Lymphoma Flashcards by Sandy 27

How is Hodgkin’s lymphoma staged?

Ann-abour staging

(via CT-PET)

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If a child presents with a burning chest pain, what severe condition must be considered?

Hodgkin’s lymphoma

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Which part of lymphoid cells does lymphoma affect?

Germline centre

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What are the 2 different types of lymphoma?

Hodgkins

Non-hodgkins

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What are the 2 different subtypes of non-hodkgins lymphoma?

Low grade

High grade

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What is the main type of low grade non-hodgkins lymphoma?

Follicular lymphoma

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What is the main type of high grade non-hodgkins lymphoma?

Diffuse large B-cell lymphpma

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What type of lymphpoma is associated with IgM paraproteins?

Low-grade non-hodgkins lymphoma

(follicular lymphpma)

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What type of lymphoma is the commonest?

Non-hodgkins

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What type of lymphoma is most comon in children?

Hodgkins

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What are the clinical featires of lymphoma?

Painless lymphadenopathy

B-symtpoms

Hepatosplenomeagly

Bone marrow failure

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Which extra-nodal disease is most commonly associated with hodgkins and non-hodgkins lymphoma?

Hodgkins -> lung disease

Non-hodgkins -> GI disease

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What lymph nodes does non-hodkins lymphoma mainly affect?

Those of the upper airway

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Which sex is most at risk of hodgkins lymphoma?

Men

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What are the investigations for lymphoma?

Lympho node core biopsy

Trephine biopsy

Bone marrow aspirate

PET-CT

Immunophenotyping

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What is the 1st line investigation for lymphpma, and how is it done?

Lymph node core biopsy

Done via -> Trephine biopsy

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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

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Screening for which gene is a good prognostic indicator for lymphoma and other cancers?

p53 gene screening

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What are the B-symptoms that are present in lymphoma?

Weight loss (>10% of TBW)

Fever

Drenching night sweats

Puritis

Fatigue

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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

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How is lymphoma treated?

Combo of chemo and monoclonal antibodies

Bone marrow transplant

Immunotherapy

Radiotherapy

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What is the main treatment for lymphoma?

Combo of chemo and monoclonal antibodies

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What antibodies are associated with hodgkins and non-hodgkins lymphoma?

Hodgkins -> CD-20

Non hodgkins -> CD-30

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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 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