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CSB092 Treatment > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

Incidence

A

Incidence is rising
More in males
15-24yrs old
Age dependent incidence -> varies with type

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2
Q

What is lymphoma

A

Malignancy that arises from LNs
Can occur anywhere lymphoid tissue is present

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3
Q

2 major classifications

A

Hodgkins and non-hodgkins

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4
Q

Most common sites

A

Most common in auxiliary nodes, mediastinal
May also be para-aortic or inguinal
RT chases “lymph chains”’

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5
Q

Hodgkins characterisitcs

A

Reed-stern berg cells
Two age groups: 15-40; 55+
Upper body—> contiguous nodes
Rarely extra nodal
Distinct type
Arise from b cells
Micro enlarged (more than one nucleus)

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6
Q

Non hodgkins characteristics

A

Risk increases with age (60+)
No site predominance
Widely disseminated node groups (non-contiguous)
Common extra nodal involvement (90% stage 3 or 4)
>30 types

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7
Q

Aetiology of hodgkins

A

Familial
Higher socioeconomic
HIV, glandular fever

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8
Q

Aetiology of non Hodgkins

A

Viral infection- HIV
Immunodeficiency
Environment - pesticide exposure

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9
Q

Classification of hodgkins

A

Lymphocyte predominant, modular sceloris, mixed cellularity, lymphocyte depleted

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10
Q

Classification of non-hodgkins

A

B cell and T cell
B cell: low grade- follicular, high grade: burkitts lymphoma

T cell: low grade: my cos is fungicides, high grade: large cell

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11
Q

Signs and symptoms of hodgkins

A

Lymphadenopathy- mediastinal, splenomagely, abdominal mass, alcohol induced pain
Systemic-, pruritus, fatigue, bone pain
B symptoms - fever, weight loss, night sweats

Advanced - liver involvement, bone marrow, bone involvement, lung involvement
Local - chest pain, cough, SVCO, Bronchial obstruction

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12
Q

Signs and symptoms of non-hodgkins

A

Lymphadenopathy in neck, more widespread, compression

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13
Q

Diagnosis of hodgkins and non-hodgkins

A

Biopsy, physical exam, full medical history, CT, FBC, bone marrow biopsy

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14
Q

Staging

A

Using Lugano system
Stage 1 - one node or a group of adjacent nodes
Stage 2 - 2 or ore nodal groups on same side of diaphragm
Stage 2 “bulky” - bulky disease
Stage 3 - nodes on both sides of diaphragm
Stage 4 - additional non-continuous extralymphatic involvement

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15
Q

Early Clinical management of hodgkins

A

Combined modality: rt+- chemo
2 months of chemo
4 weeks of finishing chemo - RT starts

If PET is negative following chemo - no RT

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16
Q

Early Clinical management of non-hodgkins

A

RT is only prescribed if
- Patient did not receive 4 cycles of CHOP
- Patients who received 4 doses of R-CHOP with tumours greater than 5cm
- Patients who received 6 cycles of RCHOP with lucky disease, inadequate chemo response and high risk of relapse

17
Q

Late Clinical management for hodgkins

A

6 cycles of chemo then PET
PET negative = 30Gy in 1.8Gy per #
PET positive = 30Gy in 1.5Gy pe r#

18
Q

Late Clinical management for non-hodgkins

A

Pet negative - 30Gy in 1.8Gy per #
Pet positive after chemo -SIB
30Gy in 1.8-2Gy per #
Residual pet positive site - 34.4Gy 2.3Gy per #

19
Q

Radiation treatment technique hodgkins

A

Involved field - 3dcrt
Mantle or inverted Y
Total nodal radiation
Tomotherapy - total nodal
Static fif IMRT
VMAT - DIBH

20
Q

Radiation treatment technique non-hodgkins

A

Treats mycosis fungoides
TSET 10-20Gy in small fraction sizes
Patients may require report courses of radiation with chronic relapse

21
Q

Positioning for hodgkins

A

H+N: arms by side or on chest, chin extended, s frmae
Thorax: arms above head or by sides, wing board, vacbag
Pelvis: arms on chest, knee support, ankle stocks.

22
Q

Positioning for non-hodgkins

A

Standing, total body electrons

23
Q

Acute side effects of treatment

A

Depends on size and location- reduced blood count, fatigue, vomiting, diarrhoea, slope is, erythema

24
Q

Late side effects

A

Secondary cancer, cardiac sequels, thyroid dysfunction, pneumonitis, gonadal effects, skeletal effects, sterility

25
Q

Why are the axillary LNs most common site of lymphoma

A

Lymph travels one way toward the subclavian veins to be returned to the venous system
Most lymph from upper body drain into the axillary nodes which can sometimes treat and filter harmful entities, causing abnormalities

26
Q

Similarities between hodgkin’s and non0hodgkins

A

Lymphocyte origin
Painless swelling of LNs
Can occur anywhere in the body
General symptoms: weight loss, fevers, night sweats

CSB092 Treatment (8 decks)

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