Non-Hodgkins Lymphoma

Question 1

What is B-lymphoblastic leukaemia?

Answer 1

A type of cancer that affects the B-lymphocytes and is characterized by the proliferation of immature B cells.

Question 2

What is Burkitt Lymphoma?

Answer 2

A fast-growing tumor associated with a doubling time of about 24 hours, sensitive to chemotherapy.

Question 3

What chemotherapy agents are typically used for Burkitt Lymphoma?

Answer 3

• Cyclophosphamide
• Vincristine
• Methotrexate

Question 4

What is the staging system used for Burkitt Lymphoma?

Answer 4

Modified An Arbor staging

Question 5

What does Stage I in Modified An Arbor staging indicate?

Answer 5

Tumor present at only one site.

Question 6

What is a common characteristic of chronic lymphocytic leukaemia?

Answer 6

It often presents with small lymphocytic lymphoma.

Question 7

What are the features of Mycosis fungoides?

Answer 7

• Severe pruritus
• Psoriasis-like lesions
• Involvement of deeper organs over time

Question 8

What is the male to female ratio for Burkitt Lymphoma?

Answer 8

3 to 4:1

Question 9

What is the peak incidence age for Burkitt Lymphoma?

Answer 9

Children aged 11 years.

Question 10

What is Sezary syndrome?

Answer 10

A type of T-cell lymphoma presenting with dermatitis, erythroderma, and generalized lymphadenopathy.

Question 11

What is the histological feature of Sezary cells?

Answer 11

Highly convoluted or folded nucleus, known as cerebriform nucleus.

Question 12

What is the significance of CD20 positivity in lymphomas?

Answer 12

Indicates the presence of B-lymphocytes, important for diagnosis and treatment.

Question 13

What is the role of Rituximab in the treatment of follicular lymphoma?

Answer 13

It is a monoclonal antibody used for treatment.

Question 14

What cytogenetic abnormality is associated with follicular lymphoma?

Answer 14

t(14; 18)

Question 15

Which lymphoma is characterized by involvement of Waldeyer’s ring?

Answer 15

Non-Hodgkin lymphoma

Question 16

What is a common clinical feature of non-Hodgkin lymphoma?

Answer 16

Lymphadenopathy that is usually superficial, asymmetric, and painless.

Question 17

What is the most common low-grade lymphoma?

Answer 17

Follicular lymphoma.

Question 18

What does the International Prognostic Index (IPI) assess?

Answer 18

Risk stratification based on age, performance status, LDH levels, and extranodal sites.

Question 19

What is a common treatment-related side effect of chemotherapy?

Answer 19

• GI symptoms
• Bone marrow suppression
• Viral reactivation

Question 20

Which environmental factors are associated with non-Hodgkin lymphoma?

Answer 20

• Agricultural pesticides
• Solvents
• Hair dyes

Question 21

What are the three forms of Burkitt lymphoma?

Answer 21

• Endemic (African)
• Sporadic
• Immunodeficiency-associated

Question 22

What is the typical presentation of endemic Burkitt lymphoma?

Answer 22

Jaw or facial bone tumor, often in children.

Question 23

What is the primary method used to diagnose lymphomas?

Answer 23

Lymph node biopsy/histology.

Question 24

True or False: Follicular lymphoma is an aggressive lymphoma.

Answer 24

False

Question 25

What is the significance of LDH levels in lymphoma?

Answer 25

Raised levels may serve as a prognostic marker.

Question 26

What are the common symptoms of lymphoma?

Answer 26

* Painless lymphadenopathy * Weight loss * Night sweats * Fatigue

Question 27

What is a characteristic cytogenetic finding in Burkitt lymphoma?

Answer 27

Chromosomal translocation t(8; 14)

Question 28

What is the treatment approach for indolent lymphomas?

Answer 28

Slowly progressive; respond well to chemotherapy but difficult to cure.

Question 29

What does the Lugano staging system assess?

Answer 29

Extent of tumor involvement in lymphoid organs and other organs.

