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Haematology > Non-hodgkins lymphoma > Flashcards

Non-hodgkins lymphoma Flashcards

1
Q

Differences between HL and NHL

AGE

A

Bimodal 15-30 and 50 yrs in H

Increaseswith age, median age being 50. Low grade NHL is 55-60

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2
Q

Gender difference

A

M;F =5;1 IN H

M;F=7;1 IN NHL

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3
Q

Hodgkins lymphoma

A

More in males

rises in adolescence peaks in 3rd decade

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4
Q

Stages difference

A

stages 1 and 2 at presentation in H

stages 3 and 4 at presentation in NHL

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5
Q

b symptons and signs

A

25-40% in H

15% in NHL

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6
Q

direction of spread difference

A

predictable axial spread in H

Random spread in NHL

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7
Q

Leukemic phase

A

rare in H

Common in NHL

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8
Q

ORIGIN DIFFERENCE

A

MAjority originate from nodal region -H

80% nodal and 20% extranodal NHL

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9
Q

Trochlear, mesenteric, pharyngeal nodes

A

Rarely involves these areas-H

Occasional involvement-NHL

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10
Q

mediastinum involvement

A

50% involvement-H

20% NHL

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11
Q

Lymph node involvement

A

subdiaphragmatic LN. gENERALISED ln AND EXTRA LYMPHATIC DX LATER-H

Widespread LN involvemenr- NHL

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12
Q

Bone marrow involvement

A

less than 10% in H

70% in NHL

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13
Q

Spread

A

Contiguous-H

Non contiguous- NHL

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14
Q

GIT AND LIVER INVOLVEMENT

A

Rare-H

COMMON-NHL

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15
Q

Superior vena cava obstruction

A

Common-NHL

Non common- H

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16
Q

CAUSES OF NHL

A

EBV
HTLV 1
immunosuppression

17
Q

First implicated virus

A

EBV

18
Q

What type of infection by EBV is associated with lymphomas

A

Latent

19
Q

Type 1 EBV latency causes

A

burkitts lymphoma

20
Q

Type 2 EBV latency causes

A

hodgkins dx

nasopharyngeal ca

21
Q

Type 3 EBV latency causes

A

HIV LYMPHOMA

22
Q

Classification of NHL

A

Indolent NHL
B cell lymphomas
T cell lymphomas

23
Q

Examples of B cell lymphomas

A 
Diffuse large B cell lymphomas
Follicular lymphoma
Mantle cell lymphoma
Marginal zone lymphomma
Burkitts lymphoma
Lymphoplasmacytic lymphoma
24
Q

Example of T cell lymphoma

A

Cutaneous T cell lymphoma
Angioimmunoblastic T cell lymphoma
Anaplastic large cell lymphoma
Enteropathy type t cell lymphoma

25
Q

Investigations in NHL

A

Investigation of waldeyers group of LN

Bone biopsy

26
Q

is staging laparatomy justifies in NHL

A

no

27
Q

Symptom status B meaning

A

unexplained fever
Drenching night weats
weight loss greater than 10%

28
Q

Bulk

A

Mediastinal mass greater than 1/10 the max diameter of the chest

29
Q

Recommendations for clinical imaging

A 
size - >1.5
Spleen- physical exam,Chest X rat, CT
Lymph angiography to identify abnormal LN
Gallium scan 
MRI
30
Q

Clinical features of NHL

A

Lymphadenopathy-widespread
Hepatosplenomegaly
Fever, night sweats, weight loss

31
Q

Systemic symptoms and signs

A

due to involvement of particular organs like GIT, lungs, CNS

Can cause delay in diagnosis and can decrease survival

32
Q

Less frequent symptoms

A 
abdominal pain
fatigue
painful adenopathy
malaise
dysphagia
cough
bone pain
edema
pruritus
33
Q

Burkitts lymphoma presents with

A

extranodal dx in the jaw in africa

in GIT and intraabdominal sites in the west

34
Q

Lymphoblastic lymphoma symptoms

A

Thymic mass
Systemic symptoms
Bone marrow failure

35
Q

In advanced NHL about half obtain

A

Complete remission

the rest obtain useful dx control

36
Q

Those who have complete remission

A

Relapse in 5 yrs

37
Q

Front line therapy being studied

A

Fludarabine and 2 chloro deoxyadenosine

38
Q

Management of treatment failures

A

Repeat previous combination after a long period of remission

Quick relapse after chlorambucil; give CHOP/fludarabine

39
Q

Valuable in 2/3 of patients heavily pretreated

A

Fludarabine, mitoxantrone, dexamethasone

Haematology (29 decks)

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