5. pataloji Hematopathology 3

Question 1

Lenfomalar nasıl ayrılır?

Answer 1

Hodgkin ve Non Hodkin

Question 2

Hodkin lenfomalar nasıl ayrılır

Answer 2

1. Nodüler Lenfosit Baskın Hodgkin lenfomlar
2. Klasik hodkin lenfomlar: 4 de ayrılır

Question 3

Klasik hodkin lenfomlara nasıl ayrılır

Answer 3

1. lenfosit zengin
2. Nodüler sklerozan
3. karma hüçreli
4. lenfositten fakir

Question 4

NHL lar nasıl ayrılır?

Answer 4

1. B hücre kökenliler
2. T/NK hücre kökenliler

Question 5

B hücre kökenli NHL’LER nasıl ayrılır?

Answer 5

1. Prekürsör B( lenfoblastik lenfoma : lösemi)
2. Matür NHL

Question 6

Matür b hücreli NHL nasıl ayrılır

Answer 6

1. KLL
2. follikuler lenfoma
3. Mantle hücreli lenfoma
4. Marjinal zone lenfoma
5. Dbbhl

5ç hairy cell lösemi

Question 7

Tnk hücre kökenli lenfomalar nasıl ayrılır

Answer 7

1. Preküskör lenfoblastik lenfoma T
2. Matür

Question 8

Matür T/NK nasıl ayrılır

Answer 8

ben ayırmam bana ne

Question 9

Most common leukemia in adult, median age: 60 yo Is?

Answer 9

Chronic lymphocytic leukemia/Small lymphocytic lymphoma

Question 10

Most common Chromosomal translocations of Chronic lymphocytic leukemia

Answer 10

del13q14.3, del11q, del17p, trizomi12q

Question 11

Chronic lymphocytic leukemia Immunfenotype is?

Answer 11

CD19, CD20, CD5, CD23 positive

Question 12

Clinical features of Chronic lymphocytic leukemia are

Answer 12

Symptomatic

• Disseminated lymphadenopaty

Hepatosplenomegaly

Pancytopenia

Lymphocytic leukocytosis

Immun disregulations

Richter transformation
* DBBHL ya dönüşüm
* Fast growing mass, B symptoms(fever, weight loss, night sweats)

Question 13

what is Bad prognosis of Chronic lymphocytic leukemia

Answer 13

Del11q ve del 17p
Absence of somatic hypermutations
NOTCH1 mutation

Question 14

what is Most common indolent NHL

Answer 14

Follicular lymphoma

Question 15

Follicular lymphoma Mimics germinal center cells. ….. …. …. ….

and ………

Answer 15

CD20, CD10, BCL6(+), CD5(-)
Associated with BCL2 translocation: t(14;18)->BCL2 overexpression : Escape from apoptosis

Question 16

What is the Most common NHL

Answer 16

Diffuse large B cell Lymphom
Median age: 60 yo

Question 17

Gene expression profil Most common NHL : Diffuse large B cell Lymphom

Answer 17

BCL6: GC B cell
MYC: transcription factor, aerobic glicolysis, Warburg effect
BCL2: antiapoptotic

Question 18

Immünphenotype: of Most common NHL : Diffuse large B cell Lymphom

Answer 18

CD20(+), high ki67 index, variable CD10 and BCL6

Question 19

Clinical fetures of Most common NHL : Diffuse large B cell Lymphom

Answer 19

Fast growing mass , B symptoms
Frequent Waldeyer ring, oropharinx/tonsil involvement
Frequent extranodal involvement/presentations
* GI tract, skin, bone, CNS
* Bone marrow involvement is rare
* Gene expression profile is associated with prognosis

MYC: Burkitt lymphoma like worse prognosis
Early stages good prognosis

Question 20

Burkitt lymphoma is imp because
1. Endemic type(Africa): ………
2. Sporadic type: ……..
3 immün deficiency associated type: ……

4. …. gene overexspression: t(8;14), t(2;8), t(8;22)
5. Frequent Apoptosis: ….

Starry sky

6. Immunphenotype:

Very aggresive tumor
* Response to CT is good

Answer 20

1. mandibular mass
2. iliocecal/intraabdominal mass
3. HIV
4. MYC
5. BCL2(-)
6. CD19, CD20, CD10, BCL6, MYC (+), BCL2(-)

Question 21

Mantle cell Lymphoma is imp because?

50 60 yaş

mimics mantle cells

1. ……= CyclinD1 expression: Cell cycle G1->S

Immunphenotype: …………………………

Clinical features: ……………..

Answer 21

t(11;14)

CD20, CD5, Cyclin D1(+), CD23(-)

painless disseminated LAP

Question 22

Marginal zone lymphoma is imp because?

Chronic inflammatory background: Autoimmun, infection

1. • Salivary gland: ……
2. Thyroid gland: …..
3. Stomach: ………..
   * Localized disease

Regresses when pathogenic agent is treated

When there is additional mutation occurs:t(11;18), t(14;18),t(1;14)
* Relapse, systemic dissemination, Richter

Answer 22

Splenic

Extranodal: MALToma

1. Sjögren syndrom
2. Hashimoto tiroiditis
3. H.pylori gastritis

Question 23

Hairy cell leukemia is imp because?

Middle ages,

1. …… mutation: %90

melanoma, langerhans cell histiocytosis

Immünphenotype: ………

Hepatomegali

Spleen involvement, massive splenomegaly

Bone marrow involvement

• Treatment: …………..

Answer 23

1. BRAF

CD19, CD20(+), CD11c, CD25, CD103, Annexin A1(+) TRAP(+)

BRAF inhibitors

Question 24

Periferal T cell lymphoma, NOS is imp because

No spesific patognomonic feature

Pleomorfism

Diffuse infiltration in …..

mmunphenotype: ……….

Clinical features: ………

Answer 24

lymph node

T cell markers: CD3, CD5, CD2, CD7

CD4: T helper

CD8: cytotoxic

Clinical features: disseminated LAP, eosinophilia, ithcing, B symptoma

Question 25

Anaplastic large cell lymphoma, ALK(+) imp because

Answer 25

Very good prognosis, can be cured 75-80% of the patients with ALCL,ALK(+)
* ALK(-): worse prognosis
* CD30(+)

Question 26

Adult T cell leukemia/lymphoma is imp bvecause

……. cause this

Fast course, fatal

Endemic: ………….

Answer 26

HTLV-1: progressive demyelinisation in the CNS and spinal cord

Japan, Carrabean, West Africa

Question 27

Mycozis fungoides and Sezary syndrome is imp because

Answer 27

CD4(+) T helper cell tumor

Question 28

Large granular lymphocytic leukemia is imp because

• T or NK cell variant

Answer 28

• T cell variant: CD3(+), indolent

NK cell variant: CD3(-),

Question 29

Ekstranodal NK/T cell lymphoma

Answer 29

• EBV(+)

High grade lymphoma, bad response to CTyanıt