Non-Hodgkin's Lymphoma

Question 1

What is the difference between lymphoma and leukaemia?

YOU DO NOT NEED TO KNOW THE SUBTYPES OF LYMPHOMA!!!!

Answer 1

Lymphoma is a malignant proliferation of mature lymphocytes (as in CLL) but they accumulate in the lymph nodes +/- other tissue

Leukaemia arises from eh bone marrow and spreads to the lymph nodes

Question 2

How do you know it is not Hodgkin’s lymphoma on light microscopy?

NON-HODGKIN’S LYMPHOMA MAKES UP 80% OF ALL LYMPHOMAS

THIS LYMPHOMA INCLUDES A WIDE RANGE OF CANCERS

Answer 2

The absence of Reed-Sternberg cells

Question 3

S+S:

There are 2 grades:

• What is meant by low grade?
• What is meant by high grade?

What is the main complaint in most?

Answer 3

Slow growing
Good prognosis
BUT hard to cure

More acute
BUT easier to cure

Lymphadenopathy

Question 4

S+S:

Extranodal manifestations - it can be almost anywhere so almost any symptom can occur:

• Gut
• Skin
• Oropharynx
• Nervous system

Other sites include bone and lungs

What will happen if there is bone marrow involvement?

Answer 4

MALT - abdo pain, weight loss, dyspepsia

T cell lymphoma - rash, discolouration

MALT - sore throat, obstructed breathing

Raised ICP
CN palsy

Pancytopenia

Question 5

Investigations:

FBC - what will it show?

LDH is raised. Why?

What is going to confirm the diagnosis?

Answer 5

Pancytopenia

High LDH activity at the time of lymphoma diagnosis reflects increased tumour bulk and predicts a less favourable prognosis irrespective of the histologic subtype

LDH is raised in other types of cancer as well

Biopsy

Question 6

What staging system is used?

Answer 6

Ann Arbor Staging System

Question 7

Management:

Same as always!

Answer 7

Same as always

Question 8

Compilations:

What respiratory pathology may present as a result of mets?

What could become compressed due to primary cancer or mets?

Answer 8

Pleural or pericardial effusion from mets

SVC obstruction
Spinal cord