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SBL > Lymphoma case studies > Flashcards

Lymphoma case studies Flashcards

1
Q

Lymphadenopathy can have many etiologies. What is the pneumonic to cover the bases?

A

MIAMI

  • Malignancy
  • Infectious
  • Auto-immune
  • Miscellaneous
  • Iatrogenic
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2
Q

With Lymphadenopathy, a detailed ____ is important

A

Detailed history

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3
Q

With Lymphadenopathy, a comprehensive physical is necessary. What things should you be checking for at the lymph nodes?

A
  • Diffuse or regional lymphadenopathy
  • Painful or painless
  • Fixed or mobile
  • Soft or hard
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4
Q

Tender lymph nodes are often?

A

Benign

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5
Q

What laboratory test should be ordered if suspicious of lymphadenopathy?

A

Biopsy

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6
Q

Common symptoms of malignant lymph nodes

A

Supraclavicular location

Hard, fixed and greater than 4 cm in size

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7
Q

What are 3 biopsy types?

A
  1. Fine needle aspiration
  2. Needle biopsy
  3. Excisional biopsy
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8
Q

What is the best way to diagnose lymphomas?

A

Excisional biopsy

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9
Q

What is the only way to diagnose Hodgkin Lymphomas?

A

Excisional biopsy

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10
Q

A fine needle aspiration takes out a ____ sample. What is it good for?

A

Liquid sample

- Metastatic cells and flow cytometry

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11
Q

A needle biopsy takes out a _____. What is it good for?

A

Solid core of tissue

- Metastatic cells and flow cytometry

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12
Q

What can only diagnose Non-Hodgkin Lymphomas?

A

Fine needle aspiration

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13
Q

Best way to diagnose a lymphoma?

A

Excisional biopsy

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14
Q

Burkitt Lymphoma translocation

A

t(8;14) - IgH next to MYC

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15
Q

Burkitt lymphoma is a fast growing mass. What is the treatment for it, especially if there is CNS involvement?

A

Intrathecal chemotherapy

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16
Q

When treating Burkitt lymphoma (or any fast growing tumor) the patients urine output has decreased. What does this indicate?

A

Tumor Lysis Syndrome

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17
Q

Tumor Lysis Syndrome - when should you suspect it?

A

After starting chemotherapy and the urine output DECREASES while the BUN and Cr INCREASE

18
Q

Tumor Lysis Syndrome is often seen with?

A

Fast growing malignancies

19
Q

What are 4 electrolyte disturbances seen with Tumor Lysis Syndrome?

A

Hyperkalemia
Hyperuricemia
Hyperphosphatemia
Hypocalcemia

20
Q

What are 4 electrolyte disturbances seen with Tumor Lysis Syndrome?

A

Hyperkalemia
Hyperuricemia
Hyperphosphatemia
Hypocalcemia

21
Q

What is the initial treatment for Tumor Lysis Syndrome?

A

IV fluids and Allopurinol

22
Q

Allopurinol can treat?

A

Tumor Lysis Syndrome

23
Q

How does Allopurinol treat Tumor Lysis Syndrome?

A

Xanthine Oxidase inhibitor (decreases uric acid)

24
Q

What can treat the hyperuricemia seen with Tumor Lysis Syndrome?

A

Rasburicase-urate oxidase

25
Q

You should not give Rasburicase-urate oxidase to patients with?

A

G6PD deficiency

26
Q

What can treat the hypocalcemia seen with Tumor Lysis Syndrome?

A

Calcium gluconate

27
Q

If the initial treatment for Tumor Lysis Syndrome does not work, you should?

A

Treat the electrolyte disturbances

28
Q

Common symptoms of Hodgkin Lymphoma?

A

Lymphadenopathy
B symptoms - fever, night sweats, weight loss
Mediastinal mass

29
Q

B symptoms

A

Fever, night sweats, weight loss

- seen often with Hodgkin Lymphoma

30
Q

What cells are seen with Hodgkin Lymphoma?

A

Reed Sternberg cells

31
Q

What is the treatment for Hodgkin Lymphoma?

A

21 or 28 day chemotherapy

32
Q

The prognosis for Hodgkin Lymphoma is?

A

Excellent

33
Q

CLL/SLL contains lots of what on peripheral smear?

A

Mature, small lymphocytes

34
Q

How does CLL/SLL present?

A

Usually asymptomatic or fatigued

35
Q

If a diagnosis of CLL/SLL is made, what should you be concerned could happen?

A

Richter transformation

36
Q

What is the Richter transformation?

A

CLL/SLL transitioning into an aggressive tumor

37
Q

If CLL/SLL undergoes the Richter transformation, what are the signs?

A
  • Going from asymptomatic or fatigued to:

= fever, night sweats, weight loss, lymphadenopathy

38
Q

What is the treatment for CLL/SLL that underwent the Richter transformation?

A

Chemotherapy + Rituximab

39
Q

Chemotherapy + Rituximab can treat?

A

CLL/SLL that underwent the Richter transformation

40
Q

What is Rituximab?

A

Monoclonal antibody to CD20 receptors

SBL (48 decks)

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