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MHD VI: Pulm > 11.18: Hemo III > Flashcards

11.18: Hemo III Flashcards

1
Q

Difference between cells involved in acute and chronic hematopoietic neoplasms?

A

Acute: immature, undifferentiated HSCs
Chronic: differentiated, mature HSCs

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2
Q

What is most common lymphoma in adults?

A
  • Diffuse large B cell

- Median ago of 60 years old

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3
Q

Presentation of diffuse large B cell lymphoma?

A
  • Rapidly enlarging symptomatic mass at single or multiple sites
  • High cure and remission rates
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4
Q

2 types of Diffuse large B cell lymphoma?

A

ABC: “Activated B cell”
GCB: “Germinal center B cell”
***IT is important to figure out which type all patients have

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5
Q

Which form of diffuse large B cell has better outcomes?

A

GCB

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6
Q

Is there translocation in diffuse large b cell?

A
  • 30% show same 14/18 swap as seen in follicular
  • We think this is because they had follicular lymphoma in past which has transformed into this
  • **BCL6 or MYC can be mutated as well
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7
Q

Presentation of PTCL?

A

“Peripheral T cell lymphoma”

  • Lymphadenopathy
  • Eosinophilia
  • Pruritis
  • Rash
  • Weight loss
  • **No definitive histologic features
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8
Q

How is PTCL diagnosed?

A
  • Genotypic and immunophenotypic analysis

- Usually CD3+ with loss of other pan T cell markers

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9
Q

Characteristics of hodgkin’s lymphoma?

A
  • Adults and children
  • Usually starts in node and moves to anatomically contiguous lymph tissue
  • Extranodal presentation is rare
  • Characterized reed sternberg cells
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10
Q

What are Reed-Sternberg cells characteristic of?

A

Hodgkin lymphoma

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11
Q

Which are the classical hodgkin’s lymphomas?

A
  1. Lymphocyte rich
  2. Lymphocyte depleted
  3. Nodular sclerosis
  4. Mixed cellularity
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12
Q

What type of cells does hodgkin’s lymphoma impact? What is thought to cause it?

A
  • Neoplasia of B cells
  • Likely product of cytokine secretion from RS cells
  • NF-kB activation by EBV or other mechanisms is common
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13
Q

What is the common event in classic hodgkin lymphoma?

A
  • Activation of NF-kB
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14
Q

Histology of hodgkin lymphoma?

A
  • RS cells “owl eye” 1 - 5% of tumor mass
  • Reactive lymphocytes, histiocytes, and granulocytes
  • Eosinophils
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15
Q

What is the following characteristic of:

  • RS cells “owl eye” 1 - 5% of tumor mass
  • Reactive lymphocytes, histiocytes, and granulocytes
  • Eosinophils
A

Hodgkin’s lymphoma

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16
Q

Which markers to classical hodgkin’s lymphoma express?

A

CD 15 and 30

17
Q

What is CD 20/45 characteristic of?

A

Nodular lymphocyte predominant hodgkin’s lymphoma

18
Q

What is CD 15/30 characteristic of?

A

Classical hodgkin’s lymphoma

19
Q

What is fibrosis of nodes characteristic of?

A

Classical nodular sclerosis hodgkin’s lymphoma

***Majority of hodgkin’s lymphoma

20
Q

What is few RS cells and many small reactive lymphocytes characteristic of?

A
  • Lymphocyte rich hodgkin’s lymphoma
21
Q

What is few lymphocytes and many RS cells indicative of?

A
  • Lymphocyte depleted hodgkin lymphoma
22
Q

Most important plasma cell disorder? Most common?

A

Important: multiple myeloma
Common: MGUS “monoclonal gammopathy of undetermined significance”

23
Q

What is waldenstrom’s macroglobulinemia?

A
  • High levels of IgM leading to increased viscosity of blood
24
Q

What happens in multiple myeloma? What is thought to cause it?

A
  • Monoclonal plasma cell proliferation involving bone marrow and skeleton at multiple sites
  • Dependent on cytokines esp. IL6
  • Abnormalities in FGFR: fibroblast growth factor receptor
25
Q

How is multiple myeloma diagnosed?

A
  • M protein in serum or urine: usually IgG or IgA
  • Bone marrow showing clonal plasmacytosis or presence of plasmacytoma
  • Bone scan should be done to look for lesions
  • Serum electrophoresis looking for Ig
26
Q

Downstream effects of multiple myeloma?

A

“CRAB”

  • hyperCalcemia
  • Renal insufficiency
  • Anemia
  • Bone lesions
27
Q

Clinical features of multiple myeloma?

A

• Bone resorption: hypercalcemia, fractures
• Suppression of humoral immunity leading to recurrent
infections
• “Bence Jones” Proteinuria causing renal insufficiency.
- Light chains are toxic to tubular epithelium

MHD VI: Pulm (20 decks)

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