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3.5a WBC Pathology I Flashcards

0
Q

Lymphoid tissue consists of? (3)

A
  1. Thymus
  2. Spleen
  3. LNs
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1
Q

What are the (2) divisions of the Hematopoietic System?

A
  1. Myeloid Tissue

2. Lymphoid Tissue

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2
Q

Myeloid tissue includes? (2)

A

BM and the cells derived from it (red cells, platelets, granulocytes, monocytes)

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3
Q

Myelogenous series (6)

A
  1. Myeloblast
  2. Promyelocyte
  3. Myelocyte
  4. Metamyelocyte
  5. Intermediate cell
  6. Mature cell
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4
Q

How is Promyelocyte differentiated from Myeloblast?

A

Presence of primary granules in promyelocyte

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5
Q

Of the myelogenous series:

  1. Youngest
  2. Scanty cytoplasm
  3. Nucleolus
A

Myeloblast

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6
Q

Of the myelogenous series:

  1. First in series
  2. Specific granules: basophil, eosinophil, neutrophil
  3. Nucleus occupies 60% of total cell size
A

Myelocyte

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7
Q

Of the myelogenous series:

  1. Sunset-like
  2. Indented nucleus
A

Metamyelocyte

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8
Q
  1. It is a stab/band cell

2. First to appear in PBS (counterpart of reticulocyte)

A

Intermediate cell

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9
Q

Of the myelogenous series: has filaments separating nuclei?

A

Mature cell

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10
Q

Refers to the decrease of WBC usually resulting from reduced numbers of NEUTROPHILS

A

Leukopenia

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11
Q

How is leukopenia similar to anemia?

A

Same cause: ineffective granulopoiesis (abnormal BM cannot produce WBC)

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12
Q

It refers to a clinically significant reduction in neutrophils

A

Agranulocytosis

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13
Q

What causes ineffective/inadequate granulocytosis? (4)

A
  1. Suppression of hematopietic stem cells
  2. Suppression of committed granulocyte precursors
  3. Ineffective maturion
  4. Congenital conditions
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14
Q

The ff describes which Ineffective/inadequate granulocytosis?

  1. Aplastic anemia (decrease in RBC, WBC, platelets)
  2. Granulocytopenia (accompanied by anemia, thrombocytopenia)
A

Suppression of hematopoietic stem cells

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15
Q

What types of drugs suppress committed granulocytic precursors? (4)

A
  1. Alkylating agents
  2. Antimetabolites
  3. Chloramphenicol
  4. Sulfonamides
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16
Q

What causes infective maturation?

A

Vitamin B12 deficiency –> decreased WBC

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17
Q

What diseases exemplify infective maturation wherein defective precursors die in the marrow? (2)

Hint: Vit. B12 deficiency

A
  1. Megaloblastic anemia

2. Myelodysplastic syndrome

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18
Q

An example of an inherited defect in specific genes that impair granulocytic deifferentiation

A

Kostmann Syndrome - severe chronic neutropenia (manifests as infection with bacteria)

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19
Q

Pathogenesis of Leukopenia (2)

A
  1. Suppression of hematopoietic stem cells

2. Increased destruction/accelerated removal of neutrophils

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20
Q

What causes increased destruction/accelerated removal of neutrophils? (3)

A
  1. Ig-mediated injury
    - Autoantibodies against WBC
    - Exposure to drugs
  2. Increased peripheral utiliation
    - Massive infection (anergy)
  3. Splenic sequestration (splenomegaly)
    - Excessive destruction secondary to enlargement of the spleen
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21
Q

What are the (2) main sources of WBC?

A
  1. Bone Marrow

2. Lymph Nodes

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22
Q

What are the (2) proliferative states?

A
  1. Reactive: benign proliferation
    - BM: Leukocytosis
    - LN: Lymphadenitis
  2. Neoplastic: malignant
    - BM: Leukemia
    - LN: Lymphoma
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23
Q

(2) Reactive proliferation of WBC in BM

A
  1. Leukocytosis

2. Leukemoid Reaction

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24
Q

What happens in REACTIVE proliferation of WBC in BM?

