Quesmed videos (Non-Hodgkin's lymphoma)

Question 1

What is a blood film finding that would indicate non-hodgkin’s lymphoma?

Answer 1

Nucleated red cells, left shift and basophilic vacuolated lymphoma cells.

Question 2

What is the typical patient for Burkitt’s lymphoma (a type of non-hodgkin’s lymphoma)?

Answer 2

Child (around 8 years old)

Swelling in jaw (or around area of other lymph node)

Typically African ethnicity.

Question 3

What are the 3 main causes of Burkitt’s lymphoma?

Answer 3

Immunodeficiency

Sporadic

Endemic

Question 4

What causes immunodeficiency Burkitt’s lymphoma?

Answer 4

Associated with HIV and immunosuppression medications

Question 5

What causes sporadic Burkitt’s lymphoma?

Answer 5

EBV is closely linked

Question 6

What causes endemic Burkitt’s lymphoma?

Answer 6

Mostly present in those from countries in places like Africa.

Associated with Malaria

Question 7

What is the characteristic blood film for Burkitt’s lymphoma?

Answer 7

Deeply blue (basophilic staining) with small vacuoles (white dots) which are lipid droplets.

Question 8

What are risk factors of non-hodgkin’s lymphoma?

Answer 8

HIV

Epstein-Barr virus

Helicobacter pylori (H. pylori) infection is associated with MALT lymphoma

Hepatitis B or C infection

Exposure to pesticides

Exposure to trichloroethylene (a chemical with a variety of industrial uses)

Family history

Question 9

What is the translocation associated with Burkitt’s lymphoma?

Answer 9

Translocation of chromosomes 8 and 14

Question 10

What is MALT lymphoma?

Answer 10

MALT lymphoma develops when the body makes abnormal B lymphocytes.

So it is a type of B cell lymphoma.

MALT stands for mucosa associated lymphoid tissue.

Question 11

Who is MALT lymphoma typically seen in?

Answer 11

Seen in patients with autoimmune disease e.g. Sjögren’s syndrome, this would increase risk of lymphoma of the tear glands and other glands.

Question 12

What are the 2 types of MALT lymphoma?

Answer 12

Gastric

Non-gastric

Question 13

What is highly associated with gastric MALT lymphoma?

Answer 13

H.pylori infection

Question 14

What is associated with non-gastric MALT lymphoma?

Answer 14

Most often associated with head and neck, lung and eyes.

Non-gastric MALT lymphoma is NOT associated with H.pylori infection.

Question 15

What is the most common type of MALT lymphoma?

Answer 15

Gastric MALT lymphoma

Question 16

H.pylori infection is present in the majority of MALT lymphoma cases. True/false?

Answer 16

True

H.pylori is present in 85-90% cases of gastric MALT lymphoma cases.

Question 17

How is gastric MALT lymphoma usually handled?

Answer 17

Usually treated by targeting the underlying H.pylori infection

Question 18

What are the main antibiotics used for MALT lymphoma?

Answer 18

Omeprazole, amoxicillin and clarithromycin.

Question 19

What antibiotics are used in MALT lymphoma for someone with a penicillin allergy?

Answer 19

Omeprazole, metronidazole and clarithromycin.

In patient with penicillin allergy, replace amoxicillin with metronidazole during treatment.