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Flashcards in Hodgkin's Lymphoma Deck (73)
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1

What is Hodgkin's lymphoma?

A malignant tumour of the lymphatic system

2

What is Hodgkin's lymphoma histologically characterised by?

The presence of multi-nucleated giant cells and associated abnormal smaller mononuclear cells

3

What are the multi-nucleated giant cells seen in Hodgkin's lymphoma known as?

Reed-Sternberg cells

4

Where do the smaller mononucleated cells in Hodgkin's lymphoma originate from?

B lymphocytes in the germinal centres of lymphoid tissue

5

What helps to determine the most favourable treatment and prognosis for Hodgkin's lymphoma?

Accurate classification of the type and staging of the disease

6

How many distinct classifications of Hodgkin's lymphoma are there?

2

7

What are the 2 classifications of Hodgkin's lymphoma?

- Classical Hodgkin's lymphoma
- Nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL)

8

What % of cases of Hodgkin's lymphoma are classical?

95%

9

What are the subtypes of classical Hodgkin's lymphoma?

- Nodular sclerosis
- Mixed cellularity
- Lymphocyte rich
- Lymphocyte-depleted

10

Are the subtypes of classical Hodgkin's lymphoma important for prognosis and management?

No

11

How is NLPHL different from classical Hodgkin's lymphoma?

Histologically distinct with absence of Reed-Sternberg cells

12

What is the risk of NLPHL?

High risk of transforming to high-grade non-Hodgkin's lymphoma

13

What is the relevance of the distinction between classical Hodgkin's lymphoma and NLPHL?

Managed differently

14

What are the risk factors for Hodgkin's lymphoma?

- EBV
- Previous mononucleosis infection
- Immunosuppression
- Cigarette smoking

15

What % of patients with Hodgkin's lymphoma have EBV within their Reed-Sternberg cells?

50%

16

How do most patients present with Hodgkin's lymphoma?

- Enlarged lymph node, typically in the lower neck or supraclavicular region
- Otherwise asymptomatic

17

What are some other ways Hodgkin's lymphoma presents?

- Mediastinal mass on routine CXR
- Chest discomfort with cough or dyspnoea

18

What term is given for systemic symptoms caused by Hodgkin's lymphoma?

B-symptoms

19

What % of patients with Hodgkin's lymphoma present with B-symptoms?

25%

20

What are some B-symptoms of Hodgkin's lymphoma?

- Drenching night sweats
- Unexplained fever >38
- Weight loss >10% over 6 months

21

What are the examination findings in Hodgkin's lymphoma?

- Lymphadenopathy
- Hepatomegaly
- Splenomegaly
- Superior vena cava syndrome

22

What are the differentials for Hodgkin's lymphoma?

- Infectious mononucleosis
- AIDS
- Non-Hodgkin's lymphoma
- TB
- Leukaemia
- Sarcoidosis
- Myeloma

23

What investigations are useful in Hodgkin's lymphoma?

- FBC
- ESR
- Tests for possible differentials
- HIV testing
- Lymph node biopsy
- CXR

24

What can an FBC exclude as differentials for Hodgkin's lymphoma?

- Leukaemia
- Mononucleosis
- Other causes of lymphadenopathy

25

Why can FBC be useful in suspected Hodgkin's lymphoma?

- Exclusion of differentials
- Indicating prognosis

26

What are some prognostic indicators for Hodgkin's lymphoma seen on FBC?

- Anaemia
- Leukocytosis
- Lymphopenia

27

Why can ESR be useful in Hodgkin's lymphoma?

Determining prognosis

28

What ESR indicates a poor prognosis for Hodgkin's lymphoma?

ESR >70

29

What can CXR be used for in suspected Hodgkin's lymphoma?

Assessing any intrathoracic lymphadenopathy and mediastinal expansion

30

How is Hodgkin's lymphoma pathologically diagnosed?

Lymph node biopsy