Term
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Definition
- cohesive malignant proliferation of abnormal lymphocytes arising in LN and/or lymphoid tissue of other organs (extranodal)
- normal LN architecture is effaced and/or infiltrated by this malignant proliferation of lymphoid cells
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Term
| clinical presentation of lymphoma (note differences btw HL and NHL) |
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Definition
- painless nodal enlargement
- constitutional symptoms
- fever
- malaise
- night sweats
- weight loss
- pruritis
- extranodal involvement more common in NHL than HD
- in NHL, tx determined by histology and stage
- in HD, tx determined by stage
- HD usually involves contaguous lymph nodes (aka its local)
- bone marrow involvement is rare at presentation in HD
- bone marrow involvement common in NHL
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Term
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Definition
- I- single LN region or singly extralymphatic organ or site
- II- involvement of two or more LN regions on same side of diaphrame
- III- LN involvement above or below diaphrame
- IV- organ involvement
- A- none of below
- B
- unexplained wieight loss of more than 10% body weight in six months before dx
- night sweats
- unexplained fever with temperature above 38 degrees
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Term
| epidemiology of Hodgkin's lymphoma |
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Definition
- risk factors
- viral infections
- associated with EBV
- genomic detection of EBV DNA in over 50% of nodular sclerosis and mixed cellularity subtypes
- wood workers
- hereditary predisposition (common HLA types)
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Term
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Definition
- classical Hodgkin lymphoma
- nodular sclerosis (I or II)
- lymphocyte rich
- mixed cellularity
- lymphocyte depleted
- nodular lymphocyte predominant Hodgkin's lymphoma
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Term
| clinical presentation of HL |
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Definition
- painless enlargement of peripheral LN (cervical or supraclavicular areas)
- diffurse pruritis
- backpain if retroperitoneal LN enlargement
- dyspnea if mediastinal LN enlargement
- rare- pain with alcohol ingestion
- rare at presenation- hepatosplenomegaly
- B symptoms
- unexplained weight loss
- night sweats
- unexplained fever
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|
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Term
|
Definition
- excisional biopsy needed
- staging
- CBC, ESR, LFTG, albumin, BUN/creatinine
- CT chest/abdomen/pelvis
- PET scan
- bone marrow aspiration/biopsy
- PFT, ECHO/MUGA
- fertility counseling as appropriate
- HIV if risk factors present
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Term
| criteria for histoplathological dx of HL |
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Definition
- Reed-Sternberg cell
- appropriate "background" cellular architecture
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Term
| Histopathologically, what separates HD from NHL |
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Definition
- R-S and mononoclear neoplastic cells constitute a small fraction of tumor
- the rest of the tumor consist of normal reactive lymphocytes, inflammatory cells, and/or fibrosis
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Term
| Markers expressed by R-S cells |
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Definition
- lymphocyte activation Ag
- CD30 (Ki-1)
- CD25 (IL-2 R)
- CD71 (transferrin R)
- granulocyte marker
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Term
| unfavorable factors in prognosis of HL |
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Definition
- bulky disease
- mass greater than 1/3 chest diameter
- any mass greater than 10 cm
- ESR greater than 50
- more than 3 sites of disease
- B symptoms
- greater than or equal to 2 extranodal sites
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Term
|
Definition
- male gender
- Hb less than 10.5
- albumin less than 4.0
- age greater than 45
- stage IV disease
- WBC greater than 15000
- lymphocyte count less than 600
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Term
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Definition
- radiotherapy in standard tx w/ 90% overall survival
- alternative approach- less intense chemo with radiotherapy without laparotomy
- pts with bulky disease (mediastinum) or with B symptoms are candidates for combined chemotherapy and radiotherapy
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Term
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Definition
- chemotherapy is primary tx
- 60% of pts can be cured
- mostly use ABVD
- adriamycin
- bleomycin
- vinblastine
- dacarbazine (DTIC)
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Term
| complications of HL therapy |
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Definition
- immunologic deficits/infections (HZV mainly, with some getting post splenectory pneumococcal sepsis)
- thyroid dysfunction (hypothyroidism)
- cardiac/pulmonary dysfunction
- gonadal dysfunction
- secondary malignancies
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Term
| fields of administered tx for HL |
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Definition
- mantle field (in thorax, head, neck)
- inverted Y (abdomen, perineum)
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Term
| salvage therapy for HL (purpose, regime) |
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Definition
- for relapses (most relapses happen within 5 yrs)
- complete response rates to second line chemo are high in pts who receive no prior chemo or whose relapses occured more than one yr after initial therapy
- pts who relapse within yr from inital chemo who never achieved complete response are candidates for high dose therapy and hematopoietic stem cell transplants
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Term
| tx of lymphocyte predominant HL |
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Definition
- early stage favorable- involved field radiation and chemo
- advanced- chemo w/ ABVD
- consider rituximab since many pts CD20 positive
- some centers use CHOP or EPOCH as LPHL (behave like indolent NHL in some cases)
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Term
| Describe lung injury seen in tx of HL |
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Definition
- radiation pneumonitis- elevated combined modality and larger fields
- decreased PFT after therapy but most patients imp;rove
- combination bleomycin and lung radiation pneumonitis can be severe
- G CSF may make it worse
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Term
| Describe cardiac disease seen in tx of HL (who has highest risk) |
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Definition
- mediastinal radiation of major risk factor
- relative risk of cardiac death 3.1
- highest risk in pts tx before age 20
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Term
| potential bone complications in those tx for HL |
|
Definition
- osteonecrosis
- decrease bone density in both men and women
- aplasia after radiotherapy
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Term
| Ascending Relative risk of malignancy complications of therapy from HL |
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Definition
- gastric cancer
- cardiac disease
- lung cancer
- breast cancer
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Term
| dx test used to best monitor pts |
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Definition
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