Podcast
Questions and Answers
Which of the following characteristics is most indicative of Hodgkin's lymphoma compared to Non-Hodgkin's lymphoma?
Which of the following characteristics is most indicative of Hodgkin's lymphoma compared to Non-Hodgkin's lymphoma?
- Presence of Reed-Sternberg cells on lymph node biopsy. (correct)
- Association with significant immunodeficiency.
- Unpredictable pattern of disease spread.
- Widespread involvement of extra-nodal sites from the outset.
A 25-year-old patient presents with painless cervical lymphadenopathy. Considering the peak incidence and common presentation, which lymphoma is initially more concerning?
A 25-year-old patient presents with painless cervical lymphadenopathy. Considering the peak incidence and common presentation, which lymphoma is initially more concerning?
- Burkitt's lymphoma, based on age of the patient.
- Non-Hodgkin's lymphoma, due to its aggressive nature.
- Multiple myeloma, based on the cervical lymphadenopathy.
- Hodgkin's lymphoma, as it has a peak incidence in the third decade. (correct)
What etiological factor has been most strongly suggested in the development of Hodgkin's lymphoma?
What etiological factor has been most strongly suggested in the development of Hodgkin's lymphoma?
- Epstein-Barr virus (EBV) infection. (correct)
- Chronic exposure to carcinogenic chemicals.
- Exposure to ionizing radiation.
- Inherited DNA repair defects.
A patient with Hodgkin's lymphoma reports significant pain in their lymph nodes after consuming alcohol. Which clinical feature does this represent?
A patient with Hodgkin's lymphoma reports significant pain in their lymph nodes after consuming alcohol. Which clinical feature does this represent?
Which clinical finding would classify a patient with Hodgkin's lymphoma as having 'B' symptoms, indicating a poorer prognosis?
Which clinical finding would classify a patient with Hodgkin's lymphoma as having 'B' symptoms, indicating a poorer prognosis?
A patient with Hodgkin's lymphoma has lymph node involvement on both sides of the diaphragm. According to the Ann Arbor staging system, what stage is this?
A patient with Hodgkin's lymphoma has lymph node involvement on both sides of the diaphragm. According to the Ann Arbor staging system, what stage is this?
Which of the following laboratory findings is most consistent with Hodgkin's lymphoma?
Which of the following laboratory findings is most consistent with Hodgkin's lymphoma?
A patient is diagnosed with early-stage Hodgkin's lymphoma (Stage IA). What is the typical treatment approach?
A patient is diagnosed with early-stage Hodgkin's lymphoma (Stage IA). What is the typical treatment approach?
What factor indicates the worst prognosis in Hodgkin's lymphoma?
What factor indicates the worst prognosis in Hodgkin's lymphoma?
What is a key difference in the peak incidence of Non-Hodgkin's lymphoma compared to Hodgkin's lymphoma?
What is a key difference in the peak incidence of Non-Hodgkin's lymphoma compared to Hodgkin's lymphoma?
Which of the following is a known etiological factor for Non-Hodgkin's lymphoma?
Which of the following is a known etiological factor for Non-Hodgkin's lymphoma?
A patient presents with generalized lymphadenopathy and Waldeyer's ring involvement. Which lymphoma is more likely?
A patient presents with generalized lymphadenopathy and Waldeyer's ring involvement. Which lymphoma is more likely?
A patient with low-grade Non-Hodgkin's lymphoma is asymptomatic. What is the most appropriate initial management?
A patient with low-grade Non-Hodgkin's lymphoma is asymptomatic. What is the most appropriate initial management?
From what cell type does multiple myeloma arise?
From what cell type does multiple myeloma arise?
What is the process called where malignant plasma cells expand and secrete immunoglobulin or light chains in multiple myeloma?
What is the process called where malignant plasma cells expand and secrete immunoglobulin or light chains in multiple myeloma?
A patient in their 60s is diagnosed with multiple myeloma. Which condition commonly precedes this diagnosis and is often asymptomatic?
A patient in their 60s is diagnosed with multiple myeloma. Which condition commonly precedes this diagnosis and is often asymptomatic?
What causes bone destruction and osteolytic lesions in multiple myeloma?
What causes bone destruction and osteolytic lesions in multiple myeloma?
What contributes to renal failure in multiple myeloma?
What contributes to renal failure in multiple myeloma?
Which laboratory finding is most indicative of multiple myeloma?
Which laboratory finding is most indicative of multiple myeloma?
When is treatment for multiple myeloma typically initiated?
When is treatment for multiple myeloma typically initiated?
Flashcards
Hodgkin's vs. Non-Hodgkin's
Hodgkin's vs. Non-Hodgkin's
Hodgkin's lymphoma is typically nodal and contiguous, has a good prognosis, and is not usually associated with immunodeficiency. Non-Hodgkin's is often extranodal, non-contiguous, has a variable outcome, and is associated with immunodeficiency.
Hodgkin's Disease Etiology
Hodgkin's Disease Etiology
Unknown, but Epstein-Barr Virus (EBV) is suspected as a contributing factor.
Hodgkin's Symptoms
Hodgkin's Symptoms
Painless, rubbery lymph node enlargement, often cervical and contiguous, sometimes with alcohol-induced pain. Also includes constitutional 'B' symptoms, anorexia, fatigue, pruritus, rash, mediastinal involvement, and hepatosplenomegaly.
