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Cancer Care > Non-Hodgkin's Lymphoma > Flashcards

Non-Hodgkin's Lymphoma Flashcards

1
Q

What are the sub-divisions of Non-Hodgkin’s lymphoma?

A

B Cell
T Cell
NK Cell

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2
Q

What are the subdivisions of B Cell Non-Hodgkin’s lymphoma’s?

A

High Grade

Low Grade

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3
Q

Give examples of high grade B Cell Non-Hodgkin’s lymphoma’s

A

Diffuse Large B Cell Lymphoma (DLBL)

Burkitt’s Lymphoma

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4
Q

Give examples of low grade B Cell Non-Hodgkin’s lymphoma

A

Follicular lymphoma

Chronic Lymphocytic Leukaemia

Mantle Cell Lymphoma

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5
Q

How prevalent is Non-Hodgkin’s lymphoma?

A

5 times more common than Hodgkin’s lymphoma

Around 1 in 39 risk for males, 1 in 51 for females

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6
Q

Identify risk factors for Non-Hodgkin’s lymphoma

A 
Age - generally over 50
Prolonged immunosuppression: diabetes, steroids, HIV
EBV
H. Pylori
Chlamydia
autoimmune diseases: SLE, sjrogrens, RA
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7
Q

What investigations do you do if you suspect Non-Hodgkin’s lymphoma?

A

FBC - cytopaenia
LDH and Calcium both raised

CT - nodal/extra-nodal involvement

Lymph node biopsy - monomorphous lymphocytic proliferation

Bone marrow aspiration and trephine - immunophenotyping

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8
Q

What staging system is used for Non-Hodgkin’s lymphoma?

A

Ann Arbour (same as Hodgkin’s Lymphoma)

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9
Q

Apart from by cell type, how else can Non-Hodgkin’s lymphoma be classified?

A

By clinical behaviour:

Indolent - low grade
Aggressive - high grade

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10
Q

What is the prognosis of low grade non-hodgkins lymphoma?

A

incurable but compatible with a number of years survival

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11
Q

What is the prognosis of high grade non-hodgkins lymphoma?

A

rapidly fatal if untreated but modern treatment can cure in majority of cases

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12
Q

How do low grade non-hodgkins lymphomas present?

A

1 or more areas of painless lymphadenopathy
Hepatosplenomegaly
Bone marrow involvement (cytopaenia)

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13
Q

How do high grade non-hodgkins lymphomas present?

How does Burkitt often present

A

Rapidly enlarging lymph node(s)
B symptoms
Extra-nodal involvement
Hepatosplenomegaly

Burkitt - abdo mass/ bowel obstruction

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14
Q

How are low grade non-hodgkins lymphomas managed?

A

generally watchful waiting until symptomatic then chemo

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15
Q

What is R-CHOP

A

Rituximab + chemo agents

Cyclophosphamide
Doxorubicin
Vincristine
Prednisolone

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16
Q

How are high grade non-hodgkins lymphomas treated?

What else is needed in the management of them?

A

R-CHOP

CNS prophylaxis - intrathecal methotrexate

Prevent tumour lysis syndrome: Rasburicase
Prevent herpes: aciclovir
Prevent pneumocystis: trimoxazole

17
Q

Why must you be wary of low grade non-hodgkins lymphomas?

A

They can transform to high grade

18
Q

How does Burkitt present on biopsy

A

Starry sky:

macrophages full of dead apoptotic tumour cells

Cancer Care (25 decks)

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