Lymphoma Flashcards
(18 cards)
What is lymphoma?
A type of cancer affecting the lymphocytes inside the lymphatic system. Cancerous cells proliferate inside the lymph nodes, causing the lymph nodes to become abnormally large = lymphadenopathy.
What are the 2 main categories of lymphoma?
Hodgkin’s lymphoma (a specific disease) and Non-Hodgkin’s lymphoma (includes all other types).
What age group does Hodgkin’s lymphoma affect?
Bimodal age distribution - peaks around 20-25 and 80 years.
What are the risk factors for Hodgkin’s lymphoma?
HIV, EBV, autoimmune conditions (e.g., RA and sarcoidosis), family history.
What are some signs of poor prognosis in Hodgkin’s lymphoma?
B symptoms, increasing age (diagnosis above 45), male sex, stage IV disease, lymphocyte depleted subtype (most aggressive and rarest form of Hodgkin’s lymphoma).
What are the different types of Non-Hodgkin’s lymphoma?
Diffuse large B cell lymphoma (typically presents as a rapidly growing painless mass in older patients), Burkitt lymphoma (particularly associated with EBV and HIV), MALT lymphoma (affects the mucosa-associated lymphoid tissue usually around the stomach).
What are the risk factors for Non-Hodgkin’s lymphoma?
HIV, EBV, helicobacter pylori infection (associated with MALT lymphoma), hep B or C infection, exposure to pesticides, exposure to trichloroethylene, family history.
How does lymphoma present?
Lymphadenopathy: enlarged lymph node(s) might be in the neck, axilla or inguinal region. They’re non-tender, feel firm or rubbery.
When may patients with Hodgkin’s lymphoma experience pain?
After drinking alcohol.
What are B symptoms?
Systemic symptoms of lymphoma: These imply a poor prognosis - fever > 38, weight loss > 10% in last 6 months, night sweats.
What are some additional non-specific symptoms of lymphoma?
Fatigue, itching, cough, shortness of breath, abdominal pain, recurrent infections.
What investigations are carried out for lymphoma?
Excisional lymph node biopsy. Reed-Sternberg cells are the characteristic finding from a biopsy of Hodgkin’s lymphoma; they are large cancerous B lymphocytes with 2 nuclei and prominent nucleoli.
What classification system is used for lymphoma?
Lugano system is used for Hodgkin’s and Non-Hodgkin’s lymphoma; it emphasizes whether the affected nodes are above or below the diaphragm.
What are the different stages of the Lugano system?
Stage 1: confined to one node or group of nodes. Stage 2: in more than one group of nodes, but on the same side of the diaphragm. Stage 3: affects lymph nodes both above and below the diaphragm. Stage 4: widespread involvement, including non-lymphatic organs such as the lungs or liver.
What treatment is used for Hodgkin’s lymphoma?
Chemotherapy and radiotherapy.
What can chemotherapy result in?
Infections, cognitive impairment, secondary cancers (e.g., leukemia), and infertility.
What does radiotherapy create a risk of?
Tissue fibrosis, secondary cancers, infertility.
What is the management of Non-Hodgkin’s lymphoma?
Depends on the type and stage: watchful waiting, chemotherapy, MCA’s (e.g., rituximab, which targets B cells), radiotherapy, stem cell transplantation, R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone).
