Pathology EMQ

Your Name: Qihua Liu

Your Identifier: Liuqihua1

Theme: Lymphoma

OPTION LIST

A	ABVD	I	Involved field XRT
B	Burkitt's lymphoma	J	R-CHOP
C	Chlorambucil	K	Stage III A
D	Diffuse large B cell lymphoma	L	Stage III B
E	Follicular NHL	M	Stage IV A
F	gastric MALT lymphoma	N	Stage IV B
G	H. Pylori eradication therapy	O	Stem cell transplant
H	Hodgkin lymphoma nodular sclerosing	P	Watch and wait

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. Which group does it belong to according to the Ann Arbor staging system: the NHL involves lymph node regions on both sides of diaphragm; the localised extranodal site/organ, including spleen, may also be involved; the systemic symptoms are also present i.e. fevers, night sweats, unexplained weight loss of at least 10% body weight in previous 6 months.

2. This type of lymphoma is very aggressive. It primarily affects children living in certain areas of Africa with swelling of lymph nodes around the jaw. It is associated with the EBV virus. Its most frequent cytogenetic change is a translocation between chromosomes 8 and 14, resulting in upregulation of oncogene myc.

3. A 58 years old gentleman presents with 6 month dyspepsia and epigastric pain. The urea breath test is positive. What is the most likely treatment?

4. A 25 years old woman complains a non-painful swelling on her neck. She also has fever, night sweats, weight loss and fatigue. The neck biopsy shows Reed-Sternberg cells. CXR shows mediastinal widening and hilar lymphadenopathy. Abdominal CT scan shows nodules in her spleen. What is the treatment for this patient?

5. Which treatment, in long term use, can cause pulmonary fibrosis and cardiomyopathy?

ANSWERS

1. L

2. B

3. G

4. A

5. A