Lymphoma and the Lymphatic System Overview

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Questions and Answers

What term is used to describe lymphadenopathy affecting two or more noncontiguous areas?

Persistent lymphadenopathy

Progressive lymphadenopathy

Generalized lymphadenopathy (correct)

Localized lymphadenopathy

Which of the following is NOT a known mechanism of lymphomagenesis?

Genetic alterations

Nutritional deficiency (correct)

Immunosuppression

Infection

Which type of lymphoma is characterized by the presence of Reed-Sternberg cells?

Hodgkin lymphoma (correct)

T-cell neoplasms

B-cell neoplasms

Non-Hodgkin lymphoma

What is the typical gender distribution in Hodgkin’s disease epidemiology?

More common in men than women Signup and view all the answers

What does a Reed-Sternberg cell represent in the context of Hodgkin's lymphoma?

A mutated lymphocyte Signup and view all the answers

The clinical feature of a lump in Hodgkin's lymphoma is typically described as:

Painless and progressive Signup and view all the answers

Which of the following factors has been implicated as a possible risk factor for Hodgkin’s disease?

HIV infection Signup and view all the answers

What is a characteristic feature of 'A' patients at the time of Hodgkin lymphoma diagnosis?

They are completely asymptomatic Signup and view all the answers

What is a characteristic symptom predicting a more aggressive clinical course in Hodgkin's disease?

Weight loss of more than 10% of body weight over six months Signup and view all the answers

Which chromosomal abnormality is associated with Burkitt's lymphoma?

t(8;14) Signup and view all the answers

Which of the following laboratory findings is most common in patients with Hodgkin's disease?

Normochromic normocytic anemia Signup and view all the answers

What is a common presenting feature of high-grade non-Hodgkin's lymphoma?

Rapidly progressive lymphadenopathy Signup and view all the answers

In which subtype of Hodgkin's disease are Reed-Sternberg cells more numerous?

Mixed Cellularity Signup and view all the answers

Which diagnostic feature is central to the diagnosis of Hodgkin's disease?

Histological examination of an excised lymph node showing Reed-Sternberg cells Signup and view all the answers

Which of the following is a characteristic of low-grade non-Hodgkin's lymphoma?

Relatively indolent but difficult to cure Signup and view all the answers

What type of lymphoma is characterized by the production of monoclonal IgM?

Lymphoplasmacytoid lymphoma Signup and view all the answers

What feature distinguishes nodular sclerosis type Hodgkin's disease?

Replacement of lymph node architecture by collagen bands and nodular areas Signup and view all the answers

Which statement regarding the survival of patients with follicular lymphoma is true?

The median survival from diagnosis is approximately 10 years Signup and view all the answers

What is a common hematological finding in Hodgkin's disease, aside from anemia?

Neutrophilia Signup and view all the answers

Which of the following hematological findings may indicate bone marrow involvement in lymphoma?

Leukoerythroblastic anemia Signup and view all the answers

What is typically seen in the histology of Lymphocyte Depleted Hodgkin's disease?

An abundance of Reed-Sternberg cells Signup and view all the answers

Which inflammatory cells are part of the malignant clone in Hodgkin's disease?

Mononuclear Hodgkin cells Signup and view all the answers

What is a common symptom associated with the presentation of non-Hodgkin lymphomas?

Asymmetric painless lymphadenopathy Signup and view all the answers

Which type of lymphoma is derived from pre-germinal center cells?

Mantle cell lymphoma Signup and view all the answers

Which cell type is primarily responsible for producing antibodies?

B cells Signup and view all the answers

What role do T cells play in relation to B cells?

They help B cells produce antibodies and fight viruses. Signup and view all the answers

In which organ do immature lymphocytes differentiate into T cells?

Thymus Signup and view all the answers

What percentage of white blood cells in the blood are lymphocytes?

20% Signup and view all the answers

Which cells are derived from multipotential lymphocytic cells within the hematopoietic system?

T lymphocytes, B lymphocytes, and Natural Killer cells Signup and view all the answers

What is a common feature of cancer cells regarding growth signals?

They grow in the absence of 'go' signals. Signup and view all the answers

What type of cells are primarily found in lymph nodes?

T and B lymphocytes Signup and view all the answers

Which type of lymphocyte is associated with memory in the immune system?

Mature B cells Signup and view all the answers

What is the primary function of lymph nodes in the lymphatic system?

Filtering foreign particles from lymphatic fluid Signup and view all the answers

Which of the following is true regarding bone marrow's role in hematopoiesis?

It is involved in the differentiation of both myeloid and lymphoid progenitor cells. Signup and view all the answers

What characteristic feature is associated with Reed-Sternberg cells in Nodular Sclerosis type of Hodgkin’s lymphoma?

Broad bands of fibrosis separating tumor nodules Signup and view all the answers

Which type of cells are referred to as 'popcorn' cells in Hodgkin’s lymphoma?

Lymphohistiocytic variants Signup and view all the answers

Which stage of Hodgkin’s lymphoma is characterized by involvement of multiple lymph node regions on the same side of the diaphragm?

Stage II Signup and view all the answers

What is the approximate 5-year survival rate for patients with Hodgkin’s lymphoma?

About 50% to over 90% Signup and view all the answers

Which of the following statements is true regarding Non-Hodgkin Lymphomas (NHL)?

NHL is the most common hematologic malignancy. Signup and view all the answers

What has been noted about the incidence of Non-Hodgkin lymphoma since 1973?

Overall incidence has increased by 73%. Signup and view all the answers

What factors are suggested to potentially influence the rising incidence of Non-Hodgkin lymphoma?

