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Haematology > Lymphomas > Flashcards

Lymphomas Flashcards

1
Q

What are lymphomas?

A

This is a group of cancers that affect the lymphocytes inside thelymphatic system; these cancerous cells proliferate within thelymph nodes and cause the lymph nodes to become abnormally large (lymphadenopathy)

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2
Q

What are the 2 main classifications of lymphoma?

A

Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma

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3
Q

How are lymphomas classified?

A

They are classified by the presence or absence of Reed-Sternberg cells (Hodgkins has these cells)

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4
Q

What is Hodgkin’s lymphoma?

A

A group of lymphomas caused by the proliferation of lymphocytes

They account for around 1/5th of all lymphomas

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5
Q

Describe the age distribution of Hodgkin’s lymphoma

A

There is abimodal age distribution with peaks around aged 20 and 75 years

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6
Q

What are some risk factors of Hodgkin’s lymphoma?

A
  • Immunosuppression (e.g. HIV, inherited immunodeficiency states)
  • Autoimmune disorders (e.g. rheumatoid arthritis, sarcoidosis)
  • EBV
  • Family history
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7
Q

What are the 2 main categories of Hodgkin lymphoma?

A

Classical
Nodular lymphocyte predominant

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8
Q

What is first line management of Hodgkin lymphoma?

A

Multi-agent chemotherapy

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9
Q

What chemotherapy agents are use din Hodgkin’s lymphoma?

A

ABVD:
- Adriamycin
- Bleomycin
- Vinblastine
- Dacarbazine

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10
Q

What is a possible risk factor of bleomycin?

A

Can cause pneumonitis

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11
Q

What are some risks of long-term chemotherapy in Hodgkin’s lymphoma?

A

Secondary cancers
Cardiovascular disease
Infertility

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12
Q

What is Non-Hodgkin’s lymphoma?

A

This is a group of lymphomas classified by the lack of Reed-Sternberg cells
This is the most common type of lymphoma

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13
Q

What are some risk factors for non-Hodgkin lymphoma?

A
  • Infections (E.g. HIV, EBV, H. pylori)
  • Hepatitis B or C infection
  • Exposure to pesticides
  • Exposure to trichloroethylene(used in several industrial processes)
  • Family history
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14
Q

What are the 2 main classes of non-Hodgkin lymphoma?

A

B-cell lymphoma
T-cell lymphoma

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15
Q

What are some notable forms of non-Hodgkin lymphoma?

A
  • Burkitt lymphoma
  • MALT lymphoma
  • Diffuse large B cell lymphoma
  • Mantle cell lymphoma
  • Marginal zone lymphoma
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16
Q

How does treatment differ between different grades of non-Hodgkin lymphoma?

A

Low grade B-cell NHL is a slow growing cancer, so chemotherapy cant cure it, as chemotherapy targets rapid proliferation and division, meaning it is incurable but manageable

High grade B-cell NHL is curable with chemotherapy, but effects the patient a lot due to its fast growing and highly aggressive nature

17
Q

What are the main 2 first line treatment options in NHL?

A
  • Multi-agent chemotherapy ± radiotherapy
  • Monoclonal antibody therapy + chemotherapy
18
Q

What chemotherapy agents are used in the treatment of NHL?

A

R-CHOP:
- Rituximab
- Cyclophosphamide
- Hydroxydaunorubicin (Doxorubicin)
- Oncovin®(Vincristine)
- Prednisolone

19
Q

What is the purpose of steroids in the treatment of NHL?

A

They have a large effect on lymphocytes and are usually used in suspected lymphoma, prior to return of results (Take biopsy first however to avoid distorting results)

20
Q

What is an example of a monoclonal antibody used in the treatment of NHL?

A

Rituximab (CD20 antibody used in B-cell lymphoma)

21
Q

What are some viruses associated with Burkitt’s lymphoma formation?

A

EBV
Malaria
HIV

22
Q

How do viruses cause Burkitt’s lymphoma?

A

Viral infection can cause DNA damage and thus genomic instability

23
Q

How do MALT lymphomas affect the body

A

MALT lymphoma affects themucosa-associated lymphoid tissue, usually around thestomach - associated withH. pylori infection

24
Q

How do diffuse large B-cell lymphomas usually present?

A

Rapidly growing painless mass in patients over 65 years

25
Q

What are some symptoms of lymphoma?

A
  • Lymphadenopathy
  • Night sweats
  • Weight loss
  • Itch without a rash
  • Alcohol induced pain (In regions of lymphadenopathy)
  • Fatigue
26
Q

How will lymph nodes usually feel in lymphoma?

A

Tender and rubbery

27
Q

What are some tests used in lymphoma?

A

serum LDH
Lymph node biopsy with staining
CT, MRI and PET
ESR and Hb

28
Q

How will LDH be affected in Hodgkin’s lymphoma?

A

It will be raised (Also raised in a number of diseases)

29
Q

What will lymph node biopsy and staining show in Hodgkin’s lymphoma?

A

Reed-Sternberg cells (Abnormally large B-cells with multiple nuclei, containing nucleoli)

30
Q

What staging system is used for Hodgkin’s lymphoma?

A

Ann-Arbor system (Stages I - IV)

Haematology (32 decks)

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