Non-Hodgkin's Lymphoma Flashcards
What is Non-Hodgkin Lymphoma?
A group of lymphomas
What are some examples of Non-Hodgkin Lymphomas?
Burkitt lymphoma
MALT lymphoma
Diffuse large B cell lymphoma
What is Burkitt’s lymphoma?
High grade B-cell neoplasm
What are the 2 major forms of Burkitt’s lymphoma?
Endemic
Sporadic
What does the endemic form of Burkitt’s lymphoma involve?
Maxilla or mandible
What does the sporadic form of Burkitt’s lymphoma involve?
Abdominal tumours
Who is Burkitt’s lymphoma more common in?
People with HIV
Which gene is Burkitt’s lymphoma associated with?
C-myc gene translocation, usually t(8:14).
Which virus is associated with the development of Burkitt’s lymphoma?
Epstein-Barr virus
What would you find on microscopy of someone with Burkitt’s lymphoma?
‘starry sky’ appearance
What does the starry sky appearance mean?
Lymphocyte sheets interspersed with macrophages containing dead apoptotic tumour cells
What is the management of Burkitt’s lymphoma?
Chemotherapy
How is Hodgkin’s lymphoma differentiated from Non-Hodgkin’s lymphoma?
Via lymph node biopsy
Present similarly
What are other differences between Hodgkin’s and non-Hodgkin’s lymphoma?
Lymphadenopathy in Hodgkin’s lymphoma can experience alcohol-induced pain in the node
‘B’ symptoms typically occur earlier in Hodgkin’s lymphoma
Extra-nodal disease is much more common in non-Hodgkin’s lymphoma
What are some examples of extra nodal disease that can occur in Non-Hodgkin’s lymphoma?
Gastric- dyspepsia, dysphagia, weight loss, abdominal pain
Bone marrow- pancytopenia, bone pain
Central nervous system-nerve palsies
What is MALT lymphoma?
It affects the mucosa-associated lymphoid tissue, usually around the stomach
It is associated with H. pylori infection.
What is Diffuse large B-cell lymphoma?
Presents as rapidly growing painless mass in patients over 65 years.
What is the management of non-Hodgkin’s lymphoma dependent on?
The specific diagnosis
What should all patients with non-Hodgkin’s lymphoma be given?
Flu/pneumococcal vaccines
What is the main presentation on non-Hodgkin’s lymphoma?
Painless lymphadenopathy-non-tender, rubbery, asymmetrical
What constitutional B symptoms can non-Hodgkin’s lymphoma present with?
Fever
Weight loss (>10% in 6 months)
Night sweats
What extra-nodal symptoms can someone with non-Hodgkin’s lymphoma present with?
Gastric-dyspepsia, dysphagia, weight loss, abdominal pain
Bone marrow- pancytopenia, bone pain
Central nervous system- nerve palsies
What is the classification for staging non-Hodgkin’s lymphoma?
Ann Arbor system
What is stage 1 of the Ann Arbor system?
One node affected?
What is stage 2 of the Ann Arbor system?
More than one node affected on the same side of the diaphragm
What is stage 3 of the Ann Arbor system?
Nodes affected on both sides of the diaphragm
What is stage 4 of the Ann Arbor system?
Extra-nodal involvement e.g. Spleen, bone marrow or CNS
What is the staging of non-Hodgkin’s lymphoma combines with?
A or B- to indicate the presence of B symptoms
Does low grade or high grade have a better prognosis?
Low grade lymphoma
Does low grade or high grade lymphoma have a better cure rate?
High grade lymphoma
What are possible signs of lymphoma?
Signs of weight loss
Lymphadenopathy (typically in the cervical, axillary or inguinal region)
Palpable abdominal mass - hepatomegaly, splenomegaly, lymph nodes
Why would you do a biopsy?
To differentiate between Hodgkin’s lymphoma and non-Hodgkin’s lymphoma
Why would you test for HIV?
Its associated with non-Hodgkin’s lymphoma (Burkitt’s lymphoma)
What might you do to asses stage of lymphoma?
CT chest, abdomen and pelvis
What can ESR be useful for?
Prognosis indicator
What are some possible complications of lymphoma?
Bone marrow infiltration
Superior vena cava obstruction
Metastasis
Spinal cord compression
What can bone marrow infiltration result in?
Anaemia
Neutropenia
Thrombocytopenia
