malignancy Flashcards
MOST Common paediatric malignancy
how do we dx between AML and ALL in staining
ALL
AML - sudan black + and mPO+, pas + diffusion
ALL: none , pas + granules
Most common age for all
2-6
Treatment for ALL
chemotherapy and intrathecal chemotherapy as normal drugs don’t cross the cns + CS
FOLLOW THE INDUCTION
CONSOLIDATION
MAINTENCE
Most common symptoms and other symptoms for ALL
BONE PAIN especially at night LETHARGY LYMPHADENOPATHY PALLOR EASY BRUSING FEVER recurrent infections - neutropenia
hepatospelenomegaly
diagnosis of ALL
def: BM biopsy (>20% blast cells)and sent off for cytology
FLOW CYMETRY :CD19 B CD 7 T CELLS
CBC: can have pancytopenia but usually its 2 cell lines down like platelets + abc and in rare cases just 1 cell line
blood smear - blast cells
tumour lysis syndrome - high k+ etc
Chest x ray - mediastinal mass
LP - check cNS involvement
abdominal us - check for Organ infiltration
what’s the level of leukocytes in ALL
can be all 3 , but usually increased !
poor prognosis associated with ALL
Philladeplphia chromosome 9, 22
<1and >10
males
Cns involvement
which type of lymphoma Is more common in childhood
NHL
Reed stenberg
seen in Hodgkin ‘owl eye’
which type of lymphoma is more common in general
NHL
Staging system for LYMPHOMAS
x ray for osteosacroma and defintive diagnosos
Ann harbour
new bony growths and periosteal reaction BONE BIPSY
- rf for Hodgkin lymphoma
- child with racoon eyes DX
EBV + HIV
neuroblastoma, child abuse and skull base fracture
Which maliganies can present with mediastinal masses
leukemia and lymphomas but more common in lymphomas which are the most common cause of an anterior mediastinal mass in children and second in adults
what kind of transplant in leukemias and lymphomas and tx for osteosarcoma
leukemias-allogenic
all 3inc limb salvage surgery
lymphomas- autologous
types of Hodgkin in detal
NS- fibrotic + cellular types and lacunar cells are charcteristic
mixed cellularity
lymphocyte rich
lymphocyte depleted
who has 2 classifications the CLASSIC(above)
NLP- nodular lymphocytic predominant subtype
treatment for Hodgkin
what bones ar einvlved in osteosacroma
Ln in hodgkin
ABVD OR BEAUCOPP +/- RT
long bones esp the metaphysis
most common is cervical, supraclavicular and sometimes mediasinal
Which lymphoma has more extra nodal sites and where can it spread too
labs for hodgkin
NHL
waldeyers ring, gut (maltoma) , skin sezary syndrome
eosiniohilia
monocytosis
lymphopenia
neutrophila
Burkits lymphoma
sighns of ewings
NHL - B cell lymphoma
night time pain
feeling a soft tissue mass
decreased ROM
PAIN
Burkits lymphoma
types of staging hodgkin
NHL - B cell lymphoma
3 types
- endemic variant - commonly involves jaw and face
- sporadic variant
- immunodeficinecy- hIV
clinical staging and pathological staging and patholoigcal reuqires. laportomy and splenectomy
nephroblastoma age
definfitve diagnosis for neuroblastoma
peak age 3-4 years old
bone marrow bipsy
most common place of metastasis of wiilms tumour
lungs
signs of films
hypertension abdominal mass - distention hematuria UTI fever
common site of metatsitis for neuroblastoma
WHICH IS MORE COMMONE OS OR EWINGS
boes affected
bones
osteosarcoma
OS: bones that form the knee and upper limb (proximal humerus)
EW: pelvis, ribs and tends to be more the diaphysis of bones but can be metaphysis
origin of neuroblastoma
prognostic factors
adrenal glands, ut can start from other areas of body like sympathetic ganglia near the spine or abdomen
AGE IS VERY IMPORTANT, the younger the child the better <18 months old