Question 30

Fill in the blank: The most common type of pediatric NHL is _______.

Answer 30

Burkitt lymphoma.

Question 31

What is the clinical relevance of cytogenetic analysis in lymphomas?

Answer 31

Reveals characteristic translocations associated with different lymphomas.

Question 32

What is the increased risk factor for Non-Hodgkin's lymphoma (NHL) in close relatives?

Answer 32

Risk increased 2–3 fold ## Footnote This indicates a genetic predisposition to NHL.

Question 33

What classification methods are used for Non-Hodgkin's lymphoma?

Answer 33

* Immunophenotyping * Cytogenetics * Molecular analysis ## Footnote These methods assist in identifying the type of lymphoma and its characteristics.

Question 34

What are the older classifications of lymphoma?

Answer 34

* Rappaport classification * Kiel classification * Lukes & Collins classification * Working formulation ## Footnote These classifications laid the groundwork for understanding lymphomas prior to newer systems.

Question 35

What are the main epidemiological trends regarding NHL?

Answer 35

* Incidence increases with age * Male to female ratio is 3:2 * Increased mean age of the population * Improvement in diagnosis * HIV pandemic * Immunosuppressive therapy ## Footnote These factors contribute to the rising incidence of NHL globally.

Question 36

What are the major categories in the WHO Classification of Haematolymphoid Tumors 5th Edition?

Answer 36

* Tumor-like lesions with B-cell predominance * Precursor B-cell neoplasms * Mature B-cell neoplasms * Precursor T-cell neoplasms * Mature T-cell & NK cell neoplasms ## Footnote This classification organizes various lymphoid tumors based on their characteristics.

Question 37

What is the definition of lymphomas?

Answer 37

Group of diseases caused by malignant lymphocytes that accumulate in lymph nodes ## Footnote This accumulation leads to clinical features such as lymphadenopathy.

Question 38

Differentiate between Hodgkin's lymphoma and Non-Hodgkin's lymphoma.

Answer 38

* Hodgkin's lymphoma: RS cells present, nodal origin, contiguous spread * Non-Hodgkin's lymphoma: B or T cells, RS cells absent, extranodal origin, non-contiguous spread ## Footnote Understanding these differences is crucial for diagnosis and treatment.

Question 39

What is the Working Formulation for lymphomas?

Answer 39

A classification invented by the National Cancer Institute to standardize lymphoma reporting ## Footnote It focuses on morphology and biological behavior but does not use immunophenotyping.

Question 40

Identify the cell type associated with Hodgkin's lymphoma and Non-Hodgkin's lymphoma.

Answer 40

* Hodgkin's lymphoma: B cell * Non-Hodgkin's lymphoma: B or T cells ## Footnote This distinction is important for understanding the pathology of these diseases.

Question 41

What is the fastest growing tumor in man?

Answer 41

Burkitt lymphoma ## Footnote This type of lymphoma is known for its rapid progression.

Question 42

Fill in the blank: The _______ form of Burkitt lymphoma commonly presents with jaw involvement.

Answer 42

endemic ## Footnote This form is often seen in regions with high prevalence of malaria.

Question 43

What is a common feature of Burkitt lymphoma?

Answer 43

* Sporadic form (lymph node involvement) * Endemic form (Abdominal presentation) * Immunodeficiency form (Jaw involvement) ## Footnote These features help in identifying the type of Burkitt lymphoma.

Question 44

What is the significance of the REAL classification?

Answer 44

Proposed in the 90s by the International Lymphoma Study group, it is the basis of the WHO classification ## Footnote The REAL classification has been revised in the 5th edition of the WHO classification.

Question 45

Which of the following is NOT associated with Burkitt lymphoma? A) Undernutrition B) EBV C) Plasmodium falciparum D) t(8;16)

Answer 45

D) t(8;16) ## Footnote The characteristic translocation for Burkitt lymphoma is t(8;14).

Question 46

True or False: In Sezary syndrome, there is usually skin involvement.

Answer 46

True ## Footnote This condition is characterized by erythroderma and circulating malignant T-cells.