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Flashcards in Leukemia and lymphoma Deck (44)
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31

Characteristic cell of hodgkins lymphoma

Reed-Sternberg

32

Epidemiology of HL and risk associations

1. Young and elderly
2. More common in males
3. Risk + if affected sibling, EBV, SLE, post transfusion, Westernisation and obesity

33

Symptoms of HL

1. Enlarged, non tender, rubbery superficial LN->cervical, axillary, inguinal
2. Weight loss, night sweats, pruritus
3. Mass effect from mediastinal mass->SVC obstruction/bronchial
4. Alcohol induced LN pain

34

Signs of HL

1. Weight loss, cachexia
2. Hepato-splenoM

35

Investigations in HL

1. FBC->anemia and low PLT
2. UEC, LFTs, LDH, Urate (cell turnover)->baseline prior to therapy commencement
3. ESR ++
4. CXR->mediastinal mass
5. PET-CT, LP
6. Contrast CT N, chest, abdomen/pelvis (for staging)
7. Excisional LN biopsy
8. Immunohistochemistry

36

Staging in HL

1. Confined single LN region
2. 2+ nodal areas on same side of diaphragm
3. Nodes on both sides of the diaphragm
4. Spread beyond the LN->liver or bone marrow

37

Management

1. Chemotherapy ABVD
Adriamycin
Bleomycin
Vinblastine
Dacarbazine
2. Radiotherapy

38

General risks in radiotherapy

1. Increased risk of secondary malignancies->solid
2. IHD
3. Hypothyroidism
4. Lung fibrosis

39

Classification of HL

1. Nodular sclerosing
2. Mixed cellularity
3. Lymphocyte rich
4. Lymphocyte depleted

40

Causes of NHL

1. Congenital immunodeficiency
2. Acquired immunodeficiency
3. HIV infection
4. Infection->HTCLV-1, EBV, H pylori
5. Environmental toxins

41

Is NHL just LN

No, can occur at other lymphoid tissue->MALT

42

Signs and symptoms of NHL

1. Nodal disease
2. Superficial lymphadenopath
3. Extranodal: oropharynx, skin, bone, gut, CNS, lung
4. Fever, night sweats, weight loss
5. Pancytopenia: anemia, infection, bleeding

43

Investigations in NHL

1. FBC->anemia and low PLT
2. UEC, LFTs, LDH, Urate (cell turnover)->baseline prior to therapy commencement
3. ESR ++
4. CXR, LP
5. PET-CT
6. Contrast CT N, chest, abdomen/pelvis (for staging)
7. Excisional LN biopsy
8. Immunohistochemistry

44

Chemotherapy regime in high grade NHL

RCHOP
Rituximab
Cyclophosphamide
Hydroxydaunorubicin
Vincristin (Oncovin)
Prednisolone