Malignancies

Question 1

What are the categories of haematological malignancies?

Answer 1

> Acute Leukemias - ALL/AML
> Chronic Leukaemias - CML/CLL
> Malignant Lymphomas - HL/NHL
> Multiple Myeloma
> Myelodysplastic Syndromes (MDS)
> Chronic Myeloproliferative Neoplasms

Question 2

What’s the difference between leukaemia &lymphoma?

Answer 2

They’re descriptive terms: Leukaemia refers to bone marrow/blood disease
Lymphoma refers to disease mostly in the lymphoid tissue

Question 3

What are the majot Acute Leukaemias?

Answer 3

Acute Lymphoblastic Leukaemia

Acute Myeloid Leukaemia

Question 4

What’s happening in an acute vs a chronic leukaemia?

Answer 4

Acute - Non-differentiating leukaemic cells with bone marrow failure

Chronic - Cells are still differentiating so you get proliferation without marrow failure

Question 5

Why is acute leukaemia so must faster than chronic?

Answer 5

Acute is rapidly fatal due to the buildup of undifferentiated blast cells and associated marrow failure

Where as marrow continues to function in chronic leukaemias

Question 6

Bone marrow failure is the main presentation of leukaemia, how does that appear?

Answer 6

Anaemia

Thrombocytopenic bleeding i.e. purpura/petechiae &mucosal bleeding

Neutropenia related bacterial/fungal infections

Question 7

Where in a lymph node are various lymphoid cells found?

Answer 7

B cells found in follicles. Undergoing selection/expansion in germinal centres & naïve cells in the mantle zone

T cells in paracortex

Plasma cells in medulla

Question 8

Lymphadenopathy is very common in Lymphoma, what about it would suggest a lymphoma instead of say an infection?

Answer 8

Localised & Painless (if it’s painful more likely to be a bacterial inf)

Generalised and painless (If it’s painful its more likely a viral infection)

Question 9

How could a lymphoma present systemically?

Answer 9

Fever
Drenching Sweats
Loss of weight
Pruritis
Fatigue