Lymphomas and Multiple Myeloma Flashcards
(49 cards)
____ are dense collections of
immune cells that filter antigens from extracellular fluid passing through
Lymph nodes
_____: disease of a lymph node
Lymphadenopathy
Lymphadenopathy:
disease of a lymph node
○ It reflects disease secondary to an increase in normal lymphocytes and macrophages in response to an antigen
Enlarged Lymph Node causes
● Lymphadenopathy
● Most often due to benign, self-limited conditions, such as viral
infections
● Other causes include accumulation of cells in response to an infection in the node itself (lymphadenitis), metastatic malignancy, or neoplastic
lymphocytes (lymphoma)
Tenderness of lymph nodes suggests _____
acute inflammation, the kind that
comes with localized or acute infections
If your patient reports lymphadenopathy of a few days or even a couple of weeks, it is appropriate to _____
wait for 3-4 weeks to see if it
resolves before arranging further workup
f your patient comes in reporting a swollen lymph node
that is _____, assess for signs concerning for malignancy
non-tender and has been present for a couple of
weeks
Lymph nodes ____ cm or greater are more concerning for malignancy
2
Good initial imaging for lymphadenopathy
Ultrasound
Types of biopsy on lymphadenopathy if malignancy is possible
○ Fine Needle Aspiration Biopsy: Less invasive but has the potential to miss the pathology within the node itself
○ Excisional Biopsy: Most ENT and General Surgeons prefer to remove the entire node to establish a more certain diagnosis
The lymphomas are often referred to as the “wet cancers” because ____
they can infiltrate any tissue
Lymphomas are generally categorized as
● Hodgkin Lymphoma: A specific type of cancer
● Non-Hodgkin Lymphomas: A large group of several types of Lymphoma
Hodgkin Lymphoma age distribution
bimodal age distribution: 20s and 50s
About 85% of children who develop Hodgkin’s are ____
male
Inheritance pattern of hodgkins?
No consistent chromosomal or hereditary pattern of inheritance
has been established
Also called “Hodgkin’s Disease”
Hodgkin Lymphoma Pathophysiology
● A malignant disease of the lymph tissue (lymph cancer)
● Characterized by the presence of
Reed-Sternberg cells
● The disease tends to start in a localized region of lymph nodes and then spreads in an orderly, predictable fashion to adjacent sites
of lymph tissues
S/S of hodgkins lymphoma
● Painless lump in neck area
● Fevers/chills
● Night sweats
● Weight loss
● Anorexia
● General malaise
● Intermittent pruritus
Some people with Hodgkin will experience pain/soreness at lymph node with ____ ingestion
ETOH (alcohol)
Pel-Ebstein pattern is sometimes seen with
Hodgkin lymphoma
Days or weeks of febrile period alternating with days or weeks of afebrile period
Excisional biopsy is
____ over FNA for diagnosis of _____
preferred; hodgkin lymphoma
Laboratory tests in hodgkin lymphoma may show:
○ Normocytic anemia (if bone marrow infiltration)
○ Elevated erythrocyte sedimentation rate (ESR)
○ Mild leukocytosis with decreased lymphocytes
Other imaging for hodgkin lymphoma
● Chest X-ray may show mediastinal lymphadenopathy
● CT chest/abdomen/pelvis required for staging
○ PET scan often used in the initial staging too
Hodgkin lympoma treatment
● General surgeon or ENT surgeon for biopsy
● If diagnosis is established, contact oncology right away to set up
consultation
● Treatment could include chemotherapy, chemo and radiation combo, and possible stem cell transplant
Ann arbor staging
○ Stage I - one nodal area/region
○ Stage II - two areas on one side of diaphragm
○ Stage III - both sides of diaphragm
○ Stage IV - disseminated; disease within bone marrow or liver
○ Addition of A - lacks constitutional symptoms
○ B- 10% weight loss over 6 months, fever, and night sweats
