LYMPHOMA

Question 1

what is lymphoma?

Answer 1

Lymphomas are a group of cancers that affect lymphocytes inside lymph nodes

Cancer cells proliferate in the lymph nodes causing them to become abnormally large

Question 2

types of lymphoma and which is more curable

Answer 2

Hodgkins lymphoma= very curable

Non hodgkins lymphoma

Question 3

staging of lymphoma?

Answer 3

Ann arbor staging

Question 4

what is the criteria for stages 1-4 in the Ann Arbor staging of lymphoma?

Answer 4

1- Only one lymph node involved
2- two or more lymph nodes on one side of diaphragm
3- nodes on either side of diaphragm (above and below)
4- spread beyond the lymph nodes

Question 5

what are the A and B symptoms of lymphoma?

Answer 5

A SYMPTOMS
-No systemic symptoms other than pruiritis

B SYMPTOMS
-weight loss (>10% in past 6 months)
-Fever (>38 degrees)
-Night sweats (drenching)

B symptoms= poor prognosis

Question 6

what is seen on bloods lymphoma?

Answer 6

-Lymphocytosis (increase lymphocyte count)

Question 7

what investigation done for lymphoma?

Answer 7

Excision lymph node biopsy= gold standard

Blood film

MUST DO IMMUNOPHENOTYPING- TO DETERMINE LINEAGE
(leucocytosis could be CLL)

Question 8

Treatment of both HL and NHL?

Answer 8

Multi agent chemotherapy +/- radiotherapy

Emergency= steroids
-compression on SVC, spinal cord, renal tract, respiratory tract ect

Question 9

what is the problem with giving steroids ?

Answer 9

Giving steroids can mess with the biopsy and cellular architecture

-but would just do it anyways in emergency

Question 10

Risks factors- Hodgkins lymphoma?

Answer 10

-20s
-EBV
-Immunosuppression e.g. HIV
-Autoimmune disorders
-FH

Question 11

symptoms specific to hodgkins lymphoma?

Answer 11

specific= lymph nodes becoming painful with drinking alocohol

FOR BOTH HL + NHL:
A symptoms= itch with no rash
B symptoms= weight loss, fever, night sweats

Question 12

what is seen on blood film- hodgkins?

Answer 12

Reed Sternberg cells
-look like owl

Question 13

what can bleomycin cause? (used in multiagent chemo +/- radiotherapy for treatment of HL)

Answer 13

penumonitis

Question 14

what can be seen on lymph node biopsy of HL?

Answer 14

nodular sclerosing

Question 15

what can NHL be split into and what type is more agressive?

Answer 15

B cell (90%)

T cell (10%)- more agressive, doesnt respond well to chemo

Question 16

describe prognosis of high grade vs low grade B cell NHL

Answer 16

High grade- more agressive but more curable

Low grade- a lot slower growing (may not even have symptoms) but lose ability to apoptose and very hard to cure and relapses a lot

Question 17

what is a very agressive, fast growing type of B cell NHL? (fastest growing human tumour)

Answer 17

Burkitts lymphoma

Question 18

what causes Burkitt lymphoma?

Answer 18

Chromosomal translocations involving c-myc (t(8:14))

Question 19

Describe a Mantle cell lymphoma

Answer 19

-type of B cell NHL
-looks low grade but is not actually
-very fast growing and doesnt really cure

Question 20

Describe a marginal zone lymphoma

Answer 20

-type of B cell NHL
-very indilent
-can leave it alone a long time and wont really do anything

Question 21

what mutation causes a follicular NHL?

Answer 21

Translocation mutation
t (14:18)