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Flashcards in Lymphoma Deck (16):
1

Hodgkins Lymphoma

Hodgkin's lymphoma is a malignant proliferation of lymphocytes characterised by the presence of the Reed-Sternberg cell. It has a bimodal age distributions being most common in the third and seventh decades

Features
lymphadenopathy (75%) - painless, non-tender, asymmetrical
systemic (25%): weight loss, pruritus, night sweats, fever (Pel-Ebstein)
alcohol pain in HL
normocytic anaemia, eosinophilia
LDH raised

2

Hodgkins hostopath

Nodular sclerosing
Most common (around 70%) Good prognosis
More common in women.
Associated with lacunar cells

Mixed cellularity
Around 20%
Good prognosis
Associated with a large number of Reed-Sternberg cells

Lymphocyte predominant Around 5% Best prognosis

Lymphocyte depleted Rare Worst prognosis

3

Burkitt's Lymphoma

Burkitt's lymphoma is a high-grade B-cell neoplasm. There are two major forms:
endemic (African) form: typically involves maxilla or mandible
sporadic form: abdominal (e.g. ileo-caecal) tumours are the most common form. More common in patients with HIV

Burkitt's lymphoma is associated with the c-myc gene translocation, usually t(8:14). The Epstein-Barr virus (EBV) is strongly implicated in the development of the African form of Burkitt's lymphoma and to a lesser extent the sporadic form.

Microscopy findings
'starry sky' appearance: lymphocyte sheets interspersed with macrophages containing dead apoptotic tumour cells

4

Gastric MALT Lymphoma

Overview
associated with H. pylori infection in 95% of cases
good prognosis
if low grade then 80% respond to H. pylori eradication

Features
paraproteinaemia may be present

5

Management Hodgekins Lymphoma

ABVD
Adriamycin
Bleomycin
Vinblastine
Dacarbazine

6

Anaplastic Large Cell Lymphoma

T-cell lymphoma
Children and young adults
Large epithelialoid lymphocytes
t(2;5)
Alk-1 protein expression

7

Peripheral T-cell Lymphoma

T-cell lymphoma
Middle aged and elderly
Agressive
Large T-cells

8

Adult T-cell Laekaemia/ Lymphoma

Carribean/ Japanese
Aggressive
HTLV-1
Lymphadenopathy, hepatosplenomegaly
Skin lesions, Raised Ca

9

Enteropathy associated T cell lymphoma

Long standing Coeliac

10

Mycosis Fungoides

Cutaneous T cell lymphoma

11

Diffuse large B-cell Lymphoma

B-cell lymphoma
Middle aged and elderly
Aggressive
Richter's transformation
Sheets of large lymphoid cells
R-CHOP

12

Mantle Cell Lymphoma

B-cell lymphoma
Middle aged, M>F
Aggressive
Disseminated at presentation
Median survival 3-5 y
Cyclin D1 dysregulation
t11;14 translocation

13

Follicular Lymphoma

B-cell lymphomaB-cell lymphoma
Translocation 14;18
centrocytes, centroblasts
Indolent

14

R-CHOP

o Cyclophosphamide 750 mg/m2 i.v. D1
o Adriamycin 50 mg/m2 i.v. D1
o Vincristine 1.4 mg/m2 i.v. D1
o Prednisolone 40 mg/m2 p.o. D1 D5

15

NHL: Histology and prognosis

• High grade

o Very aggressive
Burkitt Lymphoma
T or B cell Lymphoblastic leukaemia/lymphoma
o Aggressive
Diffuse Large B cell
Mantle cell

• Low grade (indolent)
o Follicular
o Small lymphocytic/CLL
o Mucosa associated (MALT)

16

Waldenstrom's Macroglobinaemia

Low grade NHL
Lymphoplasmacytoid cells produce monoclonal serum IgM that infiltrates LN/BM
Weight loss, fatigue, hyperviscocity
Plasmapharesis, chlorambucil
Cyclophosphamide