Lymphoma - Hodgkin's Lymphoma

Question 1

Types of Hodgkin’s lymphoma (Histology-Wise) (4).

Answer 1

1. Nodular Sclerosing.
2. Mixed Cellularity.
3. Lymphocyte Predominant (Best Prognosis).
4. Lymphocyte Depleted (Worst Prognosis).

Question 2

Risk Factors of Hodgkin’s lymphoma (5).

Answer 2

1. HIV.
2. EBV.
3. Autoimmune Conditions e.g. RA, Sarcoidosis.
4. Family History.
5. Smoking.

Question 3

Epidemiology of Hodgkin’s lymphoma.

Answer 3

Bimodal Age Distribution - peak at 20 and 75.

Question 4

Clinical Features of Hodgkin’s Lymphoma (4).

Answer 4

1. Non-Tender and Rubbery Lymphadenopathy (Neck, Axilla or Inguinal).
2. Pain in Lymph Nodes when Drinking Alcohol.
3. Constitutional Symptoms (FLAWS + Recurrent Infections).
4. Compression of Surrounding Structures : Cough, SOB, Abdominal Pain.

Question 5

Investigations of Lymphoma (4).

Answer 5

1. Raised LDH.
2. Key Diagnostic Test : Lymph Node Biopsy - Reed-Sternberg Cells.
3. CT, MRI, PET - Diagnosis, Staging.
4. Normocytic Anaemia and Eosinophilia.

Question 6

What is a Reed-Sternberg cell?

Answer 6

Abnormally large B cells with multiple nuclei that have nucleoli inside them (like Owl with Large Eyes).

Question 7

Management of Lymphoma.

Answer 7

Key : Chemotherapy and Radiotherapy (Curative).

Question 8

Risks of Lymphoma Management (2).

Answer 8

1. Chemotherapy : Leukaemia and Infertility.
2. Radiotherapy : Cancer, Damage to Tissues, Hypothyroidism.

Question 9

What else must be given to Hodgkins Lymphoma patients lifelong?

Answer 9

All patients with Hodgkin’s lymphoma (regardless of disease stage) must be given irradiated blood products to prevent transfusion-associated graft versus host disease (taGVHD), for the rest of their life.