Ann Arbor Staging
Ann Arbor Staging
Signup and view all the flashcards
Hodgkin's investigations
Hodgkin's investigations
Signup and view all the flashcards
Hodgkin's Treatment
Hodgkin's Treatment
Signup and view all the flashcards
Non-Hodgkin's Etiology
Non-Hodgkin's Etiology
Signup and view all the flashcards
Non-Hodgkin's Symptoms
Non-Hodgkin's Symptoms
Signup and view all the flashcards
Non-Hodgkin's Management
Non-Hodgkin's Management
Signup and view all the flashcards
Multiple Myeloma Origin
Multiple Myeloma Origin
Signup and view all the flashcards
Multiple Myeloma Symptoms
Multiple Myeloma Symptoms
Signup and view all the flashcards
Myeloma Investigations
Myeloma Investigations
Signup and view all the flashcards
Multiple Myeloma Management
Multiple Myeloma Management
Signup and view all the flashcards
Hodgkin's Peak Incidence
Hodgkin's Peak Incidence
Signup and view all the flashcards
Non-Hodgkin's Peak
Non-Hodgkin's Peak
Signup and view all the flashcards
Study Notes
Hodgkin vs. Non-Hodgkin Lymphoma
- Hodgkin lymphoma typically presents with nodal involvement, whereas Non-Hodgkin lymphoma does not.
- Hodgkin lymphoma spreads contiguously, unlike Non-Hodgkin lymphoma.
- Hodgkin lymphoma generally has a good outcome, while Non-Hodgkin lymphoma has a variable outcome.
- Hodgkin lymphoma is not usually associated with immunodeficiency, in contrast to Non-Hodgkin lymphoma.
Hodgkin Lymphoma
- The peak incidence of Hodgkin lymphoma is in the third decade of life.
- The exact cause of Hodgkin lymphoma is unknown, but Epstein-Barr virus (EBV) infection has been suggested as a contributing factor.
Clinical Features of Hodgkin Lymphoma
- Lymphadenopathy, particularly in the cervical region, with contiguous spread, is a common sign.
- Affected lymph nodes are typically painless, non-tender, and rubbery in consistency.
- Alcohol-induced pain in the lymph nodes may occur.
- Constitutional "B" symptoms include fever, night sweats, and weight loss of more than 10% within 6 months.
- Other symptoms include anorexia, fatigue, pruritus, and erythematous rash.
- Mediastinal involvement can manifest as hilar lymphadenopathy, leading to bronchial compression and superior vena cava (SVC) obstruction.
- Hepatomegaly and splenomegaly may also occur.
Staging of Hodgkin Lymphoma (Ann Arbor System)
- Stage I: Single lymph node region involvement.
- Stage II: Two or more lymph node regions involved on the same side of the diaphragm.
- Stage III: Lymph node regions involved on both sides of the diaphragm.
- Stage IV: Widespread disease outside the lymphatic system, such as lung involvement.
Investigations for Hodgkin Lymphoma
- Full blood count (FBC) may reveal normochromic normocytic anemia.
- Elevated erythrocyte sedimentation rate (ESR) is often observed.
- Liver function tests (LFTs), urea and electrolytes (U&Es), bone profile, and lactate dehydrogenase (LDH) levels are assessed.
- Chest X-ray (CXR) and computed tomography (CT) scans are used for imaging.
- Lymph node biopsy is essential to identify Reed-Sternberg cells, a hallmark of Hodgkin lymphoma.
- Bone marrow examination is rarely necessary.
Treatment and Prognosis of Hodgkin Lymphoma
- Early-stage disease (IA/IIA) is typically treated with chemotherapy and radiotherapy.
- Advanced-stage disease is managed with combination chemotherapy.
- Complete remission is achieved in 60-90% of cases.
- Prognosis is related to the stage of the disease; Stage I has a 90% 5-year survival rate.
- B symptoms (weight loss, night sweats, unexplained fever) indicate a worse prognosis.
Non-Hodgkin Lymphoma
- The peak incidence of Non-Hodgkin lymphoma increases with age and is rare in individuals under 40.
- Etiology includes immunodeficiency, infections, exposure to ionizing radiation and carcinogenic chemicals, and inherited disorders affecting DNA damage and repair.
Clinical Features of Non-Hodgkin Lymphoma
- Generalized lymphadenopathy is a common presentation.
- Oropharyngeal involvement (Waldeyer's ring) may occur.
- Bone marrow infiltration can lead to anemia, recurrent infections, and hemorrhage.
Management of Non-Hodgkin Lymphoma
- Low-grade disease may not require treatment if asymptomatic or may be managed with intermittent oral chemotherapy.
- High-grade disease is treated with combination chemotherapy, resulting in a 30% cure rate.
Multiple Myeloma
- Multiple myeloma arises from the malignant transformation of terminally differentiated B cells (plasma cells).
- Monoclonal expansion leads to the secretion of immunoglobulin (Ig) or light chains (paraproteins).
- Peak incidence occurs between 40 and 80 years of age.
Clinical Features of Multiple Myeloma
- Typically, a long asymptomatic phase known as monoclonal gammopathy of undetermined significance (MGUS) can last for years.
- Bone destruction occurs due to myeloma cells stimulating osteoclasts, leading to osteolytic lesions and raised serum calcium levels.
- Bone marrow failure results from marrow infiltration, causing anemia, thrombocytopenia, neutropenia, and recurrent infections.
- Renal failure develops due to the deposition and accumulation of paraproteins.
- Hyperviscosity syndrome can cause headache and dizziness.
- Amyloidosis involves the development of abnormal protein deposits in various body parts.
Investigations for Multiple Myeloma
- FBC detects bone marrow failure.
- Elevated ESR and calcium levels are common.
- U&Es demonstrate renal damage.
- Protein electrophoresis reveals monoclonal paraprotein.
- Bence-Jones proteins may be present in the urine.
Management of Multiple Myeloma
- Treatment is initiated only if there is evidence of organ damage.
- Chemotherapy is used for bone marrow failure or bone lesions.
- Most patients respond to treatment, but relapse is common.
- Radiotherapy is useful for managing bone pain.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
