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Surgical Oncology > Lymphoma > Flashcards

Flashcards in Lymphoma Deck (18)
1

4 criteria for primary GI lymphoma

no peripheral or mediastinal LNs
normal WBC/diff
primary tumor in GI tract
No liver/spleen mets

2

most common locations for GI lymphoma

Stomach (75%)
Small bowel 9%
rectal 2%

3

most common location in SB for GI lymphoma

ileum (has more lymphatic tissue)

4

predisposing conditions for GI lymphoma

Autoimmune/Immunodeficiency
Crohn's
Prior radiation

5

Endemic Middle Eastern Condition predisposing to GI lymphoma

immunoproliferative small intestinal disease (IPSID)

6

What is happening to incidence of GI lymphoma in the US?

increasing secondary to autoimmune disease (AIDS) and immunosuppresive drugs.

7

GI Lymphomas arise from:

lymphoid aggregates in the submucosa

8

Presentation of GI lymphoma

Similar to any other SB tumor
-pain
-bleeding
-intussusception
-typically bulky (>5cm) often on sarcoma differential

9

Classification systems for GI lymphoma

REAL/WHO (Revised Euro/American)

10

Most common GI lymphoma subtypes

mucosa associated lymphoid tissue (MALT 40%)
Diffuse Large B cell (40%)

11

Endoscopic staging of MALT lymphoma

Requires systematic blind biopsies

12

Genetic test that predicts sensitivity of MALT lymphoma to H pylori eradication?

(FISH) or polymerase chain reaction (PCR) testing for t(11;18)

13

Lugano staging of GI lymphoma

Stage I - tumor is confined to the gastrointestinal tract.
Stage II - The tumor extends into the abdomen. :
• Stage II1: mesenteric nodes
• Stage II2: distant abdominal nodes
• Stage IIE: locally invasive tumor (thru serosa_
Stage III - There is no stage III disease in this system.
Stage IV - There is disseminated extranodal or supra-diaphragmatic nodal involvement.

14

Genetic test that predicts poor sensitivity of MALT lymphoma to H pylori eradication?

(FISH) or polymerase chain reaction (PCR) testing for t(11;18)

15

First line treatment for MALT lymphoma

H pylori eradication alone, followed by radiologic and endoscopic surveillance.

16

Timing and effectiveness of hpylori eradication for MALT lymphoma

May take over a year
May need to repeat
~70% effective at 5 years

17

Treatment for h pylori negative MALT lymphoma

local radiation with curative intent
rituximab

18

additional organism in small bowel MALT lymphoma (not h pylori)

campylobacter jejuni