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Essential Haematology > Non Hodgkin's Lymphoma > Flashcards

Non Hodgkin's Lymphoma Flashcards

1
Q

Define Non Hodgkin’s Lymphomas

A

These are a large group of lymphoid tumours, most commonly of B- cell origin

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2
Q

These are a large group of lymphoid tumours, most commonly of B- cell origin

A

Non Hodgkin’s Lymphoma

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3
Q

How are Non Hodgkin’s Lymphomas characterized

A

By an irregular pattern of spread

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4
Q

What is the incidence of Non Hodgkin’s Lymphoma

A

17 in 100,000

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5
Q

In a list of most common malignancies where does Non Hodgkin’s Lymphoma lie

A

5th

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6
Q

What is the aetiology of Non Hodgkin’s lymphoma

A

Unknown (although infectious agents are an important cause in particular subtypes)

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7
Q

What are the three differences between Low and High grade non-Hodgkin’s Lymphoma

A

Low Grade

  • indolent
  • respond well to chemotherapy
  • difficult to cure

High Grade

  • aggressive + need urgent treatment
  • curable
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8
Q

What are the two subdivisions of Non Hodgkin’s lymphoma

A

Low grade

High grade

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9
Q

What are six clinical features of non- Hodgkin’s lymphomas

A 
1] Superficial Lymphadenopathy 
2] Constitutional symptoms 
3] Oropharyngeal involvement
4] Presenting Features (Anemia etc)
5] Abdominal Disease
6] involvement in other organs
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10
Q

What are the constitutional symptoms of Non Hodgkin’s lymphoma

A

Fever
Night sweats
Weight loss
(Occurs less frequently than in Hodgkin’s disease)

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11
Q

Describe the Oropharyngeal involvement of Non Hodgkin’s Lymphoma

A

Disease of the Oropharyngeal lymphoid structures (Waldeyer’s ring) which may cause complaints of sore throat or noisy or obstructed breathing

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12
Q

What are the presenting features of Non Hodgkin’s lymphoma

A

Anemia
Neutropenia with infections
Thrombocytopenia with purpura

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13
Q

What is the investigative method for Non Hodgkin’s lymphoma

A

Lymph node biopsy

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14
Q

What confirms clonality in B-cell lymphomas

A

Expression of either κ or λ light chains confirms clonality

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15
Q

What is type of anemia is observed in non-Hodgkin’s Lymphoma

A

Normochromic or normocytic anemia is usual but hemolytic anemia and then also occur

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16
Q

Deficiency in which line of blood cells is seen in advanced non-Hodgkin’s disease

A

Neutropenia thrombocytopenia or leucoerythroblastic features

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17
Q

Is LDH elevated in Non Hodgkin’s lymphoma

A

Yes

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18
Q

The various subtypes of NHL are associated with what

A

Characteristic Chromosomal Translocations

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19
Q

What are the four types of Non Hodgkin’s lymphoma

A

Burkitt’s lymphoma ( t(8;14) )
Follicular Lymphoma ( t(14;18) )
Mantle Cell Lymphoma ( t(11;14) )
Anaplastic large cell lymphoma ( t(2;5) )

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20
Q

What is the Chromosomal Translocation in Burkitt’s Lymphoma

A

t (8;14)

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21
Q

t (8;14) translocation is which Non Hodgkin’s lymphoma

A

Burkitt’s

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22
Q

t (14;18) translocation is which Non Hodgkin’s lymphoma

A

Follicular Lymphoma

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23
Q

t (11;14) translocation is which Non Hodgkin’s lymphoma

A

Mantle Cell Lymphoma

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24
Q

t (2;5) translocation is which Non Hodgkin’s lymphoma

A

Anaplastic large cell lymphoma

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25
Q

What is the Chromosomal Translocation in Follicular Lymphoma

A

t(14;18)

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26
Q

What is the Chromosomal Translocation in Mantle Cell Lymphoma

A

t (11;14)

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27
Q

What is the Chromosomal Translocation in Anaplastic large cell lymphoma

A

t (2;5)

28
Q

What is the main difference between T cells and B cells lymphoma

A

In B-cell Lymphomas the IMMUNOGLOBULIN GENES are clonally rearranged

While in T-cell Lymphomas the there is clinal rearrangement of the T-CELL RECEPTOR GENES

29
Q

Staging procedures for Non Hodgkin’s lymphoma usually include

A 
Chest X-Ray
Computed Tomography (CT) scanning 
Magnetic Resonance Imaging
Bone Marrow Aspiration
Trephine Biopsy
30
Q

Which method/procedure may detect disease not seen on CT Scan

A

PET

31
Q

What is most commonly used in initial staging of Non Hodgkin’s lymphoma

A

Combined PET-CT

32
Q

What is the most common form of Non Hodgkin’s lymphoma

A 
Follicular Lymphoma (low grade)
t (14;18)
33
Q

What is the likely age of patients with Follicular lymphoma

A

Middle aged or elderly

34
Q

What is the median survival for Follicular lymphoma

A

10yrs

35
Q

What is the presentation of Follicular lymphoma

A

Painless lymphadenopathy (often widespread)

Majority have stage III and IV disease

36
Q

Which drugs are used in initial treatment for Follicular lymphoma

A

Chlorambucil
Cyclophosphamide
Vincristine
Prednisolone

((CVP))

