Non hodgkin's lymphoma Flashcards
What is a lymphoma?
A malignant proliferation of lymphocytes which accumulate in the lymph nodes or other organs of the body
Which cells does non hodgkin’s lymphoma affect?
- Non hodgkin’s lymphoma can affect either B or T cells and can be further classified into high grade or low grade
Age distribution of non hodgkin’s lymphoma?
Typically effects the elderly with 1/3 of cases affecting > 75 years
Biological risk factors for non hodgkin’s lymphoma? (3)
- Elderly
- Caucasian
- Family history
Social/Medical risk factors for non hodgkin’s lymphoma? (3)
- History of viral infection (Epstein Barr virus)
- History of chemo/radiotherapy
- Immunodeficiency - HIV
- Autoimmune disease - SLE/Sjoren’s
Name 3 major class of symptoms?
- Painless lymphadenopathy - rubbery/assymetrical
- B symptoms - Fever/Weightloss/Night sweats
- Extra nodal disease
Examples of Extranodal disease?
- Gastric - dyspepsia/dysphagia/weightloss
- Bone marrow - Pancytopenia/Bone pain
- Lung/Skin/Nerve palsies
Symptoms (5)
- Weightloss
- Lymphadenopathy
- Palpable abdominal mass - hepatosplenomegaly
- Testicular mass
- Fever
How is the diagnosis of non Hodgkin’s lymphoma?
Excisional nodal biopsy - Dx investigation of choice
Burkitt’s lymphoma presentation on biopsy?
‘Starry sky’ appearance
Staging of non Hodgkin’s lymphoma?
CT of chest/abdomen/pelvis
Blood test - Investigations? (4)
- FBC and blood film - helps rule out other causes of haemological malignancy and identify anemia
- ESR - useful as prognostic indicator
- LDH - marker of cell turnover
- LFT - if liver metastasis suspected
Other investigations and scans?
- HIV screening - as this is a risk factor
- PET CT
- Bone marrow biopsy
Complications of Non - hodgkin’s
- Bone marrow infiltration - anaemia/neutropenia/thrombocytopenia
- Superior vena cava obstruction
- Spinal chord compression
Management
Chemotherapy or radiotherapy
