lymphoma Flashcards
what is lymphoma?
clonal proliferation of lymphocytes arising in a lymph node or associated tissue
solid tumour but some cells in blood
what are the 3 types of lymphoma?
Hodgkin
non-Hodgkin
-more common 6:1
what are the symptoms of lymphoma?
fever swelling of face and neck lump in neck, pits, groin excessive sweating at night unexpected weight loss breathlessness weakness loss of appetite itchiness
what is the staging of lymphoma?
requires imaging
- CT, PET/CT or MRI
1. no. nodes involved and site
2. extra-nodal involvement
3. systemic symptoms
what is the purpose of staging?
predicting prognosis and deciding tx
describe hodgkin lymphoma
peak 15-40 years
M:F 2:1
what is the clinical presentation of hodgkin lymphoma?
painless lymphadenopathy- typically cervical, fluctuate in size pain with alcohol notable
fever, night sweats. weight loss, itching
infection
what are the cure prognosis of stage 1 and 2 hodgkin lymphoma
> 90%
what is the cure prognosis for stage 3 & 4 hodgkin?
50-70%
describe non-hodgkin lymphoma
B-cell (85%)
T-cell (15%)
any age
what is the aetiology of non-hodgkin?
microbial factors strongly implicated -EBV, HIV, H.pylori autoimmune disease associated -chronic immune activation immunosuppression
what is the presentation of NHL?
lymphadeopathy -often disseminated extra-nodal disease -oropharyngeal involvement waldeyers ring -noisy breathing sore throat symptoms of marrow failure constitutional symptoms less common (fever, sweat etc.)
what is the prognosis of NHL?
> 50% relapse
aggressive disease
poor prognosis untreated
what is a multiple myeloma?
malignant proliferation of plasma cells
what are the features of multiple myeloma?
monoclonal paraprotein in blood and urine
lytic bone lesions-pain & fracture
excess plasma cells in bone marrow - marrow failure
what are the signs of multiple myeloma?
infection bone pain renal failure -paraproteins clog renal glomerular -form clumps in organs & tissues reducing function amyloidosis -in GIT prevents absorption
what is the tx of haematological malignancies?
chemo
radiotherapy
monoclonal antibodies
haemopoietic stem cell transplantation
what are the stages of tx?
induction -large dose chemo to remove disease remission -normal marrow maintenance & consolidation -require low level tx for many years relapse -disease comes back
what is included in supportive therapy?
nutrition psychological and social support prevention and tx of infection managing symptoms of side effects correcting marked blood component deficits pain control
describe chemo
cells with high turnover rate targeted
responsible for many unwanted effects in notmal high turnover tissues
side effects
long-term risk of oncogenesis
describe radiotherapy
cytotoxic effect of ionizing radiation -beam directed outside body -adjacent healthy tissue affected -spactial positioning, targeting and dosing techniques minimises risk of inducing late cancers
describe monoclonal antibodies?
specific to cancer cell antigens produced artificially in large quantities
use CD antigens on white cells
target interleukin messaging
target GF
describe haemopoietic stem cell transplant
allogenic=from live donor autologous=from px require total body irrdiation -remove marrow and maglignant cells usually stem cells from blood high risk
