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Questions about non-Hodgkin lymphoma

Non-Hodgkin lymphoma exam questions and answers for doctors, medical student finals, OSCEs, PACES and CPD. Click on the the questions below to see the answers

Question 1.

What are the common subtypes of non-Hodgkin lymphoma?

  • The common types of non-Hodgkin lymphoma are chronic lymphocytic leukaemia, follicular lymphoma, marginal zone lymphoma, diffuse large B cell lymphoma
  • For table click here

Question 2.

What clinical features discriminate between high-grade and low-grade lymphoma?

  • High-grade lymphoma is fast growing, so the duration of symptoms is usually short and rapidly progressive, with more B symptoms (fevers, sweats, weight loss) and other systemic features (malaise, loss of appetite).
  • Serum LDH is usually raised, often > 1000 U/L, and inflammatory markers such as C-reactive protein may be raised.

Question 3.

How is non-Hodgkin lymphoma staged?

The Ann Arbor classification is used for lymphoma staging, based on distribution of diseased tissue:

  • Stage I involves only one lymph node area
  • II involves 2 or more on one side of the diaphragm
  • III involves 2 or more on both sides of the diaphragm
  • IV involves any extra-lymphatic tissue (including bone marrow)
  • The presence of ‘B symptoms’ is denoted by adding B as a suffix

Question 4.

What are the classic complications of chronic lymphocytic leukaemia?

  • The typical  complications of chronic lymphocytic leukaemia are:
    • Autoimmune haemolytic anaemia
    • Hypogammaglobulinaemia

Question 5.

What are the characteristic chromosomal rearrangements and the activated gene for subtypes of NHL?

  • Follicular t(14:18), BCL-2
  • Mantle t(11:14), CCND1 (Cyclin D1)
  • Burkitt t(8:14), MYC
  • DLBCL various, BCL-6

Related pages: Non-Hogkin Lymphoma and Differential diagnosis of lymphoma

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