CPHON cancers Questions & Answers

CPHON cancers Questions & Answers Four types of non hodgkins lymphoma Lymphobastic lymphoma Burkitt's lymphoma Diffuse large B cell lymphoma Anaplastic large cell lymphoma Lymphoblastic lymphoma Mostly T cell All ages 70% medistanial mass Burkitt's lymphoma 5-10 y.o B cell Abdomen and pelvis Rapidly enlarging mass Endemic BL in Africa (EBV and jaw) Diffuse large cell lymphoma (DLCL) Mass is favorable 2/3 present with advanced diagnosis (abdomen) Lymph nodes more common than BL Anaplastic Large Cell Lymphoma (ALCL) Older children Kidney shaped T cell antigen Anaplastic lymphoma kinase (ALK) in 90% Non- hodgkins S/S 2/3 present with advanced mets CNS rare Diagnosis Burkitt's lymphoma fastest growing BMA 25% blasts= ALL Non Hodgkins staging I- 1 tumor or node II- 2+ on same side of diaphragm III- 2+ on both sides of diaphragm IV- BM or CNS Non Hodgkins Lymphoma treatment Surgery- biopsy for staging Chemo and CNS prophylactically Rituximab CD20 Recurrent- HSCT (not for anaplastic large cell lymphoma) Hodgkin's lymphoma Lymphatic system Reed sternberg cells (owl eyes) 80% painless adenopathy- firm and rubbery 2/3 with medistanial mass and tracheal/bronchial compression Subtypes of HL Classic HL (reed sternberg cells) Nodular lymphocyte predominant HL Types of classic HL Nodular sclerosis HL Mixed cellularity Lymphocyte rich classic HL Lymphocyte deleted HL Nodular Sclerosis HL Most common CD20+ Lower cervical, supraclavicular, medistanial, lymph nodes Mixed Cellularity HL 10 y.o Lymphocyte rich classic HL Localized RS with small B lymph Lymphocyte depleted HL With HIV Widespread in bone and BM Nodular Lymphocyte Predominant Hodgkin Lymphoma Increased in low socioeconomic B symptoms HL - Unexplained fever 3 days +, weight loss of 10% in 6 months, night sweats Unfavorable HL diagnosis Chest- bulky dx = medistanial mass that takes up 33% of intra thoracic diameter on chest X-ray Unfavorable Recurrent- HSCT auto Auto transplants for what dx? Neuroblastoma Hodgkins and NHL Brain tumors Infratentorial tumors Astrocytomas Brain stem gluons Medulloblastoma Ependyoma Craniopharyngioma Brain stem glioma Surgically inoperable Medulloblastoma Most common malignant CNS tumor Small round blue cell Surgical resection Radiation 3 y.o Auto HSCT 3 y.o Ependymoma Gross total resection is best - subependymomas - classic - anaplastic Craniopharyngioma Arises from Stella Adjacent to pituitary Radioactive implants Cranial nerve deficits Triad S/S- morning HA, lethargy, N/V, headache relieved from vomiting Other: Personality changes, irritability, increased head circumference, budging fontanel, sun setting eyes Brain tumor treatments Surgery is primary tx Goal= mass resection Radiation Affects ability of cells to keep dividing Proton beam therapy- deep tumors Hyperfractionated radiation -1-2x daily Auto HSCT Biologic agents- MoAb