Lymphomas

Question 1

What is lymphoma

Answer 1

Group of cancers that effect lymphocytes inside the lymphatic system & proliferate within the nodes, causing lymphadenopathy

Question 2

Hodgkin vs non-Hodgkin lymphoma

Answer 2

Hodgkin lymphoma - Lymphomas that have reed-sternberg cells

Question 3

What are reed sternberg cells

Answer 3

Large, abnormal lymphocytes
That can have multiple nuclei with nucleoli within

Question 4

Name 4 risk factors for Hodgkin lymphoma

Answer 4

• Immunosuppression (HIV, inherited immunodeficiency…)
• Autoimmune disorders (RA, sarcoidosis…)
• Infection (EBV)
• Family history

Question 5

Name 3 risk factors for non-Hodgkin lymphoma

Answer 5

• Immunosuppression (HIV)
• Autoimmune (coeliac)
• Infections (EBV, H. pylori, Hep B or C)
• Exposure to pesticides &trichloroethylene(industrial job)
• Family history

Question 6

What is Burkett lymphoma & what is it associated with

Answer 6

A type of non-Hodgkin lymphoma
Is associated with EBV, malaria & HIV

Question 7

What is MALT lymphoma & what is it associated with

Answer 7

A type of non-Hodgkin lymphoma
Affects mucosa-associated lymphoid tissue
Usually around stomach
Associated with h pylori infection & coeliac disease

Question 8

What clinical presentation is suggestive of diffuse b cell lymphoma

Answer 8

rapidly growing painless mass in patients over 65 years

Question 9

In patients with lymphoma, particularly Hodgkin’s lymphoma, when & where might they experience pain

Answer 9

Pain in the lymph nodes after drinking alcohol

Question 10

Describe the typical clinical presentation of a patient with lymphoma

Answer 10

• B cell symptoms - fever, night sweats, weight loss
• Itch without rash
• Lymphadenopathy
  - non-tender & rubbery
  - painful when drinking (hodgkins)
  - rapidly growing (diffuse B cell)

Question 11

LDH is often raised in what type of lymphoma

Answer 11

Hodgkin’s lymphoma

Question 12

What two blood test results are associated with poor prognosis in Hodgkin lymphoma

Answer 12

• notably elevated ESR (inflammatory marker)
• decreased Hb

Question 13

What test is diagnostic for lymphoma

Answer 13

(Entire) lymph node biopsy

Question 14

What finding is diagnostic for Hodgkin lymphoma

Answer 14

Presence of reed-sternberg cells in lymph node biopsy

Question 15

What investigation can be helpful in staging lymphoma

Answer 15

Imaging - CT, MRI, PET scans

Question 16

What staging method is used for Hodgkin’s lymphoma

Answer 16

Ann-arbor system

• I: single lymph node
• II: 2 or more lymph nodes/regions, same side of diaphragm
• III: nodes on both sides of the diaphragm
• IV: spread beyond lymph nodes

Can be subdivided into A or B (if B symptoms present)

Question 17

What is the standard management of lymphoma

Answer 17

Multi-agent chemotherapy +/- radiotherapy

(Often includes steroids)