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75. neoplastic diseases of lymphoid system (types of lymphomas) Flashcards

1
Q

75-1. categorization bases of lymphomas

definition of lymphoma

A

neoplastic proliferation of lymphoid cells form a mass

arises in lymph node or extranodal tissue

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2
Q

75-1. categorization bases of lymphomas

types of lymphoma (2)

A 
non hodgkin lymphoma (60%)
hodgkin lymphoma (40%)
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3
Q

75-1. categorization bases of lymphomas

types of hodgkin lymphoma (5)

A 
nodular sclerosis HL
lymphocyte rich HL
mixed cellularity HL
lymphocyte depleted HL
nodular lymphocyte predominant HL
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4
Q

75-1. categorization bases of lymphomas

classification base of non-hodgkin lymphoma (5)

A 
cell type : T cell & B cell
cell size : small, intermediate, large B cell lymphoma
pattern of cell growth
expression of surface marker
cytogenetic translocation
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5
Q

75-2. precursor T and B cell lymphoblastic leukemia

definition of T and B cell acute lymphoblastic leukemia

A

neoplastic proliferation of immature T & B cell (> 20%) in bone marrow

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6
Q

75-2. precursor T and B cell lymphoblastic leukemia

Predominant age, related disorder of T & B ALL

A

predominant in children, especially with down syndrome

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7
Q

75-2. precursor T and B cell lymphoblastic leukemia

surface marker of B-ALL (3)

A

CD10
CD19
CD20

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8
Q

75-2. precursor T and B cell lymphoblastic leukemia

surface marker of T-ALL

A

from CD2 to CD8

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9
Q

75-2. precursor T and B cell lymphoblastic leukemia

clinical presentation of T-ALL

A

teenager with medistinal mass (mediastinal tumor)

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10
Q

75-3. chronic lymphocytic leukemia, hairy cell leukemia

definition of chronic lymphocytic leukemia (CLL)

A

neoplastic proliferation of naive B cell

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11
Q

75-3. chronic lymphocytic leukemia, hairy cell leukemia

surface marker of CLL (2)

A

CD5

CD20

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12
Q

75-3. chronic lymphocytic leukemia, hairy cell leukemia

Cellular morphology of CLL (2)

A 
increased lymphocyte
smudge cell (ruptured CLL cell)
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13
Q

75-3. chronic lymphocytic leukemia, hairy cell leukemia

complication of CLL (4)

A

lymphadenopathy
hypogammaglobulinemia
autoimmune hemolytic anemia
transformation to diffuse large B cell lymphoma

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14
Q

75-3. chronic lymphocytic leukemia, hairy cell leukemia

definition of hair cell leukemia

A

neoplastic proliferation of mature B cell

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15
Q

75-3. chronic lymphocytic leukemia, hairy cell leukemia

diagnosis of hairy cell leukemia

A

cells are positive to tartrate resistant acid phosphate (TRAP)

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16
Q

75-3. chronic lymphocytic leukemia, hairy cell leukemia

clinical features of hairy cell leukemia (2)

A

splenomegaly

dry tap on bone marrow aspiration (due to marrow fibrosis)

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17
Q

75-4. multiple myeloma and related plasma cell disorders

definition of multiple myeloma

A

malignant proliferation of plasma cells in the bone marrow

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18
Q

75-4. multiple myeloma and related plasma cell disorders

characteristics of multiple myeloma (2)

A

most common primary malignancy of bone

most common malignant lesion of bone

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19
Q

75-4. multiple myeloma and related plasma cell disorders

clinical features of multiple myeloma (6)

A

bone pain with hypercalcemia : plasma cell activate RANK, activate osteoclast
elevated serum protein : M spike on serum protein electrophoresis (SPEP)
increased risk of infection : monoclonal antibody with lack of antigenic diversity
rouleaux formation of RBC : serum protein decreases charge of RBC
primary AL amyloidosis : free light chain deposit in tissue
proteinuria : free light chain is excreted in urine as Bence Jones protein, cuase renal failure

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20
Q

75-4. multiple myeloma and related plasma cell disorders

name of multiple myeloma related plasma cell diorders (2)

A

monoclonal gammopathy of undetermined significance (MGUS)

waldenstrom macroglobulinemia

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21
Q

75-4. multiple myeloma and related plasma cell disorders

characteristics of MGUS (4)

A

shows M spike on SPEP
no other features of multiple myeloma (hypercalcemia, AL amyloidosis, protein uria)
common in elderly
can develop multiple myeloma

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22
Q

75-4. multiple myeloma and related plasma cell disorders

characteristics of waldenstrom macroglobulinemia (6)

