Lymphoma

Question 1

What type of neoplasm is lymphoma?

Answer 1

Lymphoid neoplasm

Question 2

What is Hodgkin’s lymphoma?

Answer 2

B-lymphoid neoplasm - proliferation of MATURE B cells

Question 3

What is a lymphoma?

Answer 3

A solid tumour in lymph nodes- MATURE cells

Question 4

What are the 2 peaks of when Hodgkin’s lymphoma presents?

Answer 4

• 15-25
• > 65
• More common in men

Question 5

What are risk factors for Hodgkin’s lymphoma?

Answer 5

• Epstein Barr virus (EBV)
• Family history (affected sibling)
• SLE
• Post-transplant

Question 6

What are symptoms of Hodgkin’s lymphoma?

Answer 6

• Superficial lymph node enlargement (non-tender) - 60-70% cervical
• Alcohol-induced lymph node pain
• Pel-Ebstein fever (cyclic fever, up to 40 deg every 2 weeks)
• Systemic symptoms - fever, night sweats, weight loss
• Pruritis

Question 7

What is a complication of Hodgkin’s lymphoma?

Answer 7

SVCO (due to mediastinal LN involvement)

Question 8

How do you diagnose Hodgkin’s lymphoma?

Answer 8

Bloods & *LN-excision biopsy

Question 9

What characteristic/diagnostic feature do you see on LN biopsy in Hodgkin’s lymphoma?

Answer 9

Reed-Sternberg Cells (crippled germinal centre B cells) (mirror image nuclei)

Question 10

What staging is used for Hodgkin’s and Non-Hodgkin’s lymphoma?

Answer 10

Ann Arbor staging - CT ± PET CAP

Question 11

How do you curatively treat Hodgkin’s lymphoma?

Answer 11

Chemotherapy - ABVD (± radio/target or chemo/targeted)

Question 12

What is Non-Hodgkin’s lymphoma?

Answer 12

B or T or NK cell lymphoid neoplasm without Reed Sternberg cells aka all lymphoma w/o RS cells

Question 13

What type of lymphoid neoplasm is the most common in Non-Hodgkin’s lymphoma?

Answer 13

B cell lymphoid neoplasms

Question 14

What is Non-Hodgkin’s lymphoma caused by?

Answer 14

Immunodeficiency

Question 15

What are risk factors for Non-Hodgkin’s lymphoma?

Answer 15

• Acquired immunodeficiency e.g. HIV or H pylori causing gastric MALT
• Congenital immunodeficiency

Question 16

What positive test makes diagnosis of Non-Hodgkin’s lymphoma more likely?

Answer 16

Positive HIV test

Question 17

Which virus is Non-Hodgkin’s lymphoma strongly associated with?

Answer 17

HIV

Question 18

What are symptoms of Non-Hodgkin’s lymphoma?

Answer 18

• Superficial LN enlargement
• Extra nodal symptoms - gut, skin, oropharynx
• ± Systemic symptoms - fever, night sweats, weight loss
• ± BM failure - infection, anaemia, bleeding

Question 19

What investigations do you do to diagnose Non-Hodgkin’s lymphoma?

Answer 19

• Bloods incl. HIV

- BM & LN biopsy

Question 20

How do you treat Non-Hodgkin’s lymphoma?

Answer 20

• Radio + low grade chemo OR targeted + chemo + steroid (high grade) - R-CHOP

Question 21

What are the two types of Non-Hodgkin’s lymphoma?

Answer 21

• Indolent

- Aggressive

Question 22

What are signs of Hodgkin’s lymphoma?

Answer 22

• Lymphadenopathy

- Cachexia, anaemia, splenomegaly or hepatomegaly

Question 23

What is an example of an indolent (grow slowly - watched closely) Non-Hodgkin’s lymphoma?

Answer 23

Follicular lymphoma

Question 24

What is an example of an aggressive (grow and spread quickly) Non-Hodgkin’s lymphoma?

Answer 24

Large B cell lymphoma

Question 25

When can you get erythroderma in Non-Hodgkin’s lymphoma?

Answer 25

T-lymphomas such as Sézary syndrome

Question 26

What age group are typically affected by Non-Hodgkin’s lymphoma?

Answer 26

Elderly (80s)