Lymphoma and myeloma

Question 1

Multiple Myeloma

Answer 1

plasma cell dyscrasia
malignant disorder of clonal plasma cells
only one type of antibody is produced instead of variety
CRAB features: hyer-Calcaemia, Renal insufficiency, Anaemia, Bone lesions.
1 or more focal lesion on MRI bigger than 5mm

Question 2

MGUS: Monoclonal Gammopathy of Underdetermined Significance

Answer 2

Abnormal protein (monoclonal protein is detected in blood of bone marrow plasma cells +10%
biopsy-proven bony/extramedullary plasmacytoma
CRAB features

Question 3

Benign Polyclonal hyergammaglobulinaemia

Answer 3

Increased levels of certain Immunoglobulin (Ig) in blood serum.

Question 4

Primary amyloidosis

Answer 4

Light chains are produced which misfold and deposit in various organs.
Aim to switch off the production of light chains by the plasma cells.
hard to remove proteins that have already depostied.
Diagnostic criteria: Serum M-protein over 30g/L and +10% clonal plasma cells in the bone marrow

Question 5

High grade lymphoma

Answer 5

sub- acute onset (weeks-months)

curative abnormal bloods, chemosensative tumour.

Question 6

Low grade lymphoma

Answer 6

Onset months - years

Non-curative. normal bloods

Question 7

NON-Hodgkin lymphoma

Answer 7

Follicular lymphoma: neoplastic disorder of the lymphoid tissue.
Characterised by slowly enlarging lymph nodes. mean survival = 8-10 years.

Question 8

Hodgkin lymphoma

Answer 8

A malignant disorder of neoplastic lymphocytes.
characterised by Hodgkin Reed Sternberg cells within a cellular infiltrate of non-malignant inflammatory cells.
Managed with chemo and radiotherapy. many are cured.

Question 9

Chronic lymphocytic leukaemia

Answer 9

malignant disorder of mature B-cells.
most common type of leukaemia in the uk (1% all uk cancer)
Staged with the binet system