4 Lymphoma

Question 1

Which lymphomas are childhood lymphomas?

Answer 1

Burkitt, Hodgkin. (the named ones)

Question 2

90% of all lymphoma/leukemia are what type?

Answer 2

Mature B cell type. (ones with “chronic” in the name)

Question 3

Name the lympoma association: EBV

Answer 3

Burkitt, Hodgkin

Question 4

Name the lympoma association: HTLV-1

Answer 4

T cell lympoma

Question 5

Name the lympoma association: HHV-8

Answer 5

primary effusion lymphoma, Kaposi

Question 6

Name the lympoma association: H. Pylori

Answer 6

MALT lymphoma

Question 7

Name the lympoma association: B. Burdorferi?

Answer 7

cutaneious marginal zone lymphoma

Question 8

When should you biopsy a node?

Answer 8

Large, lasts over a month, keeps getting bigger.

Question 9

CLL can become what kind of lymphoma?

Answer 9

small lymphocytic lymphoma

Question 10

Which is the most common lymphoma?

Answer 10

Large B (2nd is follicular)

Question 11

Follicular lymphoma is slow or fast onset?

Answer 11

Slow and hard to detect! Think ADULTS!

Question 12

Follicular lymphoma histo & immunohisto looks like?

Answer 12

• follicles w/o polarization or tingible body macrophages

- CD20, Bcl-2, CD10 [esp Bcl-2!!]

Question 13

name the Bcl-2 gene rearrangement

Answer 13

T 14:18

Question 14

Diffuse large B cell lymphoma would present clinically as?

Answer 14

rapidly enlarging node or mass.

Question 15

Diffuse large B cell lymphoma histo & immunohisto?

Answer 15

• Large cells, starry sky (due to lots of apoptosis)

- CD19, 20 (same as a normal B cell)

Question 16

Diffuse large B cell lymphoma has what genetic changes?

Answer 16

• somatic IgV heavy chain

- t 14:18 of Bcl-2

Question 17

Better prognosis Large B lymphoma is which type?

Answer 17

germinal center type, which is negative for MUM1 (unlike activated B cell type)

Question 18

Tx for B Large B lymphoma?

Answer 18

rituximab (anti-CD20) (watch for tumor lysis syndrome)

Question 19

Jaw/orbit mass lymphoma?

Answer 19

Burkitt lymphoma endemic type (kids)

Question 20

abdominal mass lymphoma?

Answer 20

Burkitt sporadic type (kids)

Question 21

Burkitt lymphoma doubles how quickly? What is its immunohisto marker? Genetic change?

Question 22

Mantle cell lymphoma has what immunohisto? genetics?

Answer 22

• CD 5

- t11:14

Question 23

Mantle cell lymphoma has what immunohisto? genetics?

Answer 23

• CD 5

- t11:14 affecting cyclin D1

Question 24

Mantle cell lymphoma prognosis?

Answer 24

Excellent

Question 25

Marginal zone lymphoma is slow of fast-progressing?

Answer 25

SLOW

Question 26

Marginal zone lymphoma key example is? immunohisto?

Answer 26

• H. Pylori MALT lymphomas!

- CD 19 & 20 (like all B cells)

Question 27

Marginal zone lymphoma histo?

Answer 27

-scattered large cells!!!

Question 28

Hodgkin lymphoma:what main 2 types exist?

Answer 28

Classic & nodular lymphocyte predominant.

Question 29

Should you tx a single node Hodgkin with chemo?

Answer 29

No, excise. Chemo causes recurrence.

Question 30

Hodgkin immunohisto? Presentation?

Answer 30

• CD15, CD30 (they are germinal center cells)

- big node, or mediastinal mass. Sometimes constitutional symptoms. Bimodal ages affected.

Question 31

Hodgkin histo?

Answer 31

• inflammatory background

- sclerosis if “nodular sclerosing” type.

Question 32

CLL (or SLL: small lymphocytic leukemia when hematogenous involvement) has what histo?

Answer 32

• small lymphocytes, clumped chromatin. “snickerdoodle”

- Pale “prolymphocytes”

Question 33

CLL can transform to SLL or to?

Answer 33

Diffuse Large B

Question 34

CLL immunohisto? prognosis?

Answer 34

• CD5, CD23.

- Great!

Question 35

As a rule, low or high grade lymphomas are curable?

Answer 35

HIGH grade!

[high grade affect all ages, while low grade affect elderly]