Week 20 - Case 1,2,3 Flashcards
what should happen if someone as B symptoms of fever, weight loss, night sweats and a neck lump
referred to the haematologist as an urgent 2 week wait referral
does leukaemia present with lymphadenopathy
rarely - this is more in keeping with lymphoma
what are the characterisitcs of Reed-Sternberg cells
large cells that are either multi-nucleated cells, or have bilobed nuclei
where are lymphocytes present
in the circulation, bone marrow, lymph noes and other organs that form the reticulo-endothelial system, such as the liver and spleen
how are Non-Hodgkin’s lymphoma characterised
by diffuse, or nodular abnormal lymphocytes
what are the types of Hodgkin’s lymphoma
nodular sclerosis
mixed cellularity
lymphocyte depleted
what are the types of non hodkins lymphoma
High grade e.g. Diffuse Large B-cell Lymphoma & Burkitt’s Lymphoma
Lymphocyte-rich Low-grade: Follicular lymphoma
what are low grade tumours
these tumours grow slowly and may not require treatment for long periods
when they do need treatment, they are likely ro respond well to chemotherapy, but thet are very rarely cured
follicular lymphomas are low grade non-hodgkin lymphoma
what is the common used clincial staging system
the Ann Arbor System
what are the stages of the Ann Arbor system
Stage 1 : One group of lymph nodes is affected.
Stage 2: Two or more groups of nodes are affected, but the lymphoma is restricted to one side of the diaphragm only.
Stage 3: Lymphadenopathy is evident on both sides (above and below) of the diaphragm.
Stage 4: The lymphoma has spread beyond the lymph nodes to other organs such as the spleen, bone marrow, liver or lungs.
why is a letter code added to each of the above stages
A or B is added to indicate whether or not the patient has systemic symptoms such as weight loss, fevers, or night sweats
what is radiotherapy
the use of ionising radiation to treat malignant disease
what does radiotherapy preferentially treat
dividing cells and can be targeted to include the tumour and avoid normal tissue
what are the late side effects of treatment
risk of second cancers, and cardiac or hormonal problems, depending on what treatments patients recieve
is follicular NHL curable
no
what does the term purpura describe and what does it signify
purpura is the appearance of a non-blanching purple-red spots of the skin
it signifies bleeding vessels near the surface and can also occur in the mucous membrane
what are larger purpura called
ecchymoses
what size are petechiae normally
normally <1cm in size
if a bone marrow biopsy shows >20% blasts what is the most likely diagnosis
confirms the diagnosis of acute myeloblastic leukaemia (AML)
can ALL present with blasts
ALL can also present with blasts
in acute forms of leukaemia what is the peripheral blood film dominated bt
the immature cells which will be referred to as acute myeloblastic or lymphoblastic leukaemia
when does ALL develop
when a B/T precursor stage lymphoid progenitor cell becomes genetically altered through somatic changes and undergoes uncontrolled prolideration
when is ALL usually diagnosied
in those aged under 20 yeats
what is a key risk factor for CLL
being over 60 years old
