cell lymphoma