Use of herbicides and insecticides in farming states Signup and view all the answers

What is a distinguishing characteristic of the mixed cellularity type of Hodgkin's lymphoma?

Presence of numerous accessory cells like eosinophils Signup and view all the answers

Study Notes

Lymphoma Overview

Lymphoma is a cancer of the lymphatic system, encompassing lymph nodes and lymphatic tissues.
Lymphomas are categorized into Hodgkin and Non-Hodgkin types.
Hodgkin lymphoma is characterized by the presence of Reed-Sternberg cells.
Non-Hodgkin lymphomas (NHL) comprise a diverse group of cancers, originating primarily from B cells.

Cancer Cell Features

Cancer cells exhibit uncontrolled growth, unaffected by "go" or "stop" signals.
Cancer cells invade locally and metastasize to distant sites.

Lymphatic System

The lymphatic system consists of tonsils, spleen, bone marrow, and a network of lymphatic vessels connecting lymph nodes.
Lymph nodes filter foreign particles from lymphatic fluid.
Lymph nodes contain B and T lymphocytes.

Blood Cell and Lymphocyte Development

Stem cells differentiate into various blood cells, including red blood cells, basophils, neutrophils, monocytes, eosinophils, and platelets.
Stem cells also differentiate into lymphocytes, including T lymphocytes, B lymphocytes, and Natural Killer cells.

Lymphoma Classification (WHO)

Lymphoma classification is based on cell type (B-cell, T-cell, NK-cell) and precursor/mature status.
Hodgkin lymphoma is a distinct category.
Non-Hodgkin lymphoma is a broad classification encompassing multiple subtypes.

Lymphadenopathy

Lymphadenopathy refers to abnormal lymph nodes (size, consistency, or number).
Generalized lymphadenopathy suggests a systemic disease.
Localized lymphadenopathy involves a single area.

Hodgkin's Disease

First described in 1832, Hodgkin's disease (HD) is characterized by the presence of Reed-Sternberg cells.
It was initially classified as infectious but is now recognized as a cancer.
HD is prevalent in men more than women (whites > blacks > Asians).
Risk factors may include EBV, HIV, and certain occupational exposures (woodworking, farming.)
There is a possible model that shows a transforming event (perhaps EBV), loss of apoptosis, a cytokine response, and an inflammatory response.

Clinical Features of Hodgkin's Disease

The most typical presentation is a painless, non-tender, progressive lump in the neck.
Enlarged nodes are usually peripheral (neck, axillae or groin/thigh).
Patients may be asymptomatic (A-type); otherwise, the disease manifests as a debilitating illness termed "B-symptoms", including fever, night sweats and weight loss.

Hodgkin's Disease Hematological and Biochemical Findings

Normochromic normocytic anemia is common.
Neutrophilia and eosinophilia may be frequent.
Bone marrow involvement is rare in early stages; a leukoerythroblastic picture may be observed if it is involved.
ESR and CRP are elevated.
Serum lactate dehydrogenase (LDH) is elevated.

Hodgkin's Disease Diagnosis

Diagnosis relies on histological examination of an excised lymph node.
Presence of multinucleated polyploidy Reed Sternberg cells is essential for diagnosis.
Inflammatory cells (lymphocytes, neutrophils, eosinophils, plasma cells) and fibrosis are often present.

Hodgkin's Disease Classification

Hodgkin's diseases are classified into nodular sclerosis, mixed cellularity, and lymphocyte-depleted types according to specific characteristics in lymph node histology.

Hodgkin's Disease Staging

Staging systems, like the Ann Arbor system, determine the extent of the disease in the body (stage I to stage IV).
A stage is categorized by the number of lymph node areas, diaphragm location and if extralymphatic tissues are involved, such as the bone marrow.
"A" stage lacks B symptoms, while "B" stage includes them.

Hodgkin's Disease Treatment

Treatment typically involves radiotherapy, chemotherapy, or both.
5-year survival rates vary by age, stage, and histology. Generally, rates are high for those with less extensive disease and without significant B symptoms.

Non-Hodgkin Lymphomas (NHL)

NHL is a large group of lymphomas, predominately B-cell origin.
Incidence of NHL is increasing worldwide.
Possible risk factors include immunodeficiency states, autoimmune diseases, infections (EBV) and exposure to environmental agents (possible role of herbicides and insecticides).

NHL Clinical features

Can present with superficial lymphadenopathy (asymmetric painless enlargement of lymph nodes in one or more regions).
May present with constitutional symptoms (fatigue, fever).
Oropharyngeal involvement.
Other presenting features may include specific organ involvements, such as anemia, neutropenia or infections in the abdominal cavity or other organs such as skin, brain, testes or thyroid.
Haematological features include normochromic, normocytic anemia and elevated LDH levels.

NHL Classification

NHL can be categorized as low-grade or high-grade based on features such as the speed of progression (rapid vs slow)
Lymphomas like follicular, Lymphocyte, plasmablastic, Marginal zone, Mantle cell, Peripheral T-cell
are categorized into these subtypes based on their unique biological features and presentation.

NHL Treatment

Treatment strategies for NHL depend on multiple aspects of the patient.
The exact type, grade and location of lymphomas and B symptoms can determine a suitable approach.
A varied approach of treatment, ranging from chemotherapy to radiation therapies may be prescribed.

Questions

Define lymphoma
What are the types of lymphoma
What are the clinical features of lymphoma?
What are the haematological findings of lymphoma?

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Description

This quiz provides an overview of lymphoma, a cancer that affects the lymphatic system. It covers the differences between Hodgkin and Non-Hodgkin lymphomas, key features of cancer cells, and the components of the lymphatic system. Additionally, it touches upon blood cell and lymphocyte development.