23. Tumour Markers in Lymph Nodes, Spleen, Thymus, Bone Marrow

Question 1

How does immunohistochemistry help with diagnosis?

Answer 1

Evaluate architecture
Differentiate between B and T cell diseases
Classify Hodgkin’s lymphoma
Differentiate between benign and malignant
Detect monoclonality

Question 2

Is flow cytometry or immunohistochemistry faster?

Answer 2

Flow cytometry

Question 3

Is flow cytometry or immunohistory easier to read?

Answer 3

Flow cytometry

Question 4

How many markers can be used on flow cytometry at once?

Answer 4

8-10

Question 5

What are the advantages of immunohistochemistry?

Answer 5

Can see architecture

Can be sent to reference labs as sample doesn’t need to be alive

Question 6

What translocation is associated with follicular lymphoma?

Answer 6

t(14;18)

Bcl-2

Question 7

What translocation is associated with mantle cell lymphoma?

Answer 7

Cyclin D1

t(11;14)

Question 8

What oncogene is associated with large B cell lymphoma?

Answer 8

ALK

Question 9

What oncogene is associated with Burkitt’s lymphoma?

Answer 9

MYC

Question 10

What is the white pulp of the spleen made up of?

Answer 10

Lymphoid follicles (where B and T cells are produced)

Question 11

What is the red pulp of the spleen made up of?

Answer 11

Venous sinusoids

Cords

Question 12

What cases cause atrophy of the spleen?

Answer 12

Age
Sickle cell anaemia
Coeliac disease

Question 13

What are the functions of the spleen?

Answer 13

Haematopoiesis
Cell holding and destruction
Iron metabolism
Antibody formation

Question 14

What are the causes of splenomegaly?

Answer 14

Congestive (too much blood)
Infections
Blood and bone marrow disease
Lymphoma and leukaemia
Collagen vascular disease
Storage disorders
Amyloidosis

Question 15

What are causes of congestion of the spleen?

Answer 15

Liver cirrhosis

Portal vein thrombus

Question 16

What storage disorders can cause splenomegaly?

Answer 16

Hyperlipidaemia
Gauccher’s disease
Lipid storage disorders

Question 17

What are the results of hypersplenism?

Answer 17

Anaemia
Thrombocytopaenia
Leucopaenia

Question 18

What are monoclonal antibodies?

Answer 18

Lab-made molecules which are designed to bind to antigens presented by a certain type of cell

Question 19

What is the difference between hypersplenism and splenomegaly?

Answer 19

Hypersplenism is the overactive function of a spleen of any size

Question 20

What are the causes of thymic enlargement?

Answer 20

Myasthenia gravis
Thyomas
Lymphomas
Germ cell tumours
Carcinoid tumours (neuroendocrine)

Question 21

What are myeloproliferative cell neoplasms?

Answer 21

Clonal neoplastic proliferation of stem cells

Question 22

Classify myeloproliferative cell neoplasms

Answer 22

Chronic myeloid leukaemia
Myelofibrosis
Polycythaemia rubra vera
Essential thrombocythaemia

Question 23

What receptor is over expressed in myelofibrosis, PRV and essential thrombocythaemia?

Answer 23

JAK2

Question 24

How do myeloproliferative neoplasms present?

Answer 24

Anaemia
Infection
Bleeding or thrombosis
Hyperviscosity syndrome
Hyperuricaemia
Spleen infarction

Question 25

What is secondary myelofibrosis caused by?

Answer 25

Metastasis, radio and chemotherapy

Question 26

What investigations should be done for myeloproliferative disorders?

Answer 26

FBC
LAP
Bcr-abl and JAK2 genes
Uric acid
bone marrow trephine

Question 27

What happens in myelofibrosis?

Answer 27

Enlarged spleen and liver

Loss of marrow cells

Question 28

How is myelofibrosis treated?

Answer 28

Marrow stimulation

Splenectomy

Question 29

What are the causes of secondary polycythaemia?

Answer 29

High altitudes
Congenital heart defects
Tumours that produce erythropoietin

Question 30

What are the symptoms of polycythaemia?

Answer 30

Red face
Thrombosis
Haemorrhage
Increased Hb
Splenomegaly