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SALMAN HARRISON'S > 104 - Non Hodgkin Lymphoma > Flashcards

104 - Non Hodgkin Lymphoma Flashcards

1
Q

NHL (Non Hodgkin lymphoma) is a group of cancers of adult __, __, __ cells

A

B
T
NK

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2
Q

Unlike HL (Hodgkin lymphoma), NHL does not have __ cells and have other biological and clinical characteristics

A

RS (Reed Sternberg)

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3
Q

The prognosis of NHL __greatly, Unlike HL where the prognosis is __ even under __ only

A

varies
good
chemotherapy

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4
Q

NHL is __ times more common than HL, and makes up to __% of all new cancers in the US

A

10

4

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5
Q

NHL is more common in __ __, and the frequency increases with __, especially when > __

A

white
men
age
40

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6
Q

Patients with __ are more prone to develop __

A

prone

NHL

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7
Q

__and Burkitt are considered more aggressive and are more common in children

A

DLBCL

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8
Q

Which infections are correlated with NHL? 7
__- linked with Burkitt and CNS lymphoma
__- linked with T cell lymphoma
__- linked with aggressive B cell
__- linked with gastric MALT
__- linked with cutaneous MALT
__- linked with lymphoplasmacytic and MZL of the spleen
__- linked with HIV lymphoma including Castleman disease

A 
EBV
HTLV-1
HIV
H. Pylori
Borrelia 
HCV
HHV-8
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9
Q

Immunosuppressive patients are linked to NHL due to __

A

EBV

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10
Q

__% of NHL are __ cells lymphomas

A

90

B

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11
Q

Physical examination of NHL patients may suggest __ vs __ disease. Look for __ symptoms

A

aggressive
indolent
B

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12
Q

Important lab workout for NHL include: 5

A 
CBC/chemistry/LFT
protein electrophoresis (monoclonal)
B-2 microglobulin/LDH
LP
HBV/HCV/HIV
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13
Q

The recommended imaging modalities for NHL are:

A

CT-C/A/P- for staging
PET CT- for DLBCL and HL
MRI- for bone/BM/CNS

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14
Q

There are two main groups of NHL: __ which require immediate treatment with chemotherapy and considered treatable, and __ which is treated symptomatically but hard to achieve complete cure

A

aggressive

indolent

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15
Q

The most common aggressive NHL is __, while the most aggressive is __

A

DLBCL

Burkitt

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16
Q

The most common indolent NHL is __. Other lymphomas include : 3. __ is considered intermediate between the two groups

A 
FL
MZL
LPL
HCL
MCL
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17
Q

Burkitt lymphoma is more common in ___. Biopsy will reveal monotonic infiltration: __ size cells with __ nucleolus, multiple __, and __ cytoplasm. Remember- __

A 
children 
medium
round
nuclei
basophilic 
Starry sky
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18
Q

Burkitt lymphoma markers include: 5

A 
BCL2
BCL6
CD10
CD20
CD19
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19
Q

DLBCL is the most common __ cell lymphoma. More common in __, median age of __. Very often associated with __.

A

B
men
64
EBV

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20
Q

DLBCL contains __ proliferation of __ and __ lymphocytes.

A

diffuse
large
atypical

21
Q

DLBCL expresses: 3

A

CD79a
CD20
CD19

22
Q

In DLBCL __ is positive in 25-80% of times, and __ in 10%

A

BCL2

MYC

23
Q

In DLBCL when both __ and __ are positive- double hit lymphoma

A

BCL

MYC

24
Q

DLBCL=__

A

Diffuse large B-cell lymphoma

25
Q

What is the first line of treatment for DLBCL?

A

R-CHOP

rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone

26
Q

When DLBCL is localized, choose one of two options-
R-CHOP every _ weeks for _ cycles
or
R-CHOP for _ cycles followed by localized __

A

3
6
3-4
radiation

27
Q

When DLBCL is advanced- full __

A

chemotherapy

28
Q

Another option for DLBCL with mediastinal involvement and double hit (__+__)is- __

A

MYC+BCL

R-EPOCH

29
Q

If DLBCL is refractory and/or 2 lines have failed- __

A

CAR-T

30
Q

FL=__

A

Follicular lymphoma

31
Q

FL is the __ most common NHL preceded by __

A

2nd

DLBCL

32
Q

FL has __ organization. To confirm we must look for immunogenic phenotype: 6. Translocation of __ and inappropriate __ are in >85% of cases

A

follicular
CD6, CD10, CD19, CD20, CD23, BCL6
14:18
BCL2

33
Q

WHO classifies FL to 3 stages according to number of centroblasts:
I: -
II: -
III: >_

A

0-5
6-15
15

34
Q

The typical clinical presentation of FL is of unpainful __, typically in number of sites, even in atypical location such as __

A

lymphadenopathy

epitrochlear

35
Q

Asymptomatic FL patient should be __ rather than __

A

monitored

treated

36
Q

Treating FL is done with __ alone or in combination with __. ___ is also useful, and patients will usually live for - years

A

rituximab
chemotherapy
transplantation
15-20

37
Q

MZL is the second most common __ lymphoma. There are 3 types- __, __, __.

A

indolent
splenic
extranodular
nodular

38
Q

__ is a type of MZL, usually in the stomach.

A

MALT

39
Q

Lymphocytic lymphoma usually correlates with __. Most patients are diagnosed when in stage __.

A

IgM

IV

40
Q

Lymphocytic lymphoma with high IgM are referred to as- __, and may suffer from __ symptoms. __ mutation is found in __% of cases. __ is used when hypercoagulability is present

A 
Waldenstorm macroglobulinemia
hypercoagulability
MYD88
90
plasmapheresis
41
Q

Lymphocytic lymphoma is treated with __, and when refractory- consider __ inhibitor, __ and oral __.

A

rituximab
mTOR
Everolimus
BTK

42
Q

MCL (__), is an intermediate lymphoma, between indolent and aggressive. Median survival is - years

A

Mantle cell lymphoma

5-10

43
Q

MCL variant __ is more indolent, while __ is more aggressive

A

SOX11 (splenomegaly)

Blast (high Ki67)

44
Q

Mycosis fungoides is a __ cell lymphoma, known as __, with a median age of __

A

T
cutaneous
50

45
Q

In mycosis fungoides, __ continues to __ and from there to __. When continues to general erythroderma (widespread reddening of the skin) and tumor cells in circulation- __ syndrome

A

patch
plaque
tumors
Sézary

46
Q

PTCL (__) involve the __, __, __, and __. Prognosis of __ years survival

A 
Peripheral T-cell lymphoma
BM
liver
spleen
skin
2
47
Q

PTCL will usually have positive __ and __. Treatment is usually with __

A

CD3
CD4
CHOP

48
Q 
Other T cells NHL include:
AITL (\_\_)
ALCL (\_\_)
ATLL (\_\_)
Extranodal NK/T cell lymphoma- \_\_ type ()
A

angioimmunoblastic T-cell lymphoma- hyperglobulinemia
anaplastic large cell lymphoma- more in children
adult T-cell leukemia/lymphoma- more in japan- HTLV-1
nasal type- associated with EBV

SALMAN HARRISON'S (163 decks)

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