Lymphoma

Question 1

Hodgkin’s Lymphoma

Answer 1

1 in 5 lymphomas

Caused by proliferation of lymphocytes

Peaks around aged 20 and 75 years

Question 2

Risk factors

Answer 2

HIV

Epstein-Barr Virus

Autoimmune conditions such as rheumatoid arthritis and sarcoidosis

Family history

Question 3

Presentation of lymphoma

Answer 3

Lymphadenopathy
Non-tender and feel “rubbery

neck, axilla (armpit) or inguinal (groin) region

Some patients will experience pain in the lymph nodes when they drink with alcohol

Question 4

Investigations

Answer 4

Lactate dehydrogenase (LDH) often raised in Hodgkin’s lymphoma

Lymph node biopsy is the key diagnostic test
Reed-Sternberg cell

Question 5

Ann Arbor Staging

Answer 5

Stage 1: Confined to one region of lymph nodes

Stage 2: In more than one region but on the same side of the diaphragm (either above or below)

Stage 3: Affects lymph nodes both above and below the diaphragm

Stage 4: Widespread involvement including non-lymphatic organs such as the lungs or liver

Question 6

Management of lymphoma

Answer 6

Chemotherapy and radiotherapy

Chemotherapy creates a risk of leukaemia and infertility

Radiotherapy creates a risk of cancer, damage to tissues and hypothyroidism

Question 7

Non-Hodgkin Lymphoma

Answer 7

Burkitt lymphoma - EBV, malaria, HIV associated

MALT lymphoma - mucosa-associated lymphoid tissue, associated with H. pylori

Question 8

Risk factors for non-Hodgkin’s lymphoma

Answer 8

HIV

Epstein-Barr Virus

H. pylori (MALT lymphoma)

Hepatitis B or C infection

Exposure to pesticides and a specific chemical called trichloroethylene used in several industrial processes

Family history