Flashcards in Hodgkin's Lymphoma Deck (73)
What is Hodgkin's lymphoma?
A malignant tumour of the lymphatic system
What is Hodgkin's lymphoma histologically characterised by?
The presence of multi-nucleated giant cells and associated abnormal smaller mononuclear cells
What are the multi-nucleated giant cells seen in Hodgkin's lymphoma known as?
Where do the smaller mononucleated cells in Hodgkin's lymphoma originate from?
B lymphocytes in the germinal centres of lymphoid tissue
What helps to determine the most favourable treatment and prognosis for Hodgkin's lymphoma?
Accurate classification of the type and staging of the disease
How many distinct classifications of Hodgkin's lymphoma are there?
What are the 2 classifications of Hodgkin's lymphoma?
- Classical Hodgkin's lymphoma
- Nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL)
What % of cases of Hodgkin's lymphoma are classical?
What are the subtypes of classical Hodgkin's lymphoma?
- Nodular sclerosis
- Mixed cellularity
- Lymphocyte rich
Are the subtypes of classical Hodgkin's lymphoma important for prognosis and management?
How is NLPHL different from classical Hodgkin's lymphoma?
Histologically distinct with absence of Reed-Sternberg cells
What is the risk of NLPHL?
High risk of transforming to high-grade non-Hodgkin's lymphoma
What is the relevance of the distinction between classical Hodgkin's lymphoma and NLPHL?
What are the risk factors for Hodgkin's lymphoma?
- Previous mononucleosis infection
- Cigarette smoking
What % of patients with Hodgkin's lymphoma have EBV within their Reed-Sternberg cells?
How do most patients present with Hodgkin's lymphoma?
- Enlarged lymph node, typically in the lower neck or supraclavicular region
- Otherwise asymptomatic
What are some other ways Hodgkin's lymphoma presents?
- Mediastinal mass on routine CXR
- Chest discomfort with cough or dyspnoea
What term is given for systemic symptoms caused by Hodgkin's lymphoma?
What % of patients with Hodgkin's lymphoma present with B-symptoms?
What are some B-symptoms of Hodgkin's lymphoma?
- Drenching night sweats
- Unexplained fever >38
- Weight loss >10% over 6 months
What are the examination findings in Hodgkin's lymphoma?
- Superior vena cava syndrome
What are the differentials for Hodgkin's lymphoma?
- Infectious mononucleosis
- Non-Hodgkin's lymphoma
What investigations are useful in Hodgkin's lymphoma?
- Tests for possible differentials
- HIV testing
- Lymph node biopsy
What can an FBC exclude as differentials for Hodgkin's lymphoma?
- Other causes of lymphadenopathy
Why can FBC be useful in suspected Hodgkin's lymphoma?
- Exclusion of differentials
- Indicating prognosis
What are some prognostic indicators for Hodgkin's lymphoma seen on FBC?
Why can ESR be useful in Hodgkin's lymphoma?
What ESR indicates a poor prognosis for Hodgkin's lymphoma?
What can CXR be used for in suspected Hodgkin's lymphoma?
Assessing any intrathoracic lymphadenopathy and mediastinal expansion