A 
shows M spike
lymphadenopathy
visual and neurologic defect : due to hyperiscosity of IgM
bleeding
no hypercalcemia
no renal dysfunction
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23
Q

75-5. follicular lymphoma, mantle cell lymphoma, MALT-lymphoma

category of follicular lymphoma, mantle cell lymphoma, MALT-lymphoma

A

NHL, especially small B cell lymphoma

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24
Q

75-5. follicular lymphoma, mantle cell lymphoma, MALT-lymphoma

definition of follicular lymphoma

A

neoplastic proliferation of small B cells that form follicle like nodule

25
Q

75-5. follicular lymphoma, mantle cell lymphoma, MALT-lymphoma

characteristics of follicular lymphoma (2)

A

present in late adulthood

painless lymphadenopathy

26
Q

75-5. follicular lymphoma, mantle cell lymphoma, MALT-lymphoma

genes related to follicular lymphoma

A

BCL2 on chromosome 18 translocated to chromosome 14

- cause inhibition of apoptosis by overexpress Bcl2

27
Q

75-5. follicular lymphoma, mantle cell lymphoma, MALT-lymphoma

important complication of follicular lymphoma

A

progression to diffuse large B cell lymphoma

28
Q

75-5. follicular lymphoma, mantle cell lymphoma, MALT-lymphoma

differentiation of follicular lymphoma with reactive follicular hyperplasia (4)

A

disruption of normal lymph node architecture
lack of tingle body macrophage in germinal center
Bcl2 expression in follicle
monoclonality

29
Q

75-5. follicular lymphoma, mantle cell lymphoma, MALT-lymphoma

definition of mantle cell lymphoma

A

neoplastic proliferation of small B cell that expand the mantle zone

30
Q

75-5. follicular lymphoma, mantle cell lymphoma, MALT-lymphoma

characteristic of mantle cell lymphoma (2)

A

present in late adulthood

painless lymphadenopathy

31
Q

75-5. follicular lymphoma, mantle cell lymphoma, MALT-lymphoma

gene related to mantle cell lymphoma

A

cycline D1 gene on chromosome 11 translocated to chromosome 14
-overexpression of cyclin D1 promote G1/S transition

32
Q

75-5. follicular lymphoma, mantle cell lymphoma, MALT-lymphoma

definition of MALT lymphoma

A

type of marginal zone lymphoma, mucosa associated lymphoid tissue (MALT)

33
Q

75-5. follicular lymphoma, mantle cell lymphoma, MALT-lymphoma

cause of MALT lymphoma (2)

A 
autoimmune disorder (sjogren syndrome, hashimoto thyroiditis)
chronic infection (H. pylori infection)
34
Q

75-6. diffuse large B cell lymphoma, burkitt lymphoma

category of diffuse large B cell lymphoma & burkitt lymphoma

A

NHL, large B cell & intermediate sized B cell lymphoma

35
Q

75-6. diffuse large B cell lymphoma, burkitt lymphoma

definition of large B cell lymphoma

A

neoplastic proliferation of large B cell that grows diffusely in sheets

36
Q

75-6. diffuse large B cell lymphoma, burkitt lymphoma

characteristics of large B cell lymphoma (3)

A

most common form of NHL
clinically aggressive
sporadic or transition from follicular lymphoma

37
Q

75-6. diffuse large B cell lymphoma, burkitt lymphoma

definition of burkitt lymphoma

A

neoplastic proliferation of intermediate sized B cell associated with EBV

38
Q

75-6. diffuse large B cell lymphoma, burkitt lymphoma

genes related to burkitt lymphoma

A

c-myc located in chromosome 8 translocated to chromosome 14

-overexpression of c-myc promote cell growth

39
Q

75-6. diffuse large B cell lymphoma, burkitt lymphoma

characteristics of burkitt lymphoma

A

extra nodal mass in child, usually in jaws

high mitotic index and ‘starry sky’ appearance on microscopy

40
Q

75-7. mycosis fungoides, peripheral T cell lymphoma, anaplastic large cell lymphoma

category of mycosis fungoides, peripheral T cell lymphoma, anaplastic large cell lymphoma

A

T cell lymphoma

41
Q

75-7. mycosis fungoides, peripheral T cell lymphoma, anaplastic large cell lymphoma

definition of mycosis fungoides

A

neoplastic proliferation of mature CD4 T cell, infiltrate skin

42
Q

75-7. mycosis fungoides, peripheral T cell lymphoma, anaplastic large cell lymphoma

skin lesions caused by mycosis fungoides (4)

A

skin rash
plaque
nodule
pautrier microabscess (aggregate of neoplastic cells in epidermis)

43
Q

75-7. mycosis fungoides, peripheral T cell lymphoma, anaplastