introduction to lymphoma and myeloma

Question 1

describe lymphoma

Answer 1

cancer of WBC
affects mature blood cells, mainly b lymphocytes and t lymphocytes
heterogenous group
specific to genetic mutations and chromosomal translocation

Question 2

functions of lymphatic system

Answer 2

blood filtration
removal of excess fluids from tissue
absorption and transport of lipids
immune system activation

Question 3

describe primary and secondary lymph organs

Answer 3

primary = sites where stem cells can divide and become immunocompetent

secondary = sites where most of immune response occurs

Question 4

describe non-hodgkin lymphoma

Answer 4

most frequent type of lymphoma

Question 5

hodgkin lymphoma

Answer 5

less than 1% of cancers

Question 6

presentation of lymphoma

Answer 6

fever
swelling of face and neck 
lump in neck, groin and armpits 
excessive sweating at night 
unexpected weight loss 
weakness, breathlessness and itchiness

Question 7

diagnosis of lymphoma

Answer 7

lymph node biopsy
staging done position omission tomography = 4 stages

1. single lymph node region or organ
2. 2/more lymph node
   s3 = 2 more lymph node regions above or below diaphragm
   s4. widespread diseases, multiple organs with/without lymph node involvement

Question 8

aetiology of lymphoma

Answer 8

malfunctioning of bodys immune system
exposure to certain viral infections
triggers unknown

Question 9

describe hodgkin lymphoma

Answer 9

b cell malignancy
presented as non-painful enlarged lymph nodes
50’% cases due to epstein-barr virus
family history and HIV
diagnosed by biopsy of hodgkin cells and reed sternburg cells

Question 10

treatment for hodgkins

Answer 10

chemotherapy or radiotherapy

stem cell transplant

Question 11

describe non hodgkin lymphoma

Answer 11

enlarged lymph nodes and general symptoms
lumps felt under skin
main cause = chromosome translocation
virus infection/human t cell leukaemia virus = risk factors

Question 12

describe chromosome translocations

Answer 12

involved ig heavy chain /light chain in chromosome
ig genes highly expressed in beta cell
each ig gene has powerful tissue specific enhancer
most cases of follicular lymphoma carry t(14;18)(q24;q32)

Question 13

risk factors for non hodgkin lymphoma

Answer 13

virus infections = can transform b-lymphocytes in culture due to viral oncogenes LMP-1
over half of normal cells carry latent EBV infection. dont develop lymphoma due to effective immune surveillance by cytotoxic t cells

Question 14

describe low grade lymphoma

Answer 14

normal tissue architecture partially preserved
divide slowly
may be present months before diagnosis

Question 15

high grade lymphoma

Answer 15

loss of normal tissue architechture
divide rapidly
present for weeks before diagnosis
may be life threatening

Question 16

diagnosis for non-hodgkins

Answer 16

immunophenotyping
cytogenetics = FISH
light chain restriction
PCR

Question 17

treatment for non-hodgkin

Answer 17

chemotherapy
radiotherapy
stem cell transplant
monoclonal AB therapy

Question 18

describe multiple myeloma

Answer 18

tumour of bone marrow that involves plasma cells
absence of initial symptoms. later = bone pain, bleeding, frequent infection and anaemia
risk factor = obesity, radiation, family history, and certain chemicals

Question 19

3 aspects of myeloma give rise to diff clinical features

Answer 19

1. suppression of normal bone marrow, blood cell and immune cell function
2. bone resorption and release of calciums
3. accumulation of paraprotein

Question 20

diagnosis of multiple myeloma

Answer 20

serum electrophoresis for paraprotein
urine electrophoresis
bone marrow biopsy for increased levels of plasma cells
RBC sedimentation rate = high due to stacking of RBC
flow cytometery = cytogenetics to detect cause
radiological investigation of skeleton for lytic lesions

Question 21

treatment for multiple myeloma

Answer 21

radiotherapy
chemotherapy
allogenic haematopoietic stem cell transplantation in young cells