Flashcards in EXAM #3: LYMPHOMA II Deck (56):
What is the age distribution of HL?
1) 2nd and 3rd decades
2) Older than 50
Describe the presentation of HL.
- Night sweats
- Weight loss
- Lymphadenopathy, mostly above the diaphragm
How is the lymphadenopathy in HL described?
Contiguous and nontender
(vs. sporadic in NHL)
How is HL diagnosed?
1) Lymph node biopsy
2) CBC and acute phase reactants
3) PET scan
4) Bone marrow biopsy
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
What does A mean in HL?
What does B mean in HL?
What does X mean in HL?
What cell is there a neoplastic proliferation of in HL?
(ALWAYS a B-cell cancer)
What are the characteristics of RS cells?
1) Mulilobed nuclei
2) Owl eye
3) CD15 and CD30 positive
What are the subtypes of HL?
What is the most common subtype of HL?
What subtype of HL has the best prognosis?
What is the subtype of HL with the worst prognosis?
How is HL treated?
1) Chemotherapy (I-IIA)
2) Radiation (IIB- IV)
What is the standard chemotherapy regimen for HL?
What is more common, HL or NHL?
What infection is associated with Burkitt's Lymphoma and Nasopharygeal Lymphoma?
What infection is associated with Adult T-cell Lymphoma/Leukemia?
What infection is associated with Gastric MALT Lymhoma?
What is the most common etiologic factor in NHL?
Prior chemotherapy and radiation
How is NHL diagnosed?
Lymph node biopsy
Bone marrow biopsy
How does the presentation of HL and NHL differ?
B-symptoms are only seen in v. aggressive NHL
What is the additional procedure that may be required for the diagnosis of NHL?
What is the translocation seen in Follicular Lymphoma?
What is the translocation seen in SLL?
What is the translocation seen in Mantle Cell Lymphoma?
t(11:14), Cyclin D1
What is the translocation seen in Burkitt's Lymphoma?
What is the translocation seen in Diffuse Large B-Cell Lymphoma (DLCL)?
What is the most common type of NHL?
Diffuse Large B-Cell Lymphoma
What is the hallmark indolent or low grade NHL?
What is the hallmark aggressive/ intermediate grade NHL?
Diffuse Large B-cell Lymphoma
What are the hallmark very aggressive/ high grade NHLs?
- Burkitt's Lymphoma
- Lymphoblastic Lymphoma
What is the presentation of DLCL?
- Enlarging mass in nodal or extranodal site
- More common in elderly
What is the most significant prognostic factor in DLCL?
Poor performance status (2-4)
What is the standard of are for DLCL?
Chemotherapy: CHOP + Rituximab
What is Rituximab?
Anti-CD20 monoclonal antibody
What is the typical presentation of Follicular Lymphoma?
- Enlarging lymph nodes over months to years
- No B-symptoms
- Middle/late adulthood
What stage are most Follicular Lymphomas when they present?
Late i.e. III or IV
What is the prognosis for Follicular Lymhpoma?
Poor --slow growing makes it v. difficult to treat with chemotherapy and are NOT curable
What is the Richter's Transformation?
Transformation of a low grade lymphoma to a higher grade
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
What patient populations are the very aggressive NHLs seen in?
Pediatric patients and young adults
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
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*****
What is the treatment for MALToma?
Treatment of H. pylori
What are the common HIV associated Lymphomas?
What viruses are associated with HIV-associated Lymphoma?
What is the most common leukemia?
CLL i.e. Chronic Lymphocytic Leukemia
What is CLL?
Neoplastic proliferation of naive B-cells that express CD5 and CD20
What is the typical presentation of CLL?
Usually asymptomatic but may have infectious symptoms
What are the signs of CLL on exam?
What labs are typical of CLL?
High WBC count with low IgG, IgA, and IgM in later stages
What type of cell is associated with CLL on PBS?
Outline the staging of CLL.