EXAM #3: LYMPHOMA II Flashcards Preview

Hematology and Oncology > EXAM #3: LYMPHOMA II > Flashcards

Flashcards in EXAM #3: LYMPHOMA II Deck (56):
1

What is the age distribution of HL?

Bimodal distribution:
1) 2nd and 3rd decades
2) Older than 50

2

Describe the presentation of HL.

B Symptoms:
- Fever
- Chills
- Night sweats
- Pruritus
- Weight loss
- Lymphadenopathy, mostly above the diaphragm

3

How is the lymphadenopathy in HL described?

Contiguous and nontender

(vs. sporadic in NHL)

4

How is HL diagnosed?

1) Lymph node biopsy
2) CBC and acute phase reactants
3) PET scan
4) Bone marrow biopsy

5

How is HL staged?

I= 1x nodal region
II= 2x nodal regions on one side of the diaphragm
III= Both sides of the diaphragm
IV= more than one extranodal site

6

What does A mean in HL?

asymptomatic

7

What does B mean in HL?

B symptoms

8

What does X mean in HL?

"Bulky Disease"

9

What cell is there a neoplastic proliferation of in HL?

Reed-Sternberg

(ALWAYS a B-cell cancer)

10

What are the characteristics of RS cells?

1) Mulilobed nuclei
2) Owl eye
3) CD15 and CD30 positive

11

What are the subtypes of HL?

Nodular sclerosis
Lymphocyte rich
Mixed cellularity
Lymphocyte-depleted

12

What is the most common subtype of HL?

Nodular sclerosis

13

What subtype of HL has the best prognosis?

Lymphocyte-rich

14

What is the subtype of HL with the worst prognosis?

Lymphocyte-depleted

15

How is HL treated?

1) Chemotherapy (I-IIA)
2) Radiation (IIB- IV)

16

What is the standard chemotherapy regimen for HL?

ABVD regimen:
- Adriamycin
- Bleomycin
- Vinblastine
- Dacarbazine

17

What is more common, HL or NHL?

NHL

18

What infection is associated with Burkitt's Lymphoma and Nasopharygeal Lymphoma?

EBV

19

What infection is associated with Adult T-cell Lymphoma/Leukemia?

HTLV-1

20

What infection is associated with Gastric MALT Lymhoma?

H. pylori

21

What is the most common etiologic factor in NHL?

Prior chemotherapy and radiation

22

How is NHL diagnosed?

Lymph node biopsy
Bone marrow biopsy

23

How does the presentation of HL and NHL differ?

B-symptoms are only seen in v. aggressive NHL

24

What is the additional procedure that may be required for the diagnosis of NHL?

Lumbar puncture

25

What is the translocation seen in Follicular Lymphoma?

t(14:18), bcl-2

26

What is the translocation seen in SLL?

t(14:19), bcl-3

27

What is the translocation seen in Mantle Cell Lymphoma?

t(11:14), Cyclin D1

28

What is the translocation seen in Burkitt's Lymphoma?

t(8:14), c-myc

29

What is the translocation seen in Diffuse Large B-Cell Lymphoma (DLCL)?

t(3:14), bcl-6

30

What is the most common type of NHL?

Diffuse Large B-Cell Lymphoma

31

What is the hallmark indolent or low grade NHL?

Follicular Lymhoma

32

What is the hallmark aggressive/ intermediate grade NHL?

Diffuse Large B-cell Lymphoma

33

What are the hallmark very aggressive/ high grade NHLs?

- Burkitt's Lymphoma
- Lymphoblastic Lymphoma
- T-cell

34

What is the presentation of DLCL?

- B-symptoms
- Enlarging mass in nodal or extranodal site
- More common in elderly

35

What is the most significant prognostic factor in DLCL?

Poor performance status (2-4)

36

What is the standard of are for DLCL?

Chemotherapy: CHOP + Rituximab
- Cyclophosphamide
- Adriamycin
- Vincristine
- Prednisone

37

What is Rituximab?

Anti-CD20 monoclonal antibody

38

What is the typical presentation of Follicular Lymphoma?

- Enlarging lymph nodes over months to years
- No B-symptoms
- Middle/late adulthood

39

What stage are most Follicular Lymphomas when they present?

Late i.e. III or IV

40

What is the prognosis for Follicular Lymhpoma?

Poor --slow growing makes it v. difficult to treat with chemotherapy and are NOT curable

41

What is the Richter's Transformation?

Transformation of a low grade lymphoma to a higher grade

42

What is the difference between the goals of therapy for stage I and II Follicular Lymphoma vs. stage III and IV?

I and II= cure
III and IV= palliation

43

What patient populations are the very aggressive NHLs seen in?

Pediatric patients and young adults

44

For patients that have a curative NHL and relapse, what is the prognosis? What is the treatment?

- This is a v. BAD prognostically; this will likely kill the person
- Treatment involves v. high dose therapy followed by stem cell transplant to buy time

45

What is MALT lymphoma?

Marginal zone lymphoma in mucosal sites that is associated with H. pylori infection

****Note that it is the chronic inflammatory state i.e. H. pylori infection that "makes" the marginal zone that then undergoes neoplastic proliferation*****

46

What is the treatment for MALToma?

Treatment of H. pylori

47

What are the common HIV associated Lymphomas?

DLCL
Burkitt's
CNS

48

What viruses are associated with HIV-associated Lymphoma?

1) HHV-8
2) EBV

49

What is the most common leukemia?

CLL i.e. Chronic Lymphocytic Leukemia

50

What is CLL?

Neoplastic proliferation of naive B-cells that express CD5 and CD20

51

What is the typical presentation of CLL?

Usually asymptomatic but may have infectious symptoms

52

What are the signs of CLL on exam?

1) Lymphadenopathy
2) Splenomegaly

53

What labs are typical of CLL?

High WBC count with low IgG, IgA, and IgM in later stages

54

What type of cell is associated with CLL on PBS?

Smudge cells

55

Outline the staging of CLL.

0= lymphocytosis
1= lymphadenopathy
2= splenomegaly
3= Anemia
4= Thrombocytopenia

56

What is the prognosis for CLL?

Not curable; treat with chemotherapy when symptomatic