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Z Year3 Haem Conditions > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

What are two types of lymphoma?

A
  • Hodgkin’s

- Non-hodgkin’s

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2
Q

What age is affected by HL?

A

bimodal incidence 20-30 and 50+

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3
Q

What age is affected by NHL?

A

increases with age

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4
Q

What cell is affected in HL?

A

only b cell

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5
Q

What cell is affected in NHL?

A

B or T cell

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6
Q

Does HL spread?

A

single group of nodes affected

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7
Q

Does NHL spread?

A

tends to affect multiple nodes

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8
Q

What are RF for HL?

A
  1. EBV infection
  2. positive FHx
  3. young adults
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9
Q

What is RF for NHL?

A
  1. age >50 years
  2. EBV
  3. HTLV-1
  4. male sex
  5. Hpylori
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10
Q

What are common types of NHL?

A
  1. Diffuse large b cell lymphoma ( most common in adults)

2. Follicular lymphoma (most common indolent lymphoma)

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11
Q

What are types of HL and how are they differentiated?

A
  1. Nodular lymphocyte predominant HL: men CD20 and CD45

2. Classical HL: CD15 and CD30

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12
Q

What cell does HL have that NHL not have?

A
  • Reed stenberg cells (multinucleated)

- Hodgkin cell (large and mononuclear)

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13
Q

What is key feature of HL?

A

pain after alcohol intake

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14
Q

What are general symptoms of lymphoma?

A
  1. Painless lymphadenopathy
  2. Fever, night sweats, weight loss
  3. Puritus
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15
Q

What are HL signs?

A
  1. Lymphadenopathy
  2. Cachexia
  3. Anaemia
  4. Spleno- or hepatomegaly
  5. Painless cervical lymphadneopathy
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16
Q

What are NHL signs?

A
  1. Extra nodal disease: go anywhere (gut (bowel obstruction), BM (fatigue, easy bruising) , spinal cord (loss of sensation)
  2. Pancytopenia from barrow involvement
  3. Lymphadenopathy
  4. Splenomegaly
17
Q

What are HL DDx?

A
  1. NHL
  2. Lymphadenopathy from other malignancies
  3. Infectious mononucleosis
  4. Reactive lymph nodes
18
Q

What are NHL DDx?

A
  1. Hodgkin’s lymphoma
  2. Acute lymphocytic leukaemia
  3. Infectious mononuecleosis
  4. Hep C
  5. TB
19
Q

What investigations do you do for HL?

A
  • Bloods:
    1. FBC with differential
    2. Metabolic profile
    3. ESR
  • Imaging:
    4. CXR
    5. PET-CT scan
    6. Gallium scan
    7. Contrast CT neck, chest and abdo
  • Other:
    8. Excisional lymph node biopsy
    9. Immunohistochemical studies
20
Q

What investigations do you do for NHL?

A
  • Bloods:
    1. FBC with differential
    2. Blood smear
    3. LFTs
    4. LDH
    5. Basic metabolic panel
  • Other:
    1. Lymph node biopsy
    2. Skin biopsy
    3. BM biopsy
21
Q

What would FBC with differential be with HL?

A
  1. low Hb
  2. platelets
  3. WBC high or low
22
Q

Why do you do an immunohistochemical studies?

A

differentiate HL from other types

23
Q

What is FBC with differential in NHL?

A
  1. thrombocytopenia
  2. pancytopenia
  3. lymphocytosis
24
Q

What would blood smear show in NHL?

A
  1. nucleated rbc

2. left shift

25
Q

What will LDH be in NHL?

A

high

26
Q

What is the management plan for HL?

A
  • depends on stage, age and general health
    1. chemotherapy
    2. radiation therapy
  • For nodular lymphocytes predominant: rituximab
27
Q

What is the management plan for NJL?

A
  1. Chemotherapy and radiation therapy
    - depends on subtype, aggression, and spreading
    - If CD20+ can use rituximab
28
Q

What are possible complications of HL?

A
  1. Radiotherapy related thyroid abdnormalties
  2. Chemotherapy+ radiotherapy related cardiac disease, secondary malignancies
  3. Impaired immunity
29
Q

What are possible complications of NHL?

A
  1. Chemotherapy related complications
  2. Radiation related complications
  3. BM transplant related complications
  4. TLS
30
Q

What system is used in HL?

A

Ann arbour system

31
Q

Which lymphoma has best prognosis?

A
  1. classical Hodgkin lymphoma, lymphocyte rich has best prognosis
  2. HL better than NHL
32
Q

What is a subtype of for NHL?

A

Burkitt’s lymphoma

33
Q

What are RF for Brukitt’s lymphoma?

A
  • EBV infection
  • chronic malaria reduced resistance to EBV infection
  • HIV
  • Children in Africa and Brazil
34
Q

What is presentation for Burkitt’s lymphoma?

A

Rapidly enlarging lymph node in jaw

35
Q

What is buzzword for Burkitt’s lymphoma?

A

Starry sky appearance under microscope

36
Q

What is 3 main difference between NHL and HL?

A 
HL: 
1. Reed-sternberg cells
2. Skin exoriations
3. Neutrophilia
NHL:
1. NO reed-sternberg cells
2. Skin rashes e.g. mycosis fungoides 
3. Neutropenia

Z Year3 Haem Conditions (18 decks)

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