A

Blood proliferates as a result of infection –> spills into peripheral blood

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25
Q

Which reactive process is being described?

  1. (+) increase in number of white cells in blood
  2. A common reaction to a variety of INFLAMMATORY states
  3. It’s focused on the infecting organism
  4. It could be any of the ff:
    - neutrophilia
    - lymphocytosis
    - eosinophilia
    - monocytosis
A

Leukocytosis

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26
Q

Which leukocytosis is

  1. seen in bacterial infections (pyogenic bacteria)
  2. tissue necrosis –> sterile inflammation
A

Neutrophilia

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27
Q
  1. Which leukocytosis is seen in chronic, viral, immunologic infections?
  2. Bordatella pertusis infection
A

Lymphocytosis

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28
Q

Which leukocytosis is seen in asthma, allergy, parasitic infections?

A

Eosinophilia

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29
Q

Which leukocytosis is seen in chronic infection, collagen disorder (SLE)?

A

Monocytosis

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30
Q

Which reactive process is being described?

  1. (+) high levels of WBC –> stimulation of myelogenous leukemia (reactive only, not leukemic)
  2. Benign proliferation of WBC in reaction to an overwhelming infection but DOES NOT constitute leukemia
  3. You do NOT see BLASTS in PBS
A

Leukemoid reaction

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31
Q

What PBS changes are seen in reactive proliferation? (2)

A
  1. Aggravation in the primary granules found in neutrophils

2. Reactive/Atypical lymphocytes

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32
Q

What morphologic changes can be seen in neutrophils during reactive proliferation in the BM? (4)

A
  1. Toxic granules
    - elaboration/enlargement of ribosomes or endoplastic reticulum
    - coarser and darker than the normal neutrophilic granules
    - represent abnormal primary/azurophilic granules
  2. Dohle bodies
    - patches of dilated ER
  3. Cytoplasmic vacuoles
  4. Shift to the left
    - younger forms of WBC (stabs, myelocytes) are seen (NEVER BLASTS! they indicate neoplastic proliferation)
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33
Q

Which PBS change in reactive proliferation is being described?

  1. Large lymphocytes without granules (normal N:C ratio)
  2. (-) Dohle bodies and toxic granules
  3. Abundant and amoeboid cytoplasm –> RBCs tend to press on its borders (reaction to a virus)
A

Atypical lymhpocyte

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34
Q

What feature do atypical lymphocytes possess that distinguishes them from blasts?

A

N:C ratio. Blasts have scanty cytoplasm

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35
Q

Reactive proliferation of WBC in LNs (2)

A
  1. Acute lymphadenitis

2. Chronic lymphadenitis

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36
Q

Which process of reactive proliferation in LNs is being described?

  1. A reactive change secondary to MICROBIOLOGIC AGENTS and their toxins
  2. Drain foreign bodies, cell debris, bacterial products
  3. Affects cervical regions (d/t microbial drainage of teeth, tonsils), and axillary and inguinal regions (d/t infection of extremities)
  4. Nodes involved are PAINFUL and ENLARGED
A

Acute lymphadenitis

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37
Q

Which process of reactive proliferation in LNs is being described?

  1. LNs: NOT usually painful, NON-TENDER (nodal enlargement occurs over time)
  2. Related to VIRAL conditions
  3. Has three patterns
A

Chronic lymphadenitis

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38
Q

What are the (3) patterns of chronic lymphadenitits?

A
  1. Follicular hyperplasia
  2. Parafollicular/Paracortical Hyperplasia
  3. Sinus Histiocytosis
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39
Q

Which pattern of chronic lymphadenitis is being described?

  1. Refers to B-cell stimulation (humoral immune response)
  2. Defined by the presence of large oblong GERMINAL CENTERS (secondary follicles), surrounded by a collar of small resting naive B cells (mantle zone)
A

Follicular hyperplasia

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40
Q

What are the (2) regions of germinal centers?

A
  1. Centroblasts: dark zone

2. Centrocytes: light zone

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41
Q

The ff are examples of which patterns of chronic lymphadenitis?

  1. Toxoplasmosis
  2. HIV
  3. RA
A

Follicular hyperplasia

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42
Q

The ff are examples of which patterns of chronic lymphadenitis?

