5-24 KRAFTS Non-Hodgkins Flashcards
What’s the difference btwn Leukemia and Lymphoma?
Leuk – Starts in BM, spreads Myeloid or lymphoid Classified as Acute or Chronic Lymph – Starts in lymph node, spreads Lymphoid only Classified as Hodgkin or non-Hodgkin
What is the MOST COMMON CAUSE of lymphadenopathy?
Benign rxn to infection
What is the MOST COMMON MALIGNANT CAUSE of lymphadenopathy?
Metastatic carcinoma! (Not lymphoma!!!)
What are the 4 things you must know about Follicular Hyperplasia?
Large, irregular follicles in lymph node
Mixture of cells in germinal centers (heterogenous)
Tingible body macrophages
Normal B-cell response to some immune stimulus
What are the 4 things you must know about INTERfollicular Hyperplasia?
Expanded area btwn follicles
Mixture of cells
Partial effacement
Normal T-cell response to immune stimulus
What’s the rule of thumb for a benign lymphadenopathy vs a malignant one?
Benign ones tend to hurt, malignant ones don’t
What are the 4 things you must know about Non-Hodgkin Lymphoma?
Malignant prolif of lymphoid cells (blasts or mature) in lymph nodes
“Skips around”
Many subtypes
Most are B-cell
What are Sx of NHL?
Firm painless lymphadenopathy
Extranodal manifestations
“B” sx - ↓wt, night sweats, fever
What are Low-Grade vs High Grade NHL?
Low grade – Older patients Indolent (incurable!) Small, mature cells Non-destructive High grade – Sometimes kids AGGRESSIVE (curable? w/ chemo?) Big, ugly cells Destructive
What does “indolent,” mean?
Means cells just kindof accumulate
What are the 4 things you must know about Small Lymphocytic Lymphoma?
= CLL
Small mature lymphocytes
B-cell lesion, but CD5+
Long course, death from infxn
What are the 4 things you must know about Marginal Zone Lymphoma?
It’s actually a bunch of different lymphomas
They exhibit marginal zone pattern
Malt lymphoma is one
Helicobacter pylori is found in MALT
What happens if you give H.pylori antibiotic to Malt lymphoma patient?
H.pylori goes away, and Malt Lymphoma disappears!
What are the 4 things you must know about Mantle Cell Lymphoma?
Mantle zone pattern
Small angulated lymphocytes
t(11; 14) – bcl-1 and IgH
More aggressive
What does the 14 indicate in t(11; 14)?
14 is location of the heavy chain gene. That’s transcribed ALL THE TIME in lymphocytes!
What is the MOST COMMON NHL?
Follicular Lymphoma!
What are the 4 things you must know about Follicular Lymphoma?
Follicular pattern (later diffuse)
Small cleaved cell, mixed or large cell
Grade 1, 2, or 3
t(14; 18) – IgH and bcl-2
What do the different grades in Follicular Lymphoma indicate?
Lower grade = smaller, less ugly cell
Prognosis linked to grade. Grade 1 patients do better.
What is the difference between grading and staging of cancer?
Staging – Looking at patient and see how far the DISEASE HAS SPREAD
Grading – what you do when you look under the microscope
What are the characteristic cells you see in blood w/ Follicular Lymphoma?
BUTT CELLS!
What are the 4 things you must know about Mycosis Fungoide / Sézary Syndrome?
Skin lesions
Blood involvement
CEREBRIORM LYMPHOCYTES!
T-cell immunophenotype
Why is it called “Mycosis fungoides?”
Means “mushroom mushrooms, or fungus mushrooms.”
B/c natural disease progression is flat lesion raised lesion big nodule
What are the 4 things you must know about Diffuse Large-cell Lymphoma?
Large B-cells
Extranodal involvement
Grows rapidly
Bad prognosis
What are the 4 things you must know about Lymphoblasitc Lymphoma?
= ALL
Two types: B & T
Lymphoblasts in diffuse pattern
T-lymphoblastic lymphoma often in teenage male w/ mediastinal mass
What are the 4 thinsg you musut know about Burkitt Lymphoma?
= Burkitt leukemia
Child w/ fast-growing, extranodal mass
“Starry-sky” pattern
t(8; 14)
What are the 2 variants of Burkitt Lymphoma?
African variant – in face
Non-African variant – in abdomen
What does the “starry-sky pattern” refer to in Burkitt Lymphoma?
BM biopsy – all dark blue (b/c lymphocytes) w/ little white things (tingible body macrophages)
What other characteristic cell should tip you off to Burkitt Lymphoma?
B-cells w/ distinct vacuoles
What are the 4 things you must know about Adult T-cell Leukemia/Lymphoma?
Seen in Japan/Caribbean basin
HTLV-1 (virus)
Skin lesions, hypercalcemia
Very aggressive
What are the only T-cell NHL’s?
Adult T-cell Leukemia/Lymphoma
Mycosis Fungoides/Sezary Syndrome
