Newman - Lymphoma and Leukemia, LAD

Question 1

Large cell with multiple or multi-lobulated nuclei. CD15+, CD30+

Answer 1

Reed-Sternberg cell

Question 2

List the three B symptoms - systemic symptoms important in staging.

Answer 2

1. Unexplained fever 39C (~103F) degrees
2. Wt loss >10% total body over last three months
3. Drenching night sweats

Question 3

When should someone undergo CHEST RADIOGRAPHY BEFORE undergoing lymph nodebiopsy?

Answer 3

Any patient with persistent, unexplained LAD unassociated with obvious underlying inflammatory or infectious process.
Use to identify the presence or absence of a large mediastinal mass.

Question 4

• **Burkitt Location of tumor in..
  1. Sporadic
  2. Endemic/Africa

Answer 4

1. Abdomen

2. Head and neck

Question 5

***What accounts for 97% of childhood malignancies?

Answer 5

Acute leukemias (subtypes: AML, ALL; but ALL much more common in children)

Question 6

Trisomy 21 increases risk for what neoplasm?

Answer 6

ALL and AML

Question 7

AML is more likely in what age range in a child with Down Syndrome?

Answer 7

Less than 3 years old

Question 8

Marker for hematologic malignancies

Answer 8

LDH

Question 9

When do you biopsy?

Answer 9

If an enlarged supraclavicular node is palpated ALONG WITH other findings (B symptoms, multiple nodes, abnormal CXR or CT) that are consistent with malignancy.

Question 10

NHL epidemiology - part of what notable genetic syndrome?

Answer 10

Ataxia-telangiectasia

Question 11

A unilateral, large painful node with unremitting fever (104-105F) for 5 days.

Answer 11

Kawasaki

Question 12

Girl does not feel well. Tender swelling in L axilla and fever. Began shaving a few weeks ago. Most likely etiology?

Answer 12

Infectious

possibly incise and drain.

Question 13

Tularemia

Answer 13

rabbits

Question 14

Cat Scratch organism

Answer 14

bartonella henselae

Question 15

Yersinsia

Answer 15

plague

Question 16

6yo with fever and swollen L axillary adenopathy. Tender, non fluctant. Healing skin lesion on hand. Questionable liver tenderness, border at 2cm below RCM at MCL.

What is this and treat with what?

Answer 16

Cat scratch

Treat with azithromycin

Question 17

Supraclavicular lymph node, scrotal swelling NT/firm, fatigue, cough, nose bleeds - what is this and what two things indicate CXR?

Answer 17

This is Lymphoblastic Lymphoma.

1. Testicular mass esp painless w/o hx of trauma or injury ->likely malignant
2. Generalized LAD wiht respiratory symptoms.

Question 18

Neuroretinitis is an uncommon manifestation of what disease?

Macular star - exudates overlying macular, radiating outward.

Answer 18

Cat scratch disease