6.6 - Lymphoma

Question 1

what are the 3 subtypes of NHL?

Answer 1

• small B cell
• intermediate sized B cell
• large B cell

Question 2

follicular lymphoma is what subtype of NHL?

Answer 2

small B cell

Question 3

mantle cell lymphoma is what subtype of NHL?

Answer 3

small B cell

Question 4

marginal zone lymphoma is what subtype of NHL?

Answer 4

small B cell

Question 5

small lymphocytic lymphoma is what subtype of NHL?

Answer 5

small B cell

Question 6

burkitt lymphoma is what subtype of NHL?

Answer 6

intermediate sized B cell

Question 7

diffuse large B cell lymphoma is what subtype of NHL?

Answer 7

large B cell

Question 8

which lymphoma consists of “B symptoms” - HL or NHL?

Answer 8

HL

Question 9

how are HL and NHL differentiated based on spread?

Answer 9

• HL: contiguous, rarely extranodal

- NHL: diffuse, often extranodal

Question 10

what guides therapy in HL?

Answer 10

staging

Question 11

what is the mainstay treatment for HL?

Answer 11

radiation

Question 12

does leukemic phase occur in NHL? what about HL?

Answer 12

• NHL: yes

- HL: no

Question 13

follicular lymphoma is driven by what translocation? what genes are involved?

Answer 13

• t(14,18)
• BCL2 (chromosome 18) translocates to Ig heavy chain on chromosome 14
• overexpression of Bcl2 which inhibits apoptosis

Question 14

what is the treatment for follicular lymphoma? what does it target?

Answer 14

rituximab (anti-CD20 antibody)

Question 15

what is the feared complication of follicular lymphoma?

Answer 15

progression to diffuse large B cell lymphoma

Question 16

how is follicular lymphoma differentiated from reactive follicular hyperplasia?

Answer 16

follicular lymphoma shows:

• disruption of normal lymph node architecture
• LACK of tingible body macrophages in germinal centers
• Bcl2 expression in follicles
• monoclonality

Question 17

mantle cell lymphoma is driven by what translocation? what is the product?

Answer 17

• t(11,14)
• cyclin D1 (chromosome 11) translocated to Ig heavy chain on chromosome 14
• promotes G1/S transition in cell cycle via phosphorylation of proteins

Question 18

hashimoto thyroiditis, sjogren syndrome, and H. pylori are associated with what lymphoma?

Answer 18

marginal zone lymphoma

Question 19

what is the name of the cancer caused by marginal zone lymphoma in mucosal sites?

Answer 19

MALT lymphoma

Question 20

burkitt lymphoma is associated with what virus?

Answer 20

EBV

Question 21

burkitt lymphoma is driven by what translocation?

Answer 21

• t(8,14)
• c-myc translocates to Ig heavy chain on chromosome 14
• c-myc oncogene promotes cell growth

Question 22

what is the classic histology of burkitt lymphoma?

Answer 22

“starry sky”

Question 23

what is the most common NHL? is it benign or aggressive?

Answer 23

• diffuse large B cell

- aggressive (high grade)

Question 24

• t(14,18)
• BCL2 (chromosome 18) translocates to Ig heavy chain on chromosome 14
• overexpression of Bcl2 which inhibits apoptosis

Answer 24

follicular lymphoma

Question 25

• t(11,14)
• cyclin D1 (chromosome 11) translocated to Ig heavy chain on chromosome 14
• promotes G1/S transition in cell cycle via phosphorylation of proteins

Answer 25

mantle cell lymphoma

Question 26

• t(8,14)

- c-myc translocates to Ig heavy chain on chromosome 14

Answer 26

burkitt lymphoma

Question 27

“starry sky”

Answer 27

burkitt lymphoma