  1. Drugs
  2. IM
  3. Vaccines
A

Parafollicular hyperplasia

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43
Q

Which pattern of chronic lymphadenitis is being described?

1. Refers to T-cell stimulation

A

Parafollicular hyperplasia

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44
Q

In parafollicular hyperplasia, T-cells contain activated t-cells which are 3-4 times the size of resting lymphocytes that have round nuclei, open chromatin, several prominent nucleoli, and moderate amounts of pale cytoplasm. What do you call these cells?

A

Immunoblasts

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45
Q

Which pattern of chornic lymphadenitis is being described?

  1. Increase in the number and size of cells that line lymphatic sinusoids
  2. Lining lymphatic endothelial cells are hypertrophied
  3. Macrophages are increased in number

–>expansion and distention of sinuses

A

Sinus histiocytosis

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46
Q

What cells stimulate histiocytes and macrophages?

A

TH1 cells

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47
Q

Macrophages eat upB-cells that fail to produce Ab. These are seen in germinal centers as?

A

Tingle bodies - they kill bacteria

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48
Q

What are the broad categories of neoplastic proliferative states acc to cell origin? (4)

A
  1. Lymphoid neoplasm
  2. Plasma cell dyscrasias
  3. Myeloid neoplasms
  4. Histiocytoses
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49
Q
  1. All that come from myeloid stem cells

2. Only in BM

A

Myelogenous leukemia

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50
Q

Tumors of B-cell, T-cell, NK cell origin

A

Lymphoid neoplasm

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51
Q

Sources lymphoid neoplasm (2).

A
  1. BM: leukemia

2. LN: lymphoma

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52
Q

Which category of neoplastic proliferative states is being described?

  1. Predominantly in BM
  2. Leukemic type of manifestations ONLY
  3. Arise from hematopoietic progenitors
A

Myeloid neoplasm

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53
Q

(3) categories of Myeloid neoplasms

A
  1. Acute Myelogenous Leukemia (AML)
  2. Myelodysplastic Syndrome
  3. Chronic Myeloproliferative Disorder
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54
Q

Which category of myeloid neoplasm is being described?

1. immature proliferative cells accumulate in the BM

A

AML

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55
Q

Which category of myeloid neoplasm is being described?

1. Associated with infective hematopoiesis –> peripheral blood cytopenias

A

Myelodysplastic syndrome

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56
Q

Which category of myeloid neoplasm is being described?

1. Increased production of one or more terminally differentiated myeloid elements –> elevated peripheral blood count

A

Chronic myeloproliferative disorder

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57
Q

Which neoplastic proliferative state is being described?

1. Uncommon proliferative lesion of macrophages and dendritic cells

A

Histiocytoses

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58
Q

A special type of immature dendritic cell that gives rise to a spectrum of neoplastic disorders referred to as the Langerhans cell histiocytoses

A

Langerhans cell

59
Q

What are the general classifications of lymphoid neoplasms? (2)

A
  1. Lymphoma (arises from nodal tissue)

2. Lymphocytic Leukemia (arises from BM)

60
Q

Classification of Lymphoid Tumors (5)

A
  1. Precursor B-cell (pre-B cell): B-ALL (Acute Lymphoblastic)
  2. Precursor T-cell (pre-T cell): T-ALL
  3. Peripheral B cell
  4. Peripheral T cell or NK cell
  5. Hodgkins Lymphoma
61
Q

Leukocyte Common Antigen (LCA)

62
Q

Cell antigen in WBC: T-cell (4)

hint: lower numbers

A

CD1
CD5
CD4/8
CD3

63
Q

Cell antigen in WBC: B-cell (5)

hint: higher numbers

A

CD10 (germinal center B)
CD19, CD20 (pre B, mature B)
CD23 (mature B)
IgM (plasma cell)

64
Q

Cell antigens in WBC: Monocyte/macrophage (2)

65
Q

Cell antigen in WBC: Stem cell (1)

66
Q

Cell antigen in WBC: Hodgkin (2)

67
Q

The diagnosis of lymphoma depends on which markers? (5)

