Malignancy

Question 1

What is a myeloma?

Answer 1

Neoplastic disease of plasma cells (mature B cells (lymphoid lineage)), which produce antibodies (paraprotein)

Question 2

Presentation of myeloma?

Answer 2

Anaemia - due to bone marrow suppression

Kidney impairment - as paraprotein clogs up kidneys

Question 3

What is lymphoma?

Answer 3

Neoplastic disease of lymphocytes - IN lymphoid tissues
Can be peripheral, or central lymph nodes
Usually a single, solid tumour

Question 4

Difference between acute and chronic leukaemia?

Answer 4

Acute - affects stems cells - more proliferative, rapid onset

Chronic - affects cells further down the lineage - I.e. already differentiated leukocytes or lymphocytes - slow and insidious onset

Question 5

What is present in Hodgkin’s Lymphoma

Answer 5

Reed-Sternberg cells - giant, multinucleated leukocytes

EBV virus +ve in 50% of patients with HL

Question 6

What is Wilm’s tumour and how does it present

Answer 6

Tumour of renal tubules, typically unilateral

Often painless abdominal mass –> distension
Haematuria, abdo pain, UTIs, hypertension, metastases to lungs

Question 7

What is a neuroblastoma and how does it present?

Answer 7

Solid tumour of sympathetic nervous system
Common sites - adrenal, paraspinal
Presents with mass effects of tumour - dependent on location
Metastases often present

Question 8

Why is Oculomotor (CN III) palsy not a good localiser for brain malignancy?

Answer 8

Runs the whole length of the cranium
Impingement could be anywhere along that
MRI head indicated to best visualise lesion