Flashcards in Haematology 12 - Lymphoma 2 Deck (27)
How do Reed Sternberg cells appear on the blood film?
Giant cell surrounded by reactive eosinophils
What is the age distribution of Hodgkin's lymphoma?
What are the symptoms of Hodgkin's lymphoma?
Painless lymphadenopathy, that becomes painful on drinking alcohol
Constitutional B symptoms
If advanced lymphadenopathy, may --> obstructive symptoms
What is the cause of constitutional B symptoms in lymphoma?
Which investigation is used to diagnose hodgkin's lymphoma, and which diagnosis is used for staging?
Diagnosis: LN biopsy
Recall the different stages of Hodgkin's lymphoma
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
A: no B symptoms
B: one/ any of fever/ weight loss/ night sweats
Which subtype of lymphoma is most likely to affect young women?
Nodular sclerosing Hodgkin's
What type of chemotherapy is used in Hodgkin's lymphoma?
After how many cycles of chemotherapy for Hodgkin's lymphoma should the FDG-PET be repeated to check response?
What is the risk of giving radiotherapy for Hodgkin's lymphoma?
It produces a lot of collateral damage, and when given alongside chemotherapy increases the risk of secondary malignany significantly
Recall 4 prognostic markers in lymphoma
2. Performance status
3. HIV serology
4. Hep B serology
How aggressive is diffuse large B cell non-Hodgkin's lymphoma?
How aggressive is follicular non-Hodgkin's lymphoma?
How is diffuse large B cell non-Hodgkin's lymphoma treated?
R-CHOP and immunotherapy
What mutation is commonly associated with follicular non-Hodgkin's lymphoma?
Translocation of Bcl2 --> oncogene
Which subtype of non-Hodgkin's lymphoma is associated with chronic H. pylori?
Extra-nodal marginal zone lymphoma
What are the symptoms of extra-nodal marginal zone lymphoma?
Epigastric pain, ulceration and bleeding
How aggressive is enteropathy-associated non-hodgkin's lymphoma?
What is the main association of enteropathy-associated non-hodgkin's lymphoma?
What finding on a blood film is typial of CLL?
Smear/ smudge cells
Recall the surface markers of intermediate B cells vs mature B cells vs CLL mature B cells
Intermediate B cell: CD5 positive
Mature B cell: CD19 positive
Mature CLL B cell: CD5 positive and CD19 positive
What are the 2 staging methods that can be used in CLL?
Is CLL a pre- or post-germinal centre malignancy?
50% pre, 50% post
How can pre- and post-germinal centre CLL be differentiated?
Which mutation is associated with a particularly poor prognosis in CLL?
17p deletion (TP53)
What is Richter's syndrome?
Rare transformation of CLL to high grade lymphoma