Lymphoma: High/low grade, Hodgkin/Non-Hodgkin Flashcards
Define lymphoma?
Group of haematological malignancies of lymphocytes, which originates from the lymphatic system
What is the main difference between lymphoma and lymphocytic leukaemia?
Lymphoma and lymphocytic leukaemia both are cancers of lymphocytes
But lymphoma originates from lymphatic system and leukaemia originates from bone marrow
What is the usual initial clinical presentation of lymphoma?
Painless swelling of lymph node
What 3 B symptoms can present in lymphoma, and are also red flags of other haematological malignancies?
Drenching night sweats
Unexplained fever
Weight loss over 6 months, that was unintentional and over 10% baseline weight
Give the 2 main ways in which lymphoma can affect other organs, in terms of clinical presentation?
Splenomegaly
Presentation of symptoms due to lumps compressing other structures eg. shortness of breath due to lesion in lung, bowel movement changes
Give examples of signs of BMF or anaemia commonly present in clinical presentation of lymphomas, and the underlying lab finding that causes these?
Cytopenias
Which cause eg. TATT, frequent infections, bleeding or bruising easily, pallor
If a patient presents with pruritus, what can this signify when classifying the lymphoma?
Pruritus (widespread itching) is a common feature of Hodgkin lymphoma instead of Non-hodgkin lymphoma
Describe the location of the lump that characteristically presents in Hodgkin’s lymphoma, and what is the anatomical term?
Lump in chest
Mediastinal mass
Give one characteristic feature of Hodgkin’s lymphoma that presents when drinking?
Lymph node pain when drinking alcohol
Which 2 age groups are most commonly affected by Hodgkin’s lymphoma?
Young adults
Over 60 yrs old
Is Hodgkin’s lymphoma equally common in males and females?
More common in males
What virus is Hodgkin’s lymphoma associated with, and is this a causative agent?
EBV
Not causative agent
What lab investigation confirms the diagnosis of lymphomas, and why?
Lump biopsy (core biopsy or whole node excision)
Provides info about HL/NHL and grade
Why is FNA of a lymph node not used to confirm lymphoma diagnosis?
FNA can give info about cellular tissue of lymph node but not about grade or HL/NHL
Compare the history and onset of high grade (aggressive) and low grade (indolent) lymphomas?
High grade: Short history (symptomatic with rapid onset)
Low grade: Longer or no history (asymptomatic with insidious onset)
Describe the lab finding that confirms the diagnosis of Hodgkin lymphoma and Non-Hodgkin lymphoma?
Hodgkin lymphoma diagnosis: Microscopic imaging of biopsy shows presence of Reed-Sternberg cells
Non-Hodgkin lymphoma diagnosis: Microscopic imaging of biopsy shows absence of Reed-Sternberg cells
Describe the appearance of Reed-Sternberg cells, and what cancer is this a hallmark of?
Large, abnormal lymphocyte with binucleated nucleus that resembles owl eyes
Hallmark of Hodgkin lymphoma
What do each of the stages of the Ann Arbor Staging system indicate about the spread of the lymphoma?
- Localised disease
- Disease in more than 1 lymph node, on the same side of diaphragm
- Disease above and below diaphragm
- Extranodal disease (outside lymph nodes and spleen)
What mode of radiological investigation is used to for lymphoma staging?
PET scan
Radio-tracer uptake (dark areas) show metabolically active areas (due to active malignancy) or normal physiological uptake (this is would be during remission)