Achieves a response in up to 90% of pts

37
Q

How is Follicular lymphoma disease relapse treated

A

Treated with similar chemotherapy regimen’s but the disease becomes increasingly difficult to control and more intensive chemotherapy and radiolabeled antibody therapy may be considered

Autologous stem cell transplantation may be valuable in patients with a history of at least one relapse

38
Q

List five subtypes of low grade non-Hodgkin’s lymphoma

A 
Follicular lymphoma
Lymphocytic lymphoma
Lymphoplasmacytoid lymphoma
Mantle cell lymphoma
Marginal zone lymphoma
39
Q

Which lymphoma appears to be the tissue phase of chronic lymphocytic leukemia

A

Lymphocytic lymphoma

40
Q

Lymphocytic lymphoma appears to be the tissue phase of which disease

A

Chronic lymphocytic leukemia CLL

41
Q

What is the treatment for Lymphoplasmacytoid lymphomas

A

Chlorambucil
Fludarabine
Monoclonal antibodies

42
Q

Define Mantle Cell Lymphoma

A

Derived from pre germinal centre cells localized in the primary follicles or in the mantle region of secondary follicles

43
Q

What is the clinical presentation of Mantle Cell Lymphoma

A

Lymphadenopathy

Bone marrow infiltration and tumour cells in the blood

44
Q

Does Mantle Cell Lymphoma is characterized by good or poor prognosis

A

Poor

45
Q

What are the current treatment regimens for Mantle Cell Lymphoma

A 
CVP
Chlorambucil
Cyclophosphamide 
Vincristine
Prednisolone 
CHOP
Cyclophosphamide 
Hydroxodaunorubicin
Oncovin
Prednisolone

Autologous stem cell transplantation is being investigated

46
Q

What is the prognosis for Mantle Cell Lymphoma

A

Poor

Median survival 3yrs

47
Q

Describe marginal zone lymphomas

A

Extranodal

Localized

48
Q

What type of Non Hodgkin’s lymphoma is MALT (mucosa associted Lymphoid tissue)

A

Marginal zone lymphomas

49
Q

What is the cause of MALT (mucosa associted Lymphoid tissue)

A

Pre existing inflammatory or autoimmune disorder

50
Q

What is the most commonform of MALT (mucosa associted Lymphoid tissue)

A

Gastric MALT lymphoma

51
Q

Gastric MALT Lymphoma is preceded by what

A

Helicobacter (H.) pylori infection

52
Q

How is MALT Lymphoma treated (in early stages)

A

Antiobiotic therapy aimed at eliminating H pylori

53
Q

List three types of High gradeNon Hodgkin’s lymphoma

A

Lymphoblastic Lymphoma
Burkitt’s Lymphoma
Diffuse large B-cell lymphoma (DLCL)

54
Q

Define Diffuse large B-cell lymphomas

A

A heterogeneous group of disorders representing the classical ‘high-grade’ lymphomas

55
Q

What is the clinical presentation of Diffuse large B-cell lymphomas

A

Rapidly progressive lymphadenopathy
Fast rate of cellular proliferation
Progressive infiltration may affect the bone marrow, GIT, spinal cord, kidneys

56
Q

The cell of origin of DLCL has been of prognostic significance,
Which is more favorable: germinal centre or activated peripheral B cell

A

Germinal centre

57
Q

What is the treatment for DLCL Diffuse Large B-cell lymphomas

A 
R-CHOP
Rituximab
Cyclophosphamide  
Hydroxodaunorubicin
Oncovin
Prednisolone

Given 2-,3- or 4- weekly cycles for 6-8 courses

58
Q

What is the treatment for DLCL Diffuse Large B-cell lymphomas with relapse and chemotherapy sensitive disease

A

High dose chemotherapy with IFOSAMIDE, EPIRUBICIN and EPTOPOSIDE (IVE)

59
Q

What is Burkitt’s Lymphoma

A

The lymphomatous correlate of L3 acute lymphoblastic leukemia

60
Q

Endemic (African) Burkitt’s Lymphoma is seen in areas with exposure to which disease

A

Malaria

EBV

61
Q

What is the clinical presentations for Burkitt’s Lymphoma

A

Lymphadenopathy of thejaw

62
Q

Define T-cell Lymphomas

A

Peripheral T cell lymphomas that present with lymphadenopathy rather than extranodal disease are a heterogeneous group of rare tumours of CD4+ phenotype

63
Q

What are the seven variants of T cell lymphomas that are recognized

A

Peripheral T-cell Non Hodgkin’s lymphoma

Angioimmunoblastic lymphadenopathy

Mycosis fungoides

Sézary Syndrome

Adult T-cell leukemia

Angiocentric Lymphomas

Anaplastic large cell lymphoma

64
Q

Define Peripheral Tcell non Hodgkin’s lymphoma

A

These derive from post-thymic T cells at various stages of differentiation

65
Q

How is Peripheral T-cell Non Hodgkin’s lymphoma treated

A

CHOP

Cyclophosphamide
Hydroxodaunorubicin
Oncovin
Prednisolone

66
Q

Peripheral T-cell Non Hodgkin’s lymphoma treated prognosis

A

Poor

Essential Haematology (14 decks)

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