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Hematology > Lymphomas > Flashcards

Lymphomas Flashcards

1
Q

lymphoma

A

malignancy of lymphoid tx

**3rd most common malignancy in childhood

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2
Q

Etiology of lymphoma

A
  • Etiology unknown
  • Epstein-Barr virus may play a role
    o Hodgkin disease
    o Non-Hodgkin lymphoma
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3
Q

Hodgkin DZ

A

association w/ EBV

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4
Q

Hodgkin DZ epidemiology

A 
Bimodal peaks
o	Adolescence / young adult years (15-30)
(Rare before age 10)
o	Age 50+
o	Boys more than girls in childhood
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5
Q

CF of Hodgkin DZ

A

o Painless, rubbery, cervical lymphadenopathy

  • Often supraclavicular and cervical areas
  • Pain in the affected node after alcohol ingestion may occur

o Mediastinal mass causing cough or SOB

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6
Q

What are the “B” sx?

A

fever higher than 38°C for 3 consecutive days (w/o infxn)

drenching night sweats, unexplained weight loss > 10% during the prior 6 months

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7
Q

dx of hodgkin’s lymphoma

A

o Tissue biopsy
o Pleural or peritoneal fluid evaluation may be helpful
o May be accompanied by fever, weight loss
o Staged by Ann Arbor system

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8
Q

what is the pathologic hallmark of Hodgkin’s lymphoma?

A

Reed-Sternberg Cells

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9
Q

TX of Hodgkin’s

A

o Combination of chemotherapy and low-dose, involved field radiation therapy

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10
Q

Prognosis of Hodgkin’s?

A

o Three risk groups

  • Low, medium, high
  • Excellent prognosis
  • Overall survival rate 90%
  • Close to 100% in low-risk patients
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11
Q

Non-Hodgkin Lymphoma (NHL)

A
  • Neoplastic proliferation of immature lymphoid cells (unlike malignant lymphoid cells of ALL, they accumulate outside the bone marrow)
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12
Q

what is NHL associated w/?

A
  • Associated with congenital or acquired immunodeficiency states
    o B-cell
    o T-cell
    o Large-Cell (Burkitt Lymphoma)
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13
Q

epidemiology of NHL

A
  • Incidence increases with age
    o More common in whites than African-Americans
    o More common in males than females
    o Peaks between 7-11 years old
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14
Q

Clinical Findings of NHL

A

o Lymphadenopathy
o Sometimes abdominal pain
o Systemic symptoms (fever, night sweats, weight loss, etc) occur but are less common than with Hodgkin’s

isolated lymph nodes, and ski

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15
Q

what are common extralymphatic sites of NHL?

A

GI tract, skin, bone, bone marrow

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16
Q

sx of B cell involvement in NHL

A

involves bone, isolated lymph nodes and skin

17
Q

sx of T cell involvemnt

A

mediastinal mass (think potential SVC syndrome)

18
Q

Burkitt and NHL?

A

rapidly expanding jaw lesion, usually carries EBV

*** less likely to present w/ abdominal fullness

19
Q

dx eval of NHL

A

tissue bx, serum LDH is useful

20
Q

tx of NHL

A

o Distant noncontinuous metastases common
o Systemic chemotherapy mandatory
o Highly chemo-sensitive

21
Q

prognosis of NHL

A

related to stage

overall 3 yr survival rates 70-90%

22
Q

Polycythemia Vera

A

slowly progressive bone marrow disorder characterized by increased numbers of RBC and increasd total blood volume

23
Q

what is diagnostic criteira of polycythemia vera?

A
  • JAK2 mutation!

- splenomegaly, normal arterial oxygen saturation, and an elevated red cell mass

24
Q

PP of PCV?

A
  • Unregulated expansion of red cell mass causes hyperviscosity, which leads to decreased cerebral blood flow
25
Q

what are secondary causes of PCV>

A

include chronic hypoxia, often caused by cigarette smoking, and renal tumors

26
Q

what are complications of PCV?

A
  • thrombosis

- bleeding, pUD, GI bleed

27
Q

epidemiology of PCV

A
  • Median age at presentation is 60 years, and 60% of patients are male. Median survival time for patients with polycythemia vera is 11-15 years
28
Q

what can PCV convert to overtime?

A

myelofibrosis, CML, or rarely AML

29
Q

SX of PCV

A

increased blood viscosity and volume (i.e., headache, dizziness, fullness in the head and face, weakness, fatigue, tinnitus, blurred vision), burning pain, and redness of the extremities. Rarely stroke

30
Q

what is a classic sx of PCV?

A

pruritis after bathing

31
Q

what can be the most common presenting complaint?

A

epistaxis

32
Q

PE findings of PCV?

A

systolic hypertension, engorged retinal veins, and splenomegaly

33
Q

what is the most common complication of PCV?

A

Thrombosis

34
Q

what does absence of splenomegaly suggest?

A

secondary polycythemia

35
Q

laboratory findings of PCV

A

o At sea level, hematocrit levels in polycythemia vera are typically greater than 54% in males and greater than 51% in females

EPO levels are low, but red cell morphology is normal

hyperuricemia can also develop

36
Q

peripheral smear of PCV

A

neutrophilic leukocytosis, increased basophils and eosinophils, and increased numbers of large, bizarre platelets

37
Q

tx of PCV

A

phlebotomy!!!

myelosuppressive tx w/ hydroxyurea may be indicated

low dose ASA reduces risk of thrombosis

Hematology (5 decks)

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