A
  1. CD45 - LCA; differentiates carcinomas from lymphomas
  2. CD15, CD30 - Hodgkin
  3. CD19 - Pan-B marker, all B cells
  4. CD3 - peripheral T cell marker
  5. CD1,2,5,7 - precursor T cell markers
68
Q

General characteristics of Lymphoid tumors (5)

A
  1. Monoclonal population
  2. Mostly B cells
  3. Each type has its own clinical presentation
  4. Associated with immune abnormalities
  5. Recapitulation of behavior normal counterparts
69
Q

Symptoms of lymphoid tumors (3)

A
  1. Lymphadenopathy: multiple, painless, large, coalescent (otherwise, it’s lymphadenitis)
  2. Nonspecific symptoms: fever, malaise, weight loss
  3. Extranodal involvement
70
Q

Main symptom of lymphoma

A

Lymphadenopathy

71
Q
  1. The main ideologic identification of PRECURSOR tumors

2. Tells you that the tumor is very young

A

(+) TdT (Terminal Deoxynucleotidyl Transferase)

72
Q

The ff describes which lymphoma/leukemia?

  1. Originates from thymus
  2. Adolescent males
  3. Rapidly enlarging symptomatic mass: mediastinal (thymic) mass
  4. (+) lymphadenopathy, (+) splenomegaly
  5. Aggressive
A

Acute Lymphoblastic Lymphoma/Leukemia (pre-T)

73
Q

Peripheral B-cell Neoplasms (7)

A
  1. Small lymphocytic lymphoma (SLL)
  2. Chronic lymphocytic lymphoma (CLL)
  3. Follicular lymphoma
  4. Diffuse large B-cell lymphoma (DLBCL)
  5. Burkitt lymphoma
  6. Mantle cell lymphoma
  7. Marginal Cell Lymphoma/Maltoma
74
Q

Which peripheral B-cell Neoplasm:

  1. Elderly, >60, male
  2. Asymptomatic/nonspecific/mild
  3. BM involvement
  4. Can spill into blood: LN –> BM –> blood (CLL-like picture)
  5. Indolent
  6. Transformation to large B-cell lymphoma –> Richter syndrom
  7. Transformation to prolymphocyte
A

Small Lymphocytic Lymphoma (SLL)

75
Q

Chromosomal abnormality in SLL

A

Trisomy 12

76
Q

Immunophenotype of B and T markers of SLL

A
  1. B markers: CD19, 20, 23

2. T markers: CD5

77
Q

Which (2) B-cell tumors have a T-cell marker (CD5)?

A

SLL

Mantle Cell Lymphoma

78
Q

The ff microscopic features describe which Peripheral B-cell Neoplasm?

  1. Diffuse effacement of nodal architecture
  2. No more follicles
  3. (+) uniform round cells with prominent nucleoli
  4. (+) prolymphocytes
79
Q

The ff describe which peripheral B-cell neoplasm?

  1. Abnormal B cell in blood
  2. Increased WBC count (decreased WBC in SLL)
  3. Its chromosomal abnormality, age, sex, distribution, clinical picture is the same as SLL
A

Chronic Lymphocytic Lymphoma (CLL)

80
Q

Diagnosis of CLL

A

Absolute Lymphocyte count: >4000/cumm

81
Q

The most common leukemia of adults

82
Q

The ff are PBS features of which peripheral B-cell neoplasm?

  1. > 4-5 lymphocytes/OIO (normal: 1-3)
  2. 100% lymphocytes (normal: 20-40%)
  3. Smudge cell
83
Q

What characteristic feature is seen in the PBS of CLL?

A

Smudge Cell

84
Q

Lab used for diagnosis of SLL

A

Biopsy of LN

85
Q

Lab used for diagnosis of CLL

86
Q

Which peripheral B-cell neoplasm is being described?

  1. M=F, middle age
  2. Symptoms: generalized, painless lymphadenopathy with BM involvement
  3. Genetic abnormality: t(14:18) BCL-2 protooncogene
  4. Characteristically devoid of apoptotic cells (because of BLC2, which antagonizes apoptosis)
  5. Indolent, incurable
  6. Progress to Diffuse DLBL if with c-MYC
A

Follicular lymphoma

87
Q

Hallmark of follicular lymphoma

88
Q

The ff are immunophenotypes of?
CD10, 19, 20
BCL-2 protein

A

Follicular lymphoma

89
Q

Morphological characteristics describe?

