Haematology 12 - Lymphoma 2 Flashcards Preview

Year 5 - Pathology > Haematology 12 - Lymphoma 2 > Flashcards

Flashcards in Haematology 12 - Lymphoma 2 Deck (27)
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1
Q

How do Reed Sternberg cells appear on the blood film?

A

Giant cell surrounded by reactive eosinophils

2
Q

What is the age distribution of Hodgkin’s lymphoma?

A

Females 20-29

M=F, elderly

3
Q

What are the symptoms of Hodgkin’s lymphoma?

A

Painless lymphadenopathy, that becomes painful on drinking alcohol
Constitutional B symptoms
If advanced lymphadenopathy, may –> obstructive symptoms

4
Q

What is the cause of constitutional B symptoms in lymphoma?

A

Hyper-catabolic state

5
Q

Which investigation is used to diagnose hodgkin’s lymphoma, and which diagnosis is used for staging?

A

Diagnosis: LN biopsy
Staging: FDG-PET

6
Q

Recall the different stages of Hodgkin’s lymphoma

A

I: one group of nodes
II: >1 group of nodes, on one side of the diaphragm
III: Nodes on both sides of the diaphragm
IV: extranodal spread
Then:
A: no B symptoms
B: one/ any of fever/ weight loss/ night sweats

7
Q

Which subtype of lymphoma is most likely to affect young women?

A

Nodular sclerosing Hodgkin’s

8
Q

What type of chemotherapy is used in Hodgkin’s lymphoma?

A

ABVD

9
Q

After how many cycles of chemotherapy for Hodgkin’s lymphoma should the FDG-PET be repeated to check response?

A

2

10
Q

What is the risk of giving radiotherapy for Hodgkin’s lymphoma?

A

It produces a lot of collateral damage, and when given alongside chemotherapy increases the risk of secondary malignany significantly

11
Q

Recall 4 prognostic markers in lymphoma

A
  1. LDH
  2. Performance status
  3. HIV serology
  4. Hep B serology
12
Q

How aggressive is diffuse large B cell non-Hodgkin’s lymphoma?

A

High grade

13
Q

How aggressive is follicular non-Hodgkin’s lymphoma?

A

Indolent

14
Q

How is diffuse large B cell non-Hodgkin’s lymphoma treated?

A

R-CHOP and immunotherapy

15
Q

What mutation is commonly associated with follicular non-Hodgkin’s lymphoma?

A

t(14;18)

Translocation of Bcl2 –> oncogene

16
Q

Which subtype of non-Hodgkin’s lymphoma is associated with chronic H. pylori?

A

Extra-nodal marginal zone lymphoma

17
Q

What are the symptoms of extra-nodal marginal zone lymphoma?

A

Epigastric pain, ulceration and bleeding

18
Q

How aggressive is enteropathy-associated non-hodgkin’s lymphoma?

A

Very aggressive

19
Q

What is the main association of enteropathy-associated non-hodgkin’s lymphoma?

A

Coeliac

20
Q

What finding on a blood film is typial of CLL?

A

Smear/ smudge cells

21
Q

Recall the surface markers of intermediate B cells vs mature B cells vs CLL mature B cells

A

Intermediate B cell: CD5 positive
Mature B cell: CD19 positive
Mature CLL B cell: CD5 positive and CD19 positive

22
Q

What are the 2 staging methods that can be used in CLL?

A

Rai staging

Binet staging

23
Q

Is CLL a pre- or post-germinal centre malignancy?

A

50% pre, 50% post

24
Q

How can pre- and post-germinal centre CLL be differentiated?

A

VDJ sequencing

25
Q

Which mutation is associated with a particularly poor prognosis in CLL?

A

17p deletion (TP53)

26
Q

What is Richter’s syndrome?

A

Rare transformation of CLL to high grade lymphoma

27
Q

Recall 3 classes of targeted therapy that can be given to treat CLL

A
  1. BCR kinase inhibitors (eg ibrutinib and idelalisib)
  2. BCL2 inhibitors (eg venetoclax)
  3. CAR-T and other experimental cell-based therapies

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