Week 2 - Lymphoma Flashcards
Diffuse large B-cell lymphoma
Aggressive, germinal centre B cells
Follicular lymphoma
Indolent, slow growing lymphoma, can transform into more aggressive (like Diffuse large B cell), t(14;18)
Marginal zone B-cell lymphoma (MALT)
Related to chronic immune stimulation –> many cases H. pylori
Mantle cell lymphoma
Naive B cells, t(11;14), frequently has malignant cells in blood
Which markers define B or T cell origin?
CD2, CD3, CD5 = T cells, CD19, CD20, CD22, CD79a for B cells
Mature/peripheral T cell Lymphoma
Replacement of normal lymph node architecture with pleomorphic T cells and inflammatory infiltrate, can present with generalised lympadenopathy
Hodgkin Lymphoma
Germinal/post germinal centre B cells, only minority of cells in node are neoplastic (Reed-Sternberg cells), starts in single node and spreads.
Lymphoma stage I
Single lymph node region or a single extranodal tissue
Lymphoma stage II
Two or more lymph node regions on the same side of diaphragm
Lymphoma stage III
Lymph node regions on both sides of diaphragm
Lymphoma stage IV
Disseminated or multiple foci of involvement of one or more organs or extra nodal tissues
A vs B in lymphoma staging
A = absence of systemic systems, B = presence of systemic systems e.g. fever, night sweats and/or unexpected weight loss of >10%
What is the most common symptom in Hodgkin’s lymphoma?
Painless lump
Principles for establishing drug combinations for cancer
- Only drugs with some efficacy as single agents should be used
- Drugs with different limiting toxicities should be used
- Drugs should be used at optimum dose and schedule
- Drugs with different MOAs should be combined
What are Reed-Sternberg cells?
Giant cells with 2+ nuclei, lymphoid origin, characteristic of Hodgkin’s lymphoma
What is tumour lysis syndrome?
Collection of metabolic abnormalities that may occur following cytotoxic therapy. More likely to occur with rapidly proliferating tumours that are responsive to therapy.
Major metabolic effects of tumour lysis syndrome?
- Hyperkalemia
- hyperphosphataemia
- hyperuricaemia
Thyroglossal cyst
From persistent remnants of thyrogloassal duct
Non-tender, smooth cystic lump, usually midline at the level of hyoid bone, moves upwards on swallowing and protrusion of tongue
Branchial cleft cyst
From persistent remnants of the branchial cleft. Smooth cystic swelling, lateral, near angle of mandible or anterior border of sternocleidomastoid
Therapy for H. pylori is indicated in this form of lymphoma
MALT
Age distribution of Hodgkin lymphoma
Bimodal (young and >50)
Form of lymphoma endemic in parts of Africa
Burkitts
Describe the CHOP protocol and what is it used to treat?
Chemotherapy regimen used to treat non-Hodgkin lymphoma
Cyclophosphamide, Hydroxydaunorubicin, Oncovin (vincristine), Prednisone
Cyclic fever which may occur in Hodgkin’s lymphoma
Pel-Ebstein fever
Peripheral blood finding when there is extensive marrow involvement with lymphoma
Pancytopaenia
Which symptom referable to the skin may be an early sign of lymphoma?
Pruritis
On clinical examination, lymphomatous lymph nodes are often described as…
Rubbery
What chromosomal abnormality is a risk factor for lymphoma?
Klinefelters
MOPP protocol and what is it used to treat?
Combination chemotherapy used to treat Hodgkin’s
Mustargen, Oncovin, Procarbazine, Prednisone
