Lymphoma - Non-Hodgkin Lymphoma Flashcards
Non-hodgkin lymphoma (NHL) is a group of cancers that are derived from lymphocytes, specifically B and T cells. What is the incidence of NHL?
1 - 21 / 100,000
2 - 21 / 10,000
3 - 21 / 1000
4 - 21 / 100
1 - 21 / 100,000
- doubled since 1970
Slightly more common in men 1.2:1 ratio
Non-hodgkin lymphoma (NHL) is a group of cancers that are derived from lymphocytes, specifically B and T cells. What age does the incidence of NHL peak?
1 - 10-20
2 - 30-40
3 - 40-50
4 - 60-70
4 - 60-70
Is Non-hodgkin lymphoma (NHL) or Hodgkin lymphoma more common?
- NHL
Five times more likely than Hodgkin lymphoma
NHL account for >90% of lymphoid cancers
Is Non-hodgkin lymphoma (NHL) more common in developed or less developed countries?
- developed countries
Although the exact cause of Non-hodgkin lymphoma (NHL) is unknown, which of the following infections is NOT associated with causing NHL?
1 - tuberculosis
2 - HIV
3 - human T-lymphotropic virus 1
4 - Epstein–Barr virus
5 - Helicobacter pylori infection
6 - Hepatitis C
1 - tuberculosis
Linked with immunosuppression and viruses
Although the exact cause of Non-hodgkin lymphoma (NHL) is unknown, which of the following immunosuppressive conditions is NOT associated with causing NHL?
1 - rheumatoid arthritis
2 - lupus
3 - type 2 diabetes
4 - Sjögren syndrome
5 - coeliac disease
6 - Hashimoto’s thyroiditis
3 - type 2 diabetes
Which of the following can Non-hodgkin lymphoma (NHL) arise from?
1 - mature lymphocytes
2 - immature lymphocytes
3 - mature and immature lymphocytes
4 - mature, immature and pre-cursor lymphocytes
4 - mature, immature and pre-cursor lymphocytes
The point of differentiation of for the lymphocyte determines the type of lymphoma that will occur
Non-hodgkin lymphoma (NHL) can be due to progressive acquisition of DNA alterations caused by mutation, amplifications, deletions or chromosomal translocation. Particular subtypes of lymphoma are associated with specific acquired genetic abnormalities. Translocation of the BCL2 oncogene is found in which of the following types of NHL?
1 - mantel cell lymphome
2 - follicular lymphoma
3 - burkitt lymphoma
4 - diffuse large cell lymphoma
2 - follicular lymphoma
The WHO have classified Non-hodgkin lymphoma (NHL) based on a histological classification. Which of the following is NOT a classification of NHL according to the WHO?
1 - mature B-cell neoplasms
2 - immature B cell neoplasms
3 - mature T-cell and NK-cell neoplasms
4 - immature NK neoplasms
1 - mature B-cell neoplasms
3 - mature T-cell and NK-cell neoplasms
These can also be high or low grade
Non-hodgkin lymphoma (NHL) account for aprox 90% of all lymphoid cancers. Which of the following is the most common type of NHL?
1 - B cells
2 - T cells
3 - NK cells
4 - all equally likely
1 - B cells
- Diffuse Large B cell Lymphoma (DLBCL) is most common
In both acute lymphoid leukaemia (ALL) and non-Hodgkin lymphoma, the lymphocytes (B, T and NK cells) are involved. Which originates from bone and which originates from lymph nodes?
ALL = bone marrow origin and spread through the blood
non-Hodgkin lymphoma = originate in lymph nodes and spread through lymphatics
When comparing leakaemia and lymphoma, which is a solid and which is a liquid tumour?
- leukaemia = liquid (blood)
- lymphoma = solid (lymph nodes)
B cells are the most common cause of Non-hodgkin lymphoma (NHL). Which of the following receptors on the B cell is involved in NHL?
1 - CD10
2 - CD20
3 - CD4
4 - CD8
2 - CD20
- medication can target CD20
Although T cell and natural killer cell lymphomas are rare, which ethnicity are more at risk of developing these?
1 - Caucasian
2 - Irish and Welsh
3 - Asia and Caribbean
4 - South East Asian
3 - Asia and Caribbean
Enteropathy associated T cell lymphomas are a rare form of Non-hodgkin lymphoma (NHL), but which ethnicity are more susceptible to this?
1 - Caucasian
2 - Irish and Welsh
3 - Asia and Caribbean
4 - South East Asian
2 - Irish and Welsh
- gut associated
- shared HLA types and coeliac risk
Burkitt’s lymphoma is a high-grade B-cell non-Hodgkin’s lymphoma that is rapidly growing and aggressive. There are 3 main types:
- endemic
- sporadic
- immunodeficiency associated BL
However, they are all caused by which gene?