  1. Well-defined germinal center
  2. Follicles confined to the cortex
  3. Presence of inactive B collar
90
Q

The ff are microscopic characteristics of?

  1. (+) nodular aggregates throughout LN
  2. Mixture of centroblasts and centrocytes
A

Follicular lymphoma

91
Q

The ff gross features seen in the spleen describe?

1. Pulp follicles expanded by follicular lymphoma cells (prominent nodules)

A

Follicular lymphoma

92
Q

What is present in follicular lymphoma that is absent in a reactive follicle?

93
Q

Rapidly enlarging symptomatic mass at a single nodal or extranodal site - symptom of?

Nodal: Waldeyer Ring
Extranodal: GIT, skin, bones, brain

A

Diffuse Large B-cell Lymphoma (DLBCL)

94
Q

Cytogenetics of DLBCL (2)

A
  1. BCL-6
    Dysregulation –> undifferentiated proliferative state
    Has anti-p53 activity to prevent activation of DNA repair mechanism
  2. t(14:18)
    Leads to overexpresion of BCL-2, which is anti-apoptotic
95
Q

Immunophenotype of?

CD19, 20, +/- CD10

96
Q

Microscopic features of?

  1. Large cells (compared with endothelium of the blood vessel)
  2. Diffuse
  3. No follicles
  4. Invades adipose tissue
  5. Large nuclei, diffuse chromatin, prominent nucleoli
97
Q

Grossly, what usually produces multifocal expansion of white pulp? indolent or aggressive B-cell lymphoma?

98
Q

What is the histology of Burkitt’s lymphoma?

A

Starry sky appearance: monotonous sea of round cells interspersed with macrophages

99
Q

The ff are characteristics of?

  1. Children and young adults
  2. Prognosis: very agressive
  3. Symptoms: (african/endemic) facial, pelvic. (sporadic/nonendemic) abdominal (ileocecal, peritoneum)
  4. Pathogenesis: t(8,14) of c-MYC gene, EBV
  5. Immunophenotype: CD10, 19, 20; BCL-6; IgM
A

Burkitt Lymphoma

100
Q

(2) types of Burkitt Lymphoma

A
  1. Endemic

2. Sporadic

101
Q

Which type of Burkitt lymphoma:

  1. Presents as a mass involving the mandible
  2. Predilection to abdominal viscera: kindeys, ovaries, adrenals
A

Endemic Burkitt Lymphoma

102
Q

Which type of Burkitt Lymphoma?

1. Presents as a mass involving ileocecum and peritoneum

A

Sporadic Burkitt Lymphoma

103
Q

Which peripheral B-cell neoplasm?

  1. 50-60 years old, male
  2. Presents as generalized painless lymphadenopathy + extranodal spread (BM, spleen, liver, GIT [lymphomatoid polyps])
  3. Immunophenotye: -CD23
  4. Genetic abnormality: t(11:14) increased expression of cyclin D1
  5. Prognosis: very poor, not curable
A

Mantle Cell Lymphoma

104
Q

Microscopic features of?

  1. (LPO) lymphoid cells surround a small, atrophic germinal center –> mantle zone pattern of growth
  2. (HPO) homogenous population of small lymphoid cells with irregular nuclear outlines, condensed chromatin, scant cytoplasm
A

Mantle Cell Lymphoma

105
Q
  1. Tumors of Mucosa Associated Lymphoid Tissue (thus it’s aka MALToma)
  2. Erogenous group of Bcell that arise within LN, spleen, extranodal tissues
  3. Evidence of somatic hypermutation of memory Bcell origin
  4. Good prognosis
  5. Chromosomal Abnormality: t(11:18) or t(14:18)
A

Marginal Cell Lymphoma/Maltomas

106
Q

Characteristics of?

