Lymphoma

Question 1

what are the two types of lymphoma

Answer 1

hodgkins and non-hodgkins

Question 2

pathology of hodgkins lymphoma

Answer 2

malignant proliferation of lymphocytes in germinal centre of lymph nodes

Question 3

presentation of hodgkins lymphoma

Answer 3

lymphadenopathy
weight loss 
puritis 
night sweats 
fever 
SOB
cough 
infections 
abdominal pain

Question 4

characteristics of lymphadenopathy in HL

Answer 4

contiguous spread (progressive spreading e.g. left side of neck to right)
painless
asymmetrical

Question 5

investigations for hodgkins lymphoma

Answer 5

lymph node biopsy - diagnostic - reed-sternberg cells
FBC - normocytic anaemia, raised WCC
LDH - raised
CT

Question 6

risk factors for hodgkins

Answer 6

EBV
HIV
autoimmune conditions
FH

Question 7

management of hodgkins

Answer 7

combination chemotherapy ABVD
radiotherapy
monoclonal antibodies (rituximab)
immunotherapy using checkpoint inhibitors

Question 8

what is non-hodgkins lymphoma

Answer 8

group of lymphomas

develop in nodes but can be extra nodal

Question 9

commonest type of NHL

Answer 9

diffuse large B cell

Question 10

marker for diffuse large B cell NHL

Answer 10

CD20 on cells

Question 11

2nd most common NHL

Answer 11

follicular lymphoma

Question 12

presentation of NHL

Answer 12

painless lymphadenopathy
splenomegaly
B symptoms - fever, weight loss, night sweats

Question 13

manifestations of extra-nodal involvement

Answer 13

bone marrow - anaemia
GI - bowel obstruction
CNS - loss of sensation in legs

Question 14

investigations for NHL

Answer 14

biopsy is diagnostic

CT

Question 15

risk factors for NHL

Answer 15

HIV
EBV
H pylori 
Hep B or C
FH

Question 16

management of NHL

Answer 16

watchful waiting 
chemotherapy 
monoclonal antibodies - rituximab for CD20 
radiotherapy 
stem cell transplant

Question 17

Which cells are present in Hodgkins lymphomas?

Answer 17

Reed-Sternberg cells.