1 - MYC gene
2 - BCR-ABL gene
3 - BRAF gene
4 - HER2 gene
1 - MYC gene
- c-MYC
- myelocytomatosis oncogene
- Ch 8q24
Burkitt’s lymphoma is a high-grade B-cell non-Hodgkin’s lymphoma that is rapidly growing and aggressive. There are 3 main types:
- endemic
- sporadic
- immunodeficiency associated BL
Which of the above subtypes of Burkitt’s lymphoma are all the following associated with?
1 - Equatorial Africa, Papua New Guinea, most common malignancy in childhood in these areas
2 - Epstein–Barr virus in all patients
3 - Jaw/other facial bones site for presentation in 50%
4 - Geographical distribution of endemic malaria a factor in pathogenesis (associated with chronic co-infection)
- endemic
This type of Burkitts lymphoma is constantly present in a region or country, but has a slow spread
Burkitt’s lymphoma is a high-grade B-cell non-Hodgkin’s lymphoma that is rapidly growing and aggressive. There are 3 main types:
- endemic
- sporadic
- immunodeficiency associated BL
Which of the above subtypes of Burkitt’s lymphoma are all the following associated with?
1 - seen throughout the world
2 - majority present with abdominal masses (ileo-caecal)
3 - Epstein–Barr virus in 30%
4 - commonly affects children (30-50% of childhood lymphoma) and adults (1-2% of adult lymphomas)
- sporadic
Burkitt’s lymphoma is a high-grade B-cell non-Hodgkin’s lymphoma that is rapidly growing and aggressive. There are 3 main types:
- endemic
- sporadic
- immunodeficiency associated BL
Which of the above subtypes of Burkitt’s lymphoma are all the following associated with?
1 - associated with HIV, can be a manifestation of AIDS
2 - Epstein–Barr virus 25-40%
- immunodeficiency associated BL
Burkitt’s lymphoma is a high-grade B-cell non-Hodgkin’s lymphoma that is rapidly growing and aggressive. There are 3 main types:
- endemic
- sporadic
- immunodeficiency associated BL
Which virus is commonly associated with all 3 subtypes of Burkitt’s lymphoma?
1 - HIV
2 - influenza
3 - EBV
4 - HPV
3 - EBV
Burkitt’s lymphoma is a high-grade B-cell non-Hodgkin’s lymphoma that is rapidly growing and aggressive. There are 3 main types:
- endemic
- sporadic
- immunodeficiency associated BL
Which of the following would be a common finding on histology in Burkitts lymphoma?
1 - reed-sternberg cells
2 - hodgin cells
3 - starry sky appearance
4 - all of the above
3 - starry sky appearance
- very aggressive and highly proliferative disease so when packed together they appear like stars
To distinguish between Non-hodgkin lymphoma (NHL) or Hodgkin lymphoma we use a specific cell, what is this cell?
1 - reed sternberg cells
2 - cytomegalovirus
3 - aeur rods on blood smears
4 - raised basophils
1 - reed sternberg cells
Only present in Hodgkin Lymphoma
Non-hodgkin lymphoma (NHL) is an umbrella term, but which of the following is required to reach a definitive diagnosis of the NHL sub category?
1 - MDT
2 - Morphology
3 - Immunophenotyping
4 - Genetic features (increasingly)
5 - Clinical features and stage
6 - all of the above
6 - all of the above
Typically in Non-hodgkin lymphoma (NHL), where do the tumours grown?
1 - deep lymph nodes
2 - mucosa-associated lymphoid tissue (MALT)
3 - superficial lymph nodes
4 - bone marrow
3 - superficial lymph nodes
This is why they are called nodal lymphomas
75% of patients present with this
Can occur in any of the other types as well
Typically in Non-hodgkin lymphoma (NHL) tumours grow in the lymph nodes. However, when they grow elsewhere is called extra-nodal disease, which occurs in 50% of patients. All of the following are extra-nodal sites where lymphomas can occur. Which is the most common?
1 - skin
2 - sinuses
3 - GIT
4 - waldeyer ring
3 - GIT
50% of patients will have lymphoma in GIT
May cause GIT symptoms and obstruction
Most common in stomach and is associated with Helicobacter pylori
Common in cervical, axilla, inguinal and femoral lymph nodes
Does Non-hodgkin lymphoma (NHL) typically cause a purpura or petechiae rash?
- purpura
Leaking of small blood vessels due to low platelets.
Patients at increased risk of bleeding