  1. Arise from chronic inflammatory disorders
  2. Remain localized for prolonged periods
  3. Regress if inciting agent is eradicated
A

Marginal Cell Lymphoma/Maltoma

107
Q

Peripheral T-cell Neoplasms (5)

A
  1. Mycosis Fungoides/Sezary Syndrome
  2. Extranodal NK/T-cell lymphoma
  3. Adult T-cell lymphoma/Leukemia (CD4)
  4. Anaplastic Large Cell Lymphoma (CD8)
  5. Large Granular T-cell Lymphocytic Leukemia
108
Q

T-cell Lymphoma of the skin (2)

A
  1. Mycosis Fungoides

2. Sezary Syndrome

109
Q

Infiltration of the skin by neoplastic CD4 T-cells

A

Mycosis Fungoides

110
Q

Clinical stages in Mycosis Fungoides (3)

A
  1. Inflammatory/Premycotic Phase: Flat lesion
  2. Plaque Phase: Elevation of lesion
  3. Tumor Phase: Mass formation (absent in Sezary Syndrome)
111
Q

Histologic characteristics of?

  1. Epidermis and upper dermis are infiltrated by neoplastic T-cells
  2. Cerebriform appearance (d/t infolding of nuclear membrane)
  3. Extracutaneous spread (most commonly to LN, BM) - characterizes late disease progression
A

Mycosis Fungoides

112
Q

Generalized exfoliative erythroderma

A

Sezary Syndrome

113
Q

How does Sezary Syndrome differ from Mycosis Fungoides? (2)

A
  1. (-) Tumor

2. (+) Associated leukemia of sezary cells with characteristic cerebriform nuclei

114
Q
  1. Lethal midline granuloma

2. Midline malignant reticulosis

A

Extranodal NK/T-cell Lymphoma

115
Q

The ff are symptoms of?

  1. Destructive masses of sinuses
  2. Nasopharynx
  3. Involves CENTRAL portion of FACE (destructive nasopharyngeal mass)
A

Extranodal NK/T-cell Lymphoma

116
Q

Morphology of Extranodal NK/T-cell Lymphoma

A

Small and large lymphocytes invading small BV –> necrosis

117
Q

Extranodal NK/T-cell Lymphoma is associated with which virus?

118
Q

Characteristics of?

  1. Biopsy: (-) malignancy due to extensive ischemic necrosis
  2. Highly aggressive: responds to radiation therapy, not chemotherapy
  3. Poor prognosis with advanced disease
A

Extranodal NK/T-cell Lymphoma

119
Q
  1. CD4 Tcell proliferation
  2. DIRECTLY caused by Human T-cell Leukemia Retrovirus type 1 (HTLV-1)
  3. Highly aggressive, poor prognosis
A

Adult T-cell Lymphoma

120
Q

It is the ONLY lymphoma associated with a virus. Name the virus.

A

Adult T-cell Lymphoma: HTLV-1

121
Q

Symptoms of?

  1. Skin lesions: flat, thick areas
  2. Hypercalcemia
  3. General Lymphadenopathy
  4. Enlarged liver, spleen
  5. BM with peripheral blood lymphocytosis
A

Adult T-cell Lymphoma

122
Q

Morphology of?

1. CLOVER LEAF/FLOWER CELLS: multilobed nuclei

A

Adult T-cell Lymphoma

123
Q

Complications of Adult T-cell Lymphoma (1)

A

Demyelinating disorder of brain and spinal cord

124
Q

Virus that encodes Tax protein, which enhances lymphocyte growth and survival

125
Q

Characteristics of Hodgkins Lymphoma (opposite is true of Non-Hodgkins Lympoma) (4)

A
  1. Localized to a single axial group of nodes: cervical, mediastinal, para-aortic
  2. Contiguous spread
  3. Rarely involves Waldeyer’s Ring and mesenteric nodes
  4. Rare extranodal presentation
126
Q

Lymphoid neoplasms derived from B-cells forming neoplastic giant cells (RS cells) that induce accumulation of other inflammatory cells

A

Hodgkin Lymphoma

127
Q

The first human cancer to be successfully treated with radiation therapy and chemotherapy

A

Hodgkin Lymphoma

128
Q

Characteristics of?

  1. (+) RS cells
  2. Polymorphic cell
  3. Involves a single axial LN chain
  4. Spread is contiguous and stereotyped: cannot jump from site to site, LN -> spleen -> liver -> BM -> other tissues
  5. Rare extranodal presentation
A

Hodgkin Lymphoma

129
Q

Molecular pathogenesis of Hodgkin Lymphoma

A

Activation of NF-KB (transcription factor) by EBV

130
Q

In Hodgkin Lymphoma, this determines the course, choice of therapy, and prognosis of the disease

A

Ann Arbor Classification

131
Q

WHO classification of Hodgkin Lymphoma (5)

A
  1. Nodular sclerosis
  2. Mixed cellularity
  3. Lymphocyte-rich
  4. Lymphocyte depletion
  5. Lymphocyte predominance
132
Q

Which WHO classification of Hodgkin Lymphoma?
HISTO
-Bands of collagen
-Lacunar cells

CLINICAL FEATURE

  • M=F, young adults
  • Common in mediastinal and cervical regions
  • EBV-
A

Nodular sclerosis

133
Q

Which WHO classification of Hodgkin Lymphoma?
HISTO
-Many different cells, many RS

CLINICAL FEATURE

  • M>F
  • EBV+
  • Lymphadenopathy
  • Biphasic age incidence
A

Mixed cellularity

134
Q

Which WHO classification of Hodgkin Lymphoma?
HISTO
-Few lymphocyte
-Many RS and variants

CLINICAL FEATURES

  • Elderly, males
  • HIV+
  • Most EBV+
A

Lymphocyte depletion

135
Q

Which WHO classification of Hodgkin Lymphoma?
HISTO
-Many lymphocytes and RS

CLINICAL FEATURES

  • Middle age, males
  • Enlarged LNs
  • EBV+
A

Lymphocyte-rich

136
Q

Which WHO classification of Hodgkin Lymphoma?
HISTO
-Few RS/LH variant (popcorn cell)
-(-) CD15 and 30

CLINICAL FEATURES

  • Young males
  • EBV-
  • Cervical/axillary lymphadenopathy
A

Lymphocyte predominance

137
Q

Cells that release factors that induce accumulation of reactive lymphocytes, macrophages, granulocytes

138
Q

All classifications of Hodgkin Lymphoma are affected by EBV except? (2)

A
  1. Nodular sclerosis

2. Lymphocytic predominance

139
Q

In nodular sclerosis and lymphocytic predominance, what cells are seen instead of RS cells?

A

NS: Lacunar cells
LP: Popcorn cells

140
Q

All WHO classifications of Hodgkin Lymphoma will be CD15+ and CD30+ except?

A

Lymphocytic predominance

141
Q

Which type of Hodgkin Lymphoma?

  1. Most common form of HL
  2. Characterized by the presence of LACUNAR CELLS and the DEPOSITION of COLLAGEN in bands that divide LNs into circumscribed nodules
A

Nodular Sclerosis

142
Q

RS cells (3)

A

PAX5+
CD15+
CD30+

143
Q

Which type of Hodgkin Lymphoma?

  1. Involved LNs are diffusely effaced by a heterogenous cellular infiltrate (eosinophils, T-cells)
  2. Plasma cells + benign macrophages + RS cells
A

Mixed cellularity

144
Q

Which type of Hodgkin Lymphoma?

  1. Uncommon form of classical HL: reactive lymphocytes make up the majority of the infiltrate
  2. Involved LNs: diffusely effaced, vague nodularity
A

Lymphocyte-rich

145
Q

Which type of Hodgkin Lymphoma?

  1. Least common form of HL
  2. Characterized by a paucity of lymphocytes and a relative abundance or RS cells or their pleomorphic variants
A

Lymphocyte depletion

146
Q

Which type of Hodgkin Lymphoma?

  1. Uncommon, non-classical variant of HL
  2. Involved nodes: effaced by a nodular infiltrate of small lymphocytes + macrophages
  3. Contains LH (lymphocytic and histiocytic) RS variants (popcorn cell)
A

Lymphocyte predominance

Pathology (10 decks)

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