Paediatric Solid Tumors 2 Flashcards
(28 cards)
Lymphomas are (benign or malignant?) proliferation of ____________ cells usually in association with lymphoid tissues (________,_________,___________)
malignant
lymphoid
lymph node, thymus, spleen
There are two main sub types;
__________ and _________-
Hodgkin’s and Non- Hodgkin’s
____________ lymphoma accounts for 50% of all lymphomas
Only 15% occur in children less than _____ years. (Common or Rare?) in under fives
Hodgkin’s
16; rare
Three distinct forms of Hodgkin lymphoma are seen from epidemiologic studies (childhood, young adult form & older adult form)
There is a (male or female?) preponderance in the childhood form
Male
Histological classification of classical
HL???
Nodular sclerosing
Mixed cellularity
Lymphocyte rich
Lymphocyte depleted
CLINICAL FEATURES of HL
Pain_____ indolent lymph node enlargement: Lymph nodes are initially ________ or ________, (tender or non-tender?) and (fixed or mobile?)
Painless
firm or rubbery
non-tender
mobile
Clinical features of HL
______________ is the commonest site. This makes diagnosis difficult. WHY?
_________________ is an uncommon presentation
Thirty percent of the children will present with the B symptoms
________ precedes lymphadenopathy in patients who manifest this
Cervical adenopathy is
Supraclavicular lymphadenopathy
Pruritus
DIFFERENTIAL DIAGNOSES of HL
1
2
3
Infectious mononucleosis
4 infection
Toxoplasmosis
5 infection
6
7
8
Tuberculous adenitis Bacterial adenitis
Viral cervical adenitis Infectious mononucleosis Cytomegalovirus infection Toxoplasmosis
HIV infection
Non Hodgkin’s lymphoma Rhabdomyosarcoma Neuroblastoma
List the B symptoms?
Fever
Night sweats
Weight loss
PROGNOSIS of HL
Overall survival is over _______% with over 75% of children alive after 20 years
Reduction in overall toxicity by reducing the _______________
Two-thirds of relapses occur within two years of treatment
5 Year event free survival for advanced disease ranges from 60 to 90%
90
Duration of chemo
NON-HODGKIN LYMPHOMA
They are a diverse group of cancers accounting for 5 – 10% of malignancies in children younger than 15 years
The incidence _____eases with age.
(Common or Rare?) in children less than 5 years
There is a (male or female?) preponderance
The disease is different between children and adults
incr; Rare
Male
All childhood NHLs are ________________
The risk of NHL is (more or less?) in immunocompromised children
rapidly proliferating
More
PATHOLOGY of NHL
They are histologically classified into four main groups
1) ______________ lymphoma
2) ______________ lymphoma (_______ & _________)
3) ___________ lymphoma
4) _________________ lymphoma
1)Lymphoblastic lymphoma
2) Small noncleaved cell lymphoma (Burkitt & Burkitt like)
3) Large B cell lymphoma
4) Anaplastic large cell lymphoma
Immunophenotyping
1)Lymphoblastic lymphoma
2) Small noncleaved cell lymphoma (Burkitt & Burkitt like)
3) Large B cell lymphoma
4) Anaplastic large cell lymphoma
Immature T cells
B cell
B cell
T cell/ Null cell
Clinical presentation
1)Lymphoblastic lymphoma
2) Small noncleaved cell lymphoma (Burkitt & Burkitt like)
Intrathoracic tumor, mediastinal mass
Intra-abdominal, jaw, endemic BL(70%), sporadic
Clinical presentation
3) Large B cell lymphoma
4) Anaplastic large cell lymphoma
ABDOMINAL TUMOUR
Lymphadenopathy, B symptoms
COMPARISON OF ENDEMIC & SPORADIC BURKITT LYMPHOMA
Incidence
EBV association
Site of presentation
More; less
> 95%; >20%
Jaw, cns, orbit
Abdomen, marrow
DIFFERENTIAL DIAGNOSES of NHL
ABDOMINAL
• _______blastoma
• ________blastoma
• ________oma
• Abdominal __________
•_____________
Nephro
Neuro
Rhabdomyosarc
Tuberculosis
Hodgkin’s lymphoma
DIFFERENTIAL DIAGNOSES of NHL
JAW
•____________
• Ameloblastoma
• __________ ___________
• ______________
• _____________
•Dentigerous cyst
Osteomyelitis
• Hodgkin’s lymphoma
•Rhabdomyosarcoma
• Osteosarcoma
RHABDOMYOSARCOMA
The peak incidence is between 2 to 5 years
Approximately 70% are diagnosed before the age of _________
(Males or Females?) are affected more than (males or females?)
It can occur in any part of the body
10 years
Males; females
Rhabdomyosarcoma
It is classified based on pathologic features into
_________ (60%-80%)
___________(15%-20%)
____________ (8%)
_______________ (1%) & others(11%)
Embryonal
Alveolar
Undifferentiated
pleomorphic
The most common soft tissue sarcoma in childhood is??
RHABDOMYOSARCOMA
RETINOBLASTOMA
It is a ______________ malignancy of the _________ ____________ cells
neuroectodermal
embryonic retinal cells
___________ is the most common intraocular tumour of childhood
Retinoblastoma
