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Flashcards in Lymphoma Deck (53):
1

what is lymphoma

clonal neoplastic prolilferation of lymphoid cells- Hodgkin and non hodgkin

2

what is the % B cell and T cell lymphomas in NHL

85% B cell, 15% T cell

3

what is present in histology HL

Reed Sternberg cells

4

which is more common HL or NHL

NHL is 7x more common

5

most freq NHL B cell cancers

diffuse large B cell, follicular lymphoma

6

presentation patient

enlargement lymph nodes, systemic symptoms- weight loss, night sweats, local mass.

7

what are NHL split into

B cell and T cell

8

examples T cell NHL

T cell prolymphocytic leukaemia; mycosis fungoides; sezary syndrome

9

examples low grade B cell NHL

small lymphocytic leukaemia, follicular lymphoma, mantle cell, marginal cell

10

examples high grade B cell NHL

diffuse large B cell, burkitts

11

what are the types of Burkitts

spontaneous, endemic, immunodeficiency associated

12

what can patient with sporadic Burkitts present with

abdominal mass

13

what do patients have with immunodeficiency associated BL

HIV

14

do less or more aggressive tumours respond better to treatment

more aggressive. low grade tend to relapse

15

what is the cell origin of hodgkins

B cell

16

which type of HL has the best prognosis

lymphocyte rich

17

classifications classic hodgkins

nodular sclerosis, lymphocyte rich, mixed cellularity, lymphocyte depleted

18

classification HL

nodular lymphocyte predominant HL, Classic HL

19

what are reed Sternberg cells

multinucleate cells- mirror image nuclei

20

worst prognosis in classical HL

lymphocyte deplete

21

features HL

lymphadenopathy- cervical and painless; nodes fluctuate in size; 25% systemic upset- weight lo;ss, sweats, pruritus, lethargy

22

signs HL

lymph node enlargement. cachexia, anaemia, spleno/hepatomegaly

23

lab features HL

anaemia (normochromic, normocytic) leucocytosis, raised ESR, abnormal LFTs

24

diagnosis

biopsy of lymph node. FBC, film, ESR, LFT, LDH, urate, Ca

25

what indicates a worse prognosis on bloods in HL

incr ESR or decr Hb

26

what system is used for staging in HL

ann arbor staging

27

staging of HL

1- single lymph node area; 2- >2 lymph node areas above diaphragm; 3-above and below diaphragm; 4- involvement of other organs- A- no systemic symptoms, B- presence systemic syptoms

28

what diagnostic tool is used for staging

PET/CT

29

what treatment for early disease HL- stage 1A or 2A

radiotherapy

30

what treatment for advanced disease HL- stage 1B,2B,3,4

chemo- combination- 6 cycles ABVD

31

what does ABVD stand for- chemo

Adriamycin, bleomycin, vinblastine, dacarbzine

32

if pt relapses following radiotherapy alone in HL what is the prognosis following CCT

very good, >80% complete remission

33

if HL patient relapses

poor, consider stem cell transplantation

34

what is the prognosis HL

stage 1-2: >90%; 4: 50-70%

35

poor prognostic factors for HL

increasing age, male, anaemia, leucocytosis, stage 4, B symptoms, bulky tumour, incr sites disease, early relapse, high ESR, lymphopenia

36

what happens in NHL

clonal expansion of an abnormal cell

37

risk factors NHL

EBV- Burkitts; bacterial infection, radiation, drugs, autoimmune disease, immune suppression

38

clinical features NHL

lymphadenopathy- widely disseminated at presentation, splenomeg, extranodal disease, extranodal disease more common than in HL

39

lab features NHL

anaemia, pancytopenia, lymphocytosis, paraprotein, LDH raised

40

diagnosis NHL

tissue biopsy, immunophenotyping to see if B or T cell origin, antigenic markers, CT, MRI, PET, bone marrow aspirate, trephine

41

how is NHL staged

same as for HL

42

management- what can be given to patient with follicular lymphoma

rituximab

43

what can diffuse large B cell be treated with

full course chemo

44

clinical course follicular lymphoma

indolent for many years, transforms to a more aggressive large cell lymphoma in 1/3

45

what does splenic marginal cell lymphoma present with

enlarged spleen, AIHA, paraprotein, monoclonal B lymphocytes

46

where does MALT occur

mucosa associated lymphoid tissue in stomach assoc with H pylori

47

what is the prognosis of mantle cell

poor- only a few years

48

what is the most common NHL T cell

peripheral T cell lymphoma

49

how can aggressive lymphoma be treated

deep x ray therapy (DXT) with adjuvant CCT

50

difference in treatment for B and T cell tumours

rituximab is not used in T cell

51

what can be used for indolent tumours NH if they need treatment

single agent chemo or CCT

52

how is mycosis fungoides treated

skin targeted therapies- PUVA, topical steroids, vit D

53

what does rituximab do

monoclonal antibody for CD20 protein (antigen), which is found on the surface of B cell.