Presentations
- Constitutional symptoms
- Incidental findings on imaging or pathology testing
- Lymphadenopathy (swelling of lymph nodes)
- Organomegaly or masses
- Pruritus
- Rash
Conditions
- Acute lymphoblastic leukaemia:
- chronic lymphocytic leukaemia
- Hairy cell leukaemia
- Lymphoma, such as:
- Burkitt lymphoma
- diffuse large B-cell lymphoma
- follicular lymphoma
- Hodgkin lymphoma
- mantle cell lymphoma
- marginal zone lymphoma
- small lymphocytic lymphoma
- Monoclonal B-cell lymphocytosis
- Primary and secondary
(synchronous) central nervous
system lymphoma
- Primary cutaneous lymphomas
- Waldenstrom macroglobulinaemia
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Presentations
- Incidental finding on blood test or imaging
- Lymphadenopathy
- Masses
- Stridor (mediastinal mass)
- Superior vena cava obstruction
Conditions
- Castleman disease
- Other lymphomas, such as:
- anaplastic large
cell lymphoma
- splenic marginal zone lymphoma
- T-cell lymphomas
- Post-transplant
lymphoproliferative disorders
- Sézary syndrome
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Anatomy and physiology of the lymphoid system:
- lymphocyte molecular biology, such as:
- classification, molecular biology, and natural history of acute
lymphoblastic leukaemia
- classification, molecular biology, and natural history of Hodgkin and
non-Hodgkin lymphomas and related disorders
- cluster differentiation (CD) classification
- immunoglobulin assays
- management principles, such as:
- choice of chemoimmunotherapy regimen, immune effector
cell therapy, or specific targeted therapy for initial treatment,
relapse, and salvage therapy
- clinical trials
- disease-specific complications
- palliative care
- place of radiotherapy, and indications for high-dose therapy
- plasma exchange
- watch and wait
- staging and prognostic systems
Investigations and management
- Clinical findings, laboratory, nuclear medicine, and radiological
investigations, such as PET scans, and their impact on management
approaches
- Clinical trials, including recruitment and follow-up
- High-dose therapy, and assessment of patient suitability
- Interpretation of histopathological reports and additional testing, including:
- cytogenetic testing
- flow cytometry
- fluorescence in situ hybridisation (FISH)
- molecular studies
- Risk calculation / prognostic scoring
- Staging classifications
- The advantages and limitations of available diagnostic modalities,
including:
- core biopsy
- excisional biopsy
- fine needle aspirate biopsy
- wedge resection
Procedures
- Bone marrow biopsy
- Insertion of vascular access device (consent by operator only)
- Lumbar puncture
- Consequences of correct and incorrect interpretation of laboratory
reports in lymphoma, both cytogenetic and molecular
- Importance of collaborating with anatomical pathologists, nuclear medicine
physicians, radiation oncologists, and radiologists in the diagnosis and
assessment of patients in local, regional, and national multidisciplinary
meetings
- Long-term complications of the disease and therapy, including implications
for fertility, and second malignancies and their
management
- Optimal sequencing of available therapies to maximise survival
