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HAEMATOLOGY COPY > LYMPHOMA > Flashcards

LYMPHOMA Flashcards

1
Q

What proportion of lymphoma’s are non-Hodgkins lymphoma?

A

85%

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2
Q

What are the two types of lymphocytes that may form a lymphoma?

A

B and T

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3
Q

What are the markers that you should look for which would indicate a B cell lymphoma?

A

CD-19
CD-20

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4
Q

What are the markers that you should look for which would indicate a T cell lymphoma?

A

CD-4
CD-8

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5
Q

What characterises Hodgkin’s lymphoma histopathalogically?

A

The presence of Reed-Sternberg cells

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6
Q

What percentage of non-Hodgkin’s lymphomas are B cell lymphomas?

A

80%

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7
Q

What is the difference between follicular and diffuse lymphomas?

A

Follicular is more differentiated - less proliferative - and restricted to lymph nodes
Diffuse is more primitive - more proliferative - and more widespread

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8
Q

Are T-cell lymphomas follicular or diffuse?

A

Diffuse. Follicular is only in the lymph node, which is where the B cell reside.

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9
Q

From a biopsy, what factors might help you work out how proliferative the cells of lymphoma are?

A

Cleaved cells are less proliferative
Smaller cells are less proliferative
Mature cells (more like normal cells) are less proliferative
Follicular cells (versus diffuse) are less proliferative

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10
Q

Where is the most common place for MALT lymphomas to develop?

A

Stomach

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11
Q

Other than the stomach, where are the common places for MALT lymphomas to develop?

A

Small bowel
Salivary glands
Thyroid glands
Tear glands
Lungs

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12
Q

What is the infection associated with MALT lymphomas?

A

H. pylori

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13
Q

Are marginal zone B-cell lymphomas positive or negative for CD5?

A

Negative

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14
Q

Are marginal zone B-cell lymphomas positive or negative for CD10?

A

Negative

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15
Q

What is the marginal zone, which is affected by marginal B-cell lymphomas?

A

The marginal zone is the region at the interface between the non-lymphoid red pulp and the lymphoid white-pulp of the spleen or lymph node.

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16
Q

What are the features of mantle cell lymphoma?

A

B cell
Found in the mantle zone which surrounds normal germinal centre follicles

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17
Q

What are the features of Waldenstrom’s macroglobulinaemia?

A

B cell
Excessive amounts of IgM
Causes hyperviscosity

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18
Q

What are the features of mycosis fungoides?

A

T cell lymphoma
Generally affects the skin

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19
Q

What are the main high-grade non-Hodgkin lymphomas?

A

Diffuse large B cell lymphoma
Burkitt’s lymphoma
Peripheral T cell lymphoma
Lymphoblastic lymphoma

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20
Q

What is the most common type of high-grade non-Hodgkin lymphoma?

A

Diffuse large B cell lymphoma

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21
Q

Is diffuse large B cell lymphoma more common in men or women?

A

Men

22
Q

Which group of patients are most likely to develop Burkitt’s lymphoma?

A

Children and young adults

23
Q

What are three main clinical variants of Burkitt’s lymphoma?

A

Endemic
Sporadic
Immunodeficiency-associated lymphoma

24
Q

What infections are associated with endemic Burkitt’s lymphoma?

A

EBV
Malaria is believed to reduced resistance to EBV

25
Q

Which parts of the body are typically involved in endemic Burkitt’s lymphoma?

A

Facial bones especially jaw
Distal ileum
Caecum
Ovaries
Kidney
Breast

26
Q

Which parts of the body are typically involved in sporadic Burkitt’s lymphoma?

A

Ileocecal

27
Q

What is most commonly associated with immunodeficiency lymphoma?

A

HIV

28
Q

What is the gene affected in Burkitt’s lymphoma?

A

c-myc gene

29
Q

What is the main recognised risk factor for Hodgkin’s lymphoma?

A

EBV infection

30
Q

Are T cells or B cells affected in Hodgkin’s lymphoma?

A

Most commonly B cells.

31
Q

What are the B symptoms of lymphoma?

A

Weight loss
Night sweats
Fever

32
Q

Apart from the B symptoms, what are the other classic symptoms of lymphoma?

A

Lymphadenopathy
Loss of apetite
Fatigue
Respiratory distress
Itching
Hepatosplenomegaly
Symptoms of bone marrow failure

33
Q

What is the definitive method of diagnosis for lymphoma?

A

Lymph node biopsy

34
Q

What tests might be carried out on the lymph node biopsy?

A

Immunophenotyping
Flow cytometry
FISH (fluorescence in situ hybridisation)

35
Q

What is the system used for staging lymphomas?

A

Ann-Arbor staging system

36
Q

What does stage I mean in the Ann-Arbor staging system of lymphomas?

A

The cancer is located in a single region, usually one lymph node and the surrounding area. Stage I often will not have outward symptoms.

37
Q

What does stage II mean in the Ann-Arbor staging system of lymphomas?

A

The cancer is located in two separate regions, an affected lymph node or organ and a second affected area, and that both affected areas are confined to one side of the diaphragm - that is, both are above the diaphragm, or both are below the diaphragm.

38
Q

What does stage III mean in the Ann-Arbor staging system of lymphomas?

A

The cancer has spread to both sides of the diaphragm, including one organ or area near the lymph nodes or the spleen.

39
Q

What does stage IV mean in the Ann-Arbor staging system of lymphomas?

A

Diffuse or disseminated involvement of one or more extralymphatic organs, including any involvement of the liver, bone marrow, or nodular involvement of the lungs.

40
Q

What does the A or B mean in the staging of lymphoma?

A

Absence or presence of B symptoms

41
Q

What does the S mean in the staging of lymphoma?

A

Splenic involvement

42
Q

What does the E mean in the staging of lymphoma?

A

Disease is “extranodal” (not in the lymph nodes) or has spread from lymph nodes to adjacent tissue.

43
Q

What stage would you assign to a lymphoma where two affected lymph nodes are found both above the diaphragm in someone experiencing night sweats?

A

Stage IIB

44
Q

What stage would you assign to a lymphoma where two lymph nodes above the diaphragm are found to be affected as well as the spleen in someone experiencing frequent fevers?

A

Stage IIIB S

45
Q

What grade of lymphoma are most successfully treated?

A

High grade

46
Q

What is the initial approach to the treatment of low-grade lymphomas?

A

Wait and watch

47
Q

What is an alternative approach to the wait and watch strategy in someone with follicular lymphoma?

A

Rituximab

48
Q

What is the approach for someone diagnosed with high-grade lymphoma?

A

Aggressive chemotherapy

49
Q

What is the chemotherapy regimen often used in the treatment of high-grade lymphoma?

A

CHOP
Cyclophosphamide
Hydroxydaunorubicin (or Adriamycin)
Oncovin (vincristine)
Prednisolone

Rituximab can be added to make R-CHOP

50
Q

How is early staged Hodgkin’s lymphoma treated?

A

Often with radiotherapy alone as long as it can be localised

51
Q

After relapse of high-grade lymphoma, what is the treatment of choice?

A

High-dose chemotherapy followed by autologous stem cell transplantation

52
Q

What is the peak age for Hodgkin’s lymphoma?

A

15-35

HAEMATOLOGY COPY (12 decks)

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