Lymphomas

Question 1

Functions of the Lymphatic System

Answer 1

Maintain fluid levels
Houses immune system
Absorb digestive tract fats
Removing cellular waste
Protect against microbes

Question 2

Lymphatic Vessels

Answer 2

Low pressure, one-way, valved, w/collecting ducts that empty lymph into thoracic duct subclavian vein blood stream

Question 3

Lymphatic Fluid

Answer 3

Contains extracellular fluid, nutrients, damaged cells, foreign invaders, WBCs…

Question 4

Lymph Nodes

Answer 4

> 600
Monitor and Cleanse lymph fluid

Question 5

Lymphatic System: Spleen

Answer 5

-Largest lymphatic organ
-Filters and stores blood and produces WBC
-B- and T-cell

Question 6

Lymphatic System: Thymus

Answer 6

-Matures T-cell

Question 7

Lymphatic System: Tonsils and adenoids

Answer 7

Trap pathogens from food and air

Question 8

Lymphatic System: Bone Marrow

Answer 8

Hematopoiesis: produce WBC, platelets, RBCs

Question 9

Lymphatic System: Peyer’s Patches

Answer 9

-Patches of lymphoid tissue in mucous membranes of small intestine

Question 10

Lymphatic System: Appendix

Answer 10

Protects intestines from bacteria prior to absorption and housing “good bacteria”

Question 11

Lymphedema

Answer 11

-Fluid accumulation from block due to scar tissue or removal via surgery/radiation
-Can be painful or disfiguring and risk infection

Question 12

Lymphadenopathy

Answer 12

-Any abnormal lymph node
-Anything >1cm or palpable
-Persistent x 2 weeks

Question 13

Lymphoma

Answer 13

-Rubbery, conglomerate, non-tender, fixed nodes
-Lymphadenopathy, hepatosplenomegaly
-B symptoms
-Symptoms related to organ involvement
-Most common blood cancer

Question 14

B Symptoms

Answer 14

-Sign of Lymphoma
-Cyclical, nocturnal fevers
-Drenching night sweats
-Weight loss > 10%
-Fatigue

Question 15

Lymphatic System Workup

Answer 15

-CBC (anemia, thrombocytopenia, leukocytosis-smear, flow, cytometry)
-CMP (hypercalcemia)
-LDH increased
-ESR increased
-PET-CT
-Biopsy
-Bone Marrow Biopsy

Question 16

Hodgkin Lymphoma

Answer 16

-Reed Sternberg Cells
-EBV infection-risk factor
-Painless LAD (neck and chest), B-symptoms, Pruritis
Pain with EtOH.
-

Question 17

B cells

Answer 17

mature in marrow, but remain antigen naïve; then diversify further when exposed to antigens in lymph tissue (nodes, spleen, MALT)

Question 18

T cells

Answer 18

move to thymus to mature before moving to lymph tissue to function in inflammatory response, mediate direct cytotoxicity against virus or cancer infected cells, or assist B-cells;

Question 19

Non-Hodgkins Lymphomas (NHL)

Answer 19

-100 subtypes
-B cell & T cell
-Risk Factors-Viral infections, bacterial infections (ex. H. pylori), immunocompromise, exposures (herbicides, pesticides)

Question 20

NHL-T cell Lymphomas

Answer 20

-Generally aggressive, difficult to treat, poor prognosis
-Types (7)

Question 21

NHL B cell Lymphomas

Answer 21

—>90 subtypes
-Aggressive
Acute, treatable (curable?)
Indolent

-Chronic, slow growing, non-curable

Question 22

Burkitt Lymphoma

Answer 22

-Endemic to African children
-Sporadic in western world, especially children and young adults
-Bulky abdominal mass (sporadic), neck mass (endemic)
-B-symptoms
-Bone marrow involvement
-CNS disease

Question 23

Follicular NHL

Answer 23

-2nd most common, 20-30% of all NHLs
-Graded based on centroblasts
-Risk factors-potentially cigarette use, excess EtOH, increased BMI
-Painless, increasing LAD

Question 24

Tumor Lysis Syndrome

Answer 24

-Massive and abrupt release of cellular contents into blood stream after rapid tumor cell lysis (spontaneous or treatment)
-Clinically can cause weakness, arrhythmias, paralysis, ARF, tetany, AMS
-Treat with IVF, electrolyte management, rasburicase, allopurinol, HD