Oncology Flashcards
Mortality rate for pediatric cancer?
40%
Children < 9 yo most likely have what cancer?
Leukemia
Children 10-19 yo most likely have what cancer?
Lymphoma
What is the most common childhood cancer?
Leukemia (33%)
ALL incidence peaks at what age?
4 yo
Dx of ALL?
- FAB morphology
- Plt count < 100,00
- Blast cells on peripheral smear
- Bone marrow aspirate for confirmation
What is the Tx of ALL?
Radiation + Chemotherapy
What are (2) PE signs of ALL?
- Splenomegaly
- Mediastinal mass
20% of childhood cancers are what type of leukemia?
AML
AML incidence is increased at what age?
1-10 yo
AML incidence increases during what period of growth?
Adolescence
What is the 3rd most common childhood cancer?
Lymphoma
What is a cardinal histologic feature of lymphoma?
Reed-Sternberg Cells
Reed-Sternberg cells are diagnostic for what type of lymphoma?
Hodgkin’s Lymphoma
You should suspect lymphoma after mono (EBV) if what occurs?
Lymphadenopathy that does not resolve
What lymph nodes are commonly enlarged in lymphoma?
Supraclavicular lymph nodes
What is diagnostic procedure for lymphoma?
Biopsy
What is Ann Arbor Stage I lymphoma?
Single node or single site (100% cure rate)
Radiation only
What is Ann Arbor Stage II lymphoma?
≥2 lymph nodes or regions on the same side of the diaphragm
Radiation only
What is Ann Arbor Stage III lymphoma?
Lymph node regions on both sides of diaphragm
Chemotherapy alone or with radiation
What is Ann Arbor Stage IV lymphoma?
Disseminated disease: Lung, Bone, Bone Marrow, Liver
Chemotherapy alone or with radiation
Neuroblastoma originates from which cells?
Neural crest cells
What is the most common solid extra-cranial childhood tumor?
Neuroblastoma
What is the median age of neuroblastoma development?
2 yo
What are the S/Sx of neuroblastoma?
- Pseudorosettes on biopsy
- Bluish tinged SQ nodules
- Abdominal swelling
Blueberry Muffin
Excessive VMA in urinalysis leads you to the suspicion of what childhood cancer?
Neuroblastoma
What is the most common childhood renal tumor?
Wilms Tumor
What are common features to Wilms tumor patients?
- HTN
- Hematuria
- Hemihypertrophy (1 side bigger than other)
- Aniridia (absence of iris)
Myc amplification is seen in what disease?
Neuroblastoma
Translocation 15;17 is noted in which cancer?
AML; Acute promyelocytic
What translocation is not for a poor prognosis in ALL is noted in what cancer?
4;11
What is the translocation noted in ALL/CML?
Philadelphia Chromosome (9;22)
Leukemia has an increased incidence in what pediatric population?
Down Syndrome patients
What are common sites of leukemia relapse?
- Bone marrow (repeat chemo & possible BM transplant)
- Testicles
- CNS
What are good prognostic features of bone marrow transplant for leukemia?
- 1-10 yo
- WBC < 100,000
- Lack of Mediastinal mass or CNS involvement
- B-cell immunophenotyped
- 12;21 translocation
Reed-Sternberg cells appear like what type of animal?
Owl
What type of translocation means a poor prognosis for neuroblastoma?
myc translocation
What type of scan is recommended to evaluate for metastasis of neuroblastoma?
MIBG scan
What is the Tx of a localized neuroblastoma?
complete surgical resection (curative)
What is the Tx of advanced neuroblastoma?
Chemo then surgery
What do pseudorosettes mean for a neuroblastoma patient?
- Clumps of tumor cells in biopsy
- Means metastasis to bone marrow (likely)
What does ecchymosis of proptosis mean for neuroblastoma patients?
- Spread to orbits
- Can look like abuse
