Lymphoma Flashcards
What is the definition of lymphoma?
Malignant proliferations of lymphocytes
Hodgkin’s and non Hodgkin’s lymphoma
Hodgkin’s classification: Nodular sclerosis, mixed cellularity, lymphocyte rich, lymphocyte depleted
Non-Hodgkin’s lymphoma: Diffuse large B cell lymphomas, Mucosa associated lymphoid tissue (MALT) lymphoma, T cell lymphomas
How common is lymphoma?
2 peaks in young adults and elderly
Non Hodgkin’s 5 times more common that Hodgkin’s
What is the pathophysiology of lymphoma?
- Malignant proliferations of lymphocytes
- Accumulate in lymph nodes = lymphadenopathy
- May be found in peripheral blood or infiltrate organs
- Hodgkin’s: cells with mirror image nuclei called Reed-Sternberg cells are seen
- Non Hodgkin’s lymphoma: all lymphomas without Reed Sternberg cells. Mostly derived from B-cell lines
- Staged via the Ann Arbor system
What are the risk factors/aetiology of lymphoma?
- Affected sibling
- Epstein Barr virus
- SLE
- Post transplantation
- Obese
- Immunodeficiency (HIV)
- H.pylori
- Toxins
- Smoking
- Congenital
What are the signs/symptoms of lymphoma?
- Enlarged, painless, non tender, rubbery, superficial lymph node
- Typically, cervical, axillary or inguinal
- Fever
- Weight loss
- Night sweats
- Prutitus (itching)
- Lethargy
- Alcohol induce lymph node pain
- Mass effect (if medianstinal lymph nodes are involved) – bronchial/SVC obstruction
- Splenomegaly
- Hepatomegaly
What investigations are carried out when lymphoma is suspected?
- Lymph node excision biopsy
- FBC – if ↓ indicates worse prognosis
- Flood film
- ESR – if ↑ indicates worse prognosis
- LFT
- LDH
- Urate
- Calcium
- CXR
- CT/PET of thorax, abdo and pelvis
What is the surgical treatment for lymphoma?
• Peripheral stem cell transplant
What is the pharmacological treatment for lymphoma?
- Chemotherapy – ABVD (Adriamycin, Bleomycin, Vinblastine, Dacarbazine)
- Radiotherapy
