Non-hodgkins lymphoma

Question 1

define non hodgkins lymphoma?

Answer 1

lymphomas are malignancies of lymphoid cells originating in lymph nodes or other lymphoid tissues.
• Non-Hodgkin’s lymphomas are all lymphomas which aren’t Hodgkin’s

Question 2

what is the most common non-hodgkin lymphoma?

Answer 2

o Most commonly diffuse large B cell lymphoma

Question 3

what are risk factors for non-hodgkin lymphoma?

Answer 3

•	Oncogenic viruses 
•	Other risk factors: 
o	Radiotherapy  
o	Immunosuppressive agents  
o	Chemotherapy  
o	Immunodeficiency (HIV, HBV, HCV)
o	Autoimmune disease (SLE, Sjogren’s, coeliac) 
o	Chemical agents (pesticides)

Question 4

epidemiology of non-hodgkins lymphoma?

Answer 4

• Non-Hodgkin’s lymphoma is more common than Hodgkin’s lymphoma
• Common in the elderly >75 years

Question 5

symptoms of non-Hodgkin’s lymphoma?

Answer 5

• Painless enlarging mass
• Systemic Symptoms
• Symptoms related to organ involvement

Question 6

examples of Symptoms related to organ involvement

Answer 6

o	Gastric (dyspepsia, dysphagia, weight loss, abdominal pain) 
o	Bone marrow (pancytopenia, bone pain) 
o	Lungs
o	Skin 
o	CNS palsies

Question 7

signs of NHL?

Answer 7

o Mycosis fungoides - looks like a fungal infection
• Abdominal mass
• Testicular mass
lymphadenopathy

Question 8

gold standard investigation for non-hodgkins lymphoma?

Answer 8

excisional node biopsy

Question 9

what might be seen on bloods?

Answer 9

o	Normocytic Anaemia  
o	Neutropaenia 
o	Thrombocytopaenia  
o	High ESR (prognosis) 
o	LDH (indicator of cell turnover) 
o	HIV, HBV and HCV serology 
o	Calcium may be raised

Question 10

how to stage non-hodgkins lymphoma?

Answer 10

o Ann Arbor Staging

Question 11

main difference between hodgkins and non-hodgkins?

Answer 11

• Hodgkins has alcohol induced pain
• Hodgkins had earlier B symptoms
• Hodgkins doesn’t have extra nodal disease