23 - Lymphoma Flashcards
1
Q
Important subtypes
A
- B cell
- Follicular
- Small lymphocytic lymphoma
- Diffuse large B-cell lymphoma (DLBCL)
- Burkitt
- Hodgkin
- Gastric MALT
- Myeloma
2
Q
Laboratory studies (Traige)
A
- Microbiology
- Flow cytometry
- Histology (formalin fixation)
- PCR
- FISH
- Cytogenetics
3
Q
Fresh node triage
A
Cut surface smear and rapid H+E stain
4
Q
follicular lymphoma
A
- Germinal center expansion (CD10+, BCL6+)
- Lambda light chain restricted
- B cell (CD19+, CD20+)
- Follicular histology pattern
5
Q
Small lymphocytic lymphoma/leukaemia
(SLL/CLL)
A
Often leukaemic in addition to nodes
6
Q
Mantle cell lymphoma
A
Defined by overexpression of cyclin D1
7
Q
Germinal center markers
A
- CD10
- BCL6
8
Q
BCL2
A
- Anti-apoptotic marker
- Normal T cells, resting B cells
9
Q
Clonality
A
- Cells that are expressing the same light chains and kappa/lambda
- Expanded from common clone
- Assessed by flow cytometry (shows if kappa or lambda
10
Q
Lymphoma staging
A
- Renal, liver function
- HIV, HCV, HBV (infection due to reduced immunity)
- Bone marrow trephine
- CT scan (lesions)
- PET scan (metabolic activity)
11
Q
Indications for treatment
A
- Progressive disease or bulky disease
- Organ dysfunction
- Systemic B symptoms
- Cytopenias
12
Q
FDC network
A
Dense network of stromal cells that plays a key role in B-cell activation and antibody affinity maturation
13
Q
Follicular lymphoma transformation
A
- Can transform into DLBCL, sometimes to aggressive double hit lymphoma
- BCL2-IgH fusion seen in 90% FL
- Additional MYC- or BCL6- break apart associated with transformation and poor prognosis (is the second hit in ‘double hit’)
14
Q
FL mutations
A
t(14;18)(q32;q21)
15
Q
R-CHOP
A
Rituximab (anti-CD20) to treat FL
