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Haematology > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

What age group is most commonly affected by Hodgkin’s lymphoma?

A

Bimodal age distribution with peaks 15-35 years and then >50 years

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2
Q

In which sex is Hodgkin’s lymphoma more common?

A

Men

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3
Q

Describe the characteristic features of Reed Sternberg cells in Hodgkin’s lymphoma?

A

Owl’s eyes appearance where there is a double nucleus

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4
Q

What are Hodgkin’s cells?

A

Large mononuclear neoplastic cells seen in Hodgkin’s lymphoma

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5
Q

In classic Hodgkin’s lymphoma, neoplastic cells are ‘crippled’. What is meant by this term?

A

They are incapable of secreting immunoglobulins

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6
Q

Which virus may play a role in the aetiology of Hodgkin’s lymphoma?

A

Epstein-Barr virus

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7
Q

In Hodgkin’s lymphoma the majority of the tumour is made up of neoplastic Reed–Sternberg and Hodgkin’s cells. T/F?

A

False - the majority. of the tumour is made up of other types of cells including fibroblasts, lymphocytes, granulocytes. and plasma cells

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8
Q

What is the most common presentation of classical Hodgkin’s lymphoma?

A

Assymmetrical and painless lymphadenopathy - usually in the cervical region

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9
Q

Systemic symptoms affect a minority of patients with Hodgkin’s lymphoma at presentation. What are these symptoms?

A 
Fever
Sweats (particularly at night)
Weight loss
Pruritus
Fatigue
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10
Q

Lymphocyte predominant nodular Hodgkin’s lymphoma has a more indolent course of disease than classical Hodgkin’s lymphoma. T/F?

A

True

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11
Q

Lymphocyte predominant nodular Hodgkin’s lymphoma can transform into what other type of lymphoma?

A

Large B cell non-Hodgkin’s lymphoma

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12
Q

What is the key investigation in the diagnosis of Hodgkin’s lymphoma?

A

Lymph node biopsy

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13
Q

What tests are required for staging of Hodgkin’s lymphoma?

A

FBC
Bone marrow aspiration and trephine biopsy
Imaging (usually CT(

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14
Q

Describe the Ann-Arbor system for staging Hodgkin’s lymphoma?

A

Stage 1) single node involved
Stage 2) multiple nodes involved on the same side of the diaphragm
Stage 3) multiple nodes involved on different sides of the diaphragm
Stage 4) Extra-nodal involvement
(A) denotes absence and (B) denotes presence of B symptoms

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15
Q

Describe the management of early stage Hodgkin’s lymphoma

A

Combination of chemotherapy (ABVD regimen) and radiotherapy

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16
Q

What is the prognosis of Hodgkin lymphoma?

A

Prognosis is good with cure rates of around 90% for early stage disease

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17
Q

What are the possible late effects of treatment of Hodgkin lymphoma?

A 
Secondary malignancy
Cardiac disease
Lung damage
Sterility
Endocrine dysfunction
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18
Q

What is the most common haematological malignancy?

A

Non-hodgkin’s lymphoma

19
Q

What are the two most common subtypes of non-hodgkin’s lymphoma?

A

Follicular lymphoma

Diffuse large B cell lymphoma

20
Q

Which cell type does non-hodgkin lymphoma most commonly arise from?

A

B cells

21
Q

What is the most common presentation of non-hodgkin lymphoma?

A

Painless lymphadenopathy, usually in the cervical region

22
Q

What complications may result from enlarged nodes in non-hodgkin’s lymphoma?

A

Superior vena cava syndrome

Hydronephrosis

23
Q

What symptoms can result from extra nodal involvement of non-hodgkin lymphoma in the intestines?

A

Vague abdominal pain
Anaemia (due to bleeding)
Dysphagia

24
Q

What are the potential symptoms of CNS disease which can occur in non-hodgkin lymphoma?

A

Headache
CN palsies
Spinal cord compression

25
Q

What is the term for non-Hodgkin lymphoma that arises in skin?

A

Mycosis fungoides

26
Q

When systemic symptoms of non-Hodgkin lymphoma occur this usually indicates advanced disease. T/F?

A

True

27
Q

What metabolic complications can result from non-Hodgkin lymphoma?

A

Hyperuricaemia
Renal failure
Hypercalcaemia

28
Q

What investigations are used for the diagnosis of non-Hodgkin lymphoma?

A 
FBC 
Blood film
Lymph node biopsy
Immunophenotyping
Genetic testing
Molecular techniques
Bone marrow examination and biopsy
29
Q

What is the name of the monoclonal antibody which can be used in the treatment of lymphomas which express CD20?

A

Rituximab

30
Q

Which subtype of non-hodgkin lymphoma is caused by a. translocation of chromosomes 14 and 18?

A

Follicular lymphoma

31
Q

Which gene is over expressed in follicular lymphoma?

A

BCL2

32
Q

Follicular lymphoma is an aggressive tumour type. T/F?

A

False - it is generally an indolent tumour

33
Q

Follicular lymphoma typically presents with disseminated disease. How is this treated?

A

Chemotherapy. using the R-CVP regimen

34
Q

What is the prognosis of follicular lymphoma?

A

Fairly good prognosis with median survival 10-15 years

35
Q

Diffuse large B cell lymphoma is an aggressive tumour type. T/F?

A

True

36
Q

Which subtype of non-hodgkin lymphoma is caused by a. translocation of chromosomes 8 and 14?

A

Burkitt’s lymphoma

37
Q

Which gene is unregulated in Burkitt’s lymphoma?

A

MYC gene

38
Q

Extra-nodal involvement is common in Burkitt’s lymphoma. Where is this extra-nodal involvement typically seen?

A

In Africa this is typically in the jaw and neck

Elsewhere extra-nodal involvement typically affects the abdomen

39
Q

What is the prognosis of Burkitt’s lymphoma?

A

There is a good chance of cure in younger patients

40
Q

Which subtype of non-hodgkin lymphoma is caused by a. translocation of chromosomes 11 and 14?

A

Mantle cell lymphoma

41
Q

Which gene is unregulated in mantle cell lymphoma?

A

BCL1

42
Q

What is the prognosis of mantle cell lymphoma?

A

Poor prognosis with median survival only 4 years

43
Q

Which condition is associated with marginal zone lymphoma of MALT?

A

Gastritis due to h.pylori infection

44
Q

T cell lymphomas generally have a worse prognosis of B cell lymphomas. T/F?

A

True

Haematology (10 decks)

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