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Flashcards in Lymphoma Deck (12):
1

Two types of lymphoma

Non-hodgins
Hodgkins

2

Definition of lymphoma

malignant proliferation of lymphocytes

3

Hodgkins Rfs

Immunodeficiency

4

Presentation of non hodgkins

75% nodal disease (localised or generalised)
25% extra-nodal disease (ropharyngeal, skin, gut, CNS

Systemic - B symptoms
Marrow involvement - pancytopenia

5

Types of non-hodgkins lymphoma

Low grade- Follicular lymphoma
-widely disseminated presentation
-indolent course
- incurable

High grade- Diffuse large B cell
-more loaclised
-rapid growth
->50% curable

6

Investigations of non-hodgkins

Lymph node
-Biopsy + immunohistochemistry for CD20
-Staging
a. Vloods same as hodgkins (LHD)
b. CT scan (abdo =/- pelvis
-Bone marrow
a. aspirate
b. trephine

7

Treatment of non-hodgkins

Treatment depends on disease subtype
Low grade- watch and wait

RCHOP!
Rituximab - mab (CD20 on B-lymphocytes is target)
Cyclophosphamide - chemo
Hydroxdaunorubicin -chemo
Oncovine (vincristine) - chemo
Prednisolone - steroid

8

Hodgkins presentation

2 peaks of incidence (young, elderly)

Lymphadenopathy
accumulate in lymph nodes causing lymphadenopathy
- enlarged
-painless & non tender
-rubbery
- alcohol induced LN pain
- usually contangious

B symptoms
- Night sweats
-Fever >38o
-Weight loss >10%

hepatomeagaly, splenomegaly, pruritis

9

Blood film special feature

Reed-stern berg cells (bi-nuclear)

10

Investigations in hodgkins lymphoma

Tissue diagnosis
Lymph node exicision
Biopsy

CT scan (neck, chest, abdo, pevis)

BM
- aspirate
-trephine

Blood tests
-FBC
-ESR
-U and es
-LFTS
-LDH (raised as increased during cell turnover

11

Staging of hodkins lymphoma

Ann Arbour system
-Single LN region
- 2 or > nodal areas on same side of diaphragm
-nodes on both sides of the diaphragm
-spread beyond lymph nodes

A- no symptomatic symptoms (except pruritis)
B- B symptoms

12

Treatment of hodgkins

Relapse
- peripheral stem cell transplant

Radiotherapy
- dependent on age + stage

ABVD
A- adriamycin
B- bleomycin
V- vincristine
D- Dacarbazine

High cure rates (>80%)