Lymphoma Basics
What are the three “B symptoms” in lymphoma?
Fever, night sweats, and unintentional weight loss.
What is the preferred biopsy method for suspected lymphoma?
Excisional lymph node biopsy.
Hodgkin lymphoma classically demonstrates what age distribution pattern?
Bimodal age distribution
A 68-year-old man presents with rapidly enlarging lymph nodes, elevated LDH, and B symptoms. Biopsy shows large atypical B cells with diffuse architecture and CD20 positivity. What is the most likely diagnosis?
Diffuse large B-cell lymphoma (DLBCL).
What is the key pathologic feature that distinguishes classical Hodgkin lymphoma from non-Hodgkin lymphoma?
Reed-Sternberg cells.
What staging system is most commonly used for lymphoma?
Ann Arbor staging system.
In advanced classical Hodgkin lymphoma, this chemotherapy regimen is commonly used as first-line therapy in North America. And what does each letter represent?
ABVD
A – Adriamycin (doxorubicin)
B – Bleomycin
V – Vinblastine
D – Dacarbazine
Name 2 types of indolent (low-grade) non-Hodgkin lymphoma.
Follicular lymphoma
Marginal zone lymphoma
Extranodal (MALT)
Nodal
Splenic
Small lymphocytic lymphoma
Chronic lymphocytic leukemia
Lymphoplasmacytic lymphoma
Waldenstrom macroglobulinemia
Hairy cell leukemia
Splenic marginal zone lymphoma
Primary cutaneous follicle center lymphoma
Primary cutaneous marginal zone lymphoma
Odd one out! Identify the indolent type:
Diffuse large B-cell lymphoma
Burkitt lymphoma
Peripheral T-cell lymphoma
Follicular lymphoma
Follicular
A 45-year-old presents with enlarged cervical and supraclavicular nodes. PET-CT shows involvement of these two regions only, both above the diaphragm. No B symptoms.
What stage is this?
Stage II
This potentially life-threatening toxicity associated with ABVD is dose-dependent and worsened by high oxygen exposure.
Give me the one agent that causes it; and the specific name of the condition
Bleomycin-induced pulmonary toxicity
(accept: Bleomycin pneumonitis / pulmonary fibrosis)
What is the typical most seen regimen for Diffuse large b cell lymphoma in RGH... and what does each letter stand for?
RCHOP
Rituximab
Cyclophosphamide
Doxorubicin (Hydroxydaunorubicin)
Vincristine (Oncovin)
Prednisone
This tumor suppressor protein, when mutated, is associated with chemotherapy resistance and poorer outcomes across many lymphomas.
p53 (TP53)
Which of the following does not form part of the International Prognostic Index (IPI) in Diffuse large B-cell lymphoma:
Age, LDH, ECOG performance status, or uric acid?
Uric acid
What are the four histologic subtypes of classical Hodgkin lymphoma? and which one is the most common one?
Nodular sclerosis
Mixed cellularity
Lymphocyte-rich
Lymphocyte-depleted
A 58-year-old man presents with generalized lymphadenopathy and lymphocytosis. Excisional lymph node biopsy shows small to medium-sized lymphoid cells with irregular nuclear contours. Immunophenotype is CD5+, CD20+, CD23–. FISH demonstrates t(11;14).
Which non-Hodgkin lymphoma is defined by this translocation?
Mantle cell lymphoma.
In many lymphomas, glucose is preferentially converted to lactate despite adequate oxygen — this phenomenon is known as what?
Warburg effect
This 5-point scale is used to interpret PET response in lymphoma by comparing uptake to mediastinum and liver.
Deauville score
A patient with relapsed Hodgkin lymphoma after autologous transplant is started on a CD30-targeted antibody-drug conjugate. What drug is this?
Brentuximab
A patient with splenomegaly, cytopenias, and “hairy” projections on smear likely has what mutation?
BRAF V600E.