Lymphoma

Question 1

What is lymphoma?

Answer 1

A type of cancer affecting the lymphocytes inside the lymphatic system

Cancerous cells proliferate inside lymph nodes, causing lymphadenopathy.

Question 2

What are the two main categories of lymphoma?

Answer 2

• Hodgkin’s lymphoma
• Non-Hodgkin’s lymphoma

Question 3

What is the most common type of lymphoma?

Answer 3

Hodgkin’s lymphoma

Question 4

What is the bimodal age distribution of Hodgkin’s lymphoma?

Answer 4

Peaks at 20-25 and 80 years

Question 5

List some risk factors for Hodgkin’s lymphoma.

Answer 5

• HIV
• Epstein-Barr virus
• Autoimmune conditions (e.g. RA and sarcoidosis)
• Family history

Question 6

What are the main types of Non-Hodgkin’s lymphoma?

Answer 6

• Diffuse large B cell lymphoma
• Burkitt lymphoma
• MALT lymphoma

Question 7

What characterizes diffuse large B cell lymphoma?

Answer 7

Rapidly growing painless mass in older patients

Question 8

What is Burkitt lymphoma associated with?

Answer 8

HIV and Epstein-Barr virus

Question 9

What does MALT lymphoma affect?

Answer 9

Mucosa-associated lymphoid tissue, usually around the stomach

Question 10

List some risk factors for Non-Hodgkin’s lymphoma.

Answer 10

• HIV
• Epstein-Barr virus
• H. pylori (MALT lymphoma)
• Hepatitis B and C
• Exposure to pesticides
• Exposure to trichloroethylene
• Family history

Question 11

What are the common symptoms of lymphoma?

Answer 11

• Lymphadenopathy
• B symptoms (fever, weight loss, night sweats)
• Other non-specific symptoms (fatigue, itching, cough, SOB, abdominal pain, recurrent infections)

Question 12

Describe lymphadenopathy in lymphoma.

Answer 12

Non-tender, feels firm and rubbery; in Hodgkin’s, may be tender post-alcohol

Question 13

What are B symptoms in lymphoma?

Answer 13

• Fever
• Weight loss
• Night sweats

Question 14

What is the primary investigation for lymphoma?

Answer 14

Lymph node biopsy

Question 15

What cells are identified in Hodgkin’s lymphoma?

Answer 15

Reed-Sternberg cells

Question 16

What imaging techniques are used for staging lymphoma?

Answer 16

• CT
• MRI
• PET

Question 17

What classification is used for Hodgkin’s and Non-Hodgkin’s lymphoma?

Answer 17

Lugano classification

Question 18

What does Stage 1 of the Lugano classification indicate?

Answer 18

Confined to one node or one group of nodes

Question 19

What does Stage 2 of the Lugano classification indicate?

Answer 19

In more than one group of nodes but on the same side of the diaphragm

Question 20

What does Stage 3 of the Lugano classification indicate?

Answer 20

Affects lymph nodes above and below the diaphragm

Question 21

What does Stage 4 of the Lugano classification indicate?

Answer 21

Widespread involvement, including non-lymphatic organs

Question 22

What is the management for Hodgkin’s lymphoma?

Answer 22

• Chemotherapy
• Radiotherapy

Question 23

What are the management options for Non-Hodgkin’s lymphoma?

Answer 23

• Watchful waiting
• Chemotherapy
• Monoclonal antibodies (e.g. rituximab)
• Radiotherapy
• Stem cell transplant

Question 24

What is Burkitt’s lymphoma?

Answer 24

High-grade B-cell malignancy.
Two major forms:
1. endemic (African)
2. sporadic (in HIV)

Question 25

What is the key microscopic finding in Burkitt's lymphoma?

Answer 25

'Starry sky' appearance of lymphocytes

Question 26

What is a big risk of chemotherapy in treating Burkitt's lymphoma?

Answer 26

Tumour lysis syndrome