Lymphoma (Hodgkin's) Flashcards
What is lymphoma?
Lymphomas are a group of cancers that affect the lymphocytes inside the lymphatic system. These cancerous cells proliferate within the lymph nodes and cause the lymph nodes to become abnormally large (lymphadenopathy).
Briefly differenttiate between Hodgkin’s and non-Hodgkin’s lymphoma
There are two main categories of lymphoma: Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. Hodgkin’s lymphoma is a specific disease and non-Hodgkins lymphoma encompasses all the other lymphomas.
Out of all the lymphomas, how many are Hodgkin’s lymphoma?
Overall 1 in 5 lymphomas are Hodgkin’s lymphoma.
What is Hodgkin’s lymphoma?
Hodgkin’s lymphoma are malignant lymphomas characterised by the presence of Reed-Sternberg cells.
What are the risk factors for Hodgkin’s lymphoma?
- HIV
- Epstein-Barr Virus
- Autoimmune conditions such as rheumatoid arthritis and sarcoidosis
- Family history
How does Hodgkin’s lymphoma present?
Lymphadenopathy is the key presenting symptom. The enlarged lymph node or nodes might be in the neck, axilla (armpit) or inguinal (groin) region. They are characteristically non-tenderand feel “rubbery”. Some patients will experience pain in the lymph nodes when they drink with alcohol.
B symptoms are the systemic symptoms of lymphoma:
- Fever
- Weight loss
- Night sweats
Other symptoms can include:
- Fatigue
- Itching
- Cough
- Shortness of breath
- Abdominal pain
- Recurrent infections
In Hodgkin’s lymphoma what cell is abnormally proliferated?
It is caused by proliferation of lymphocytes.
At what age groups does Hodgkin’s lymphoma affect?
There is a bimodal age distribution with peaks around aged 20 and 75 years.
How is lactate dehydrogenase (LDH) affected in Hodgkin’s lymphoma?
LDH is a blood test that is often raised in Hodgkin’s lymphoma but is not specific and can be raised in other cancers and many non-cancerous diseases.
It indicate high red cell turnover.
What is the key diagnostic test for Hodgkin’s lymphoma?
Lymph node biopsy is the key diagnostic test.
What cell is characteristic of Hodgkin’s lymphoma?
The Reed-Sternberg cell is the key finding from lymph node biopsy in patients with Hodgkin’s lymphoma.
Briefly describe Reed-Sternberg cells
They are abnormally large B cells that have multiple nuclei that have nucleoliinside them. This can give them the appearance of the face of an owl with large eyes.
What imaging is required for diagnosing and staging Hodgkin’s lymphoma?
CT, MRI and PET scans can be used for diagnosing and staging lymphoma and other tumours.
What stagin is used for Hodgkin’s and non-Hodgkin’s lymphoma?
The Ann Arbor staging system is used for both Hodgkins and non-Hodgkins lymphoma.
Briefly describe Ann Arbor staging
The Ann Arbor staging system is used for both Hodgkins and non-Hodgkins lymphoma. The system puts importance on whether the affected nodes are above or below the diaphragm. A simplified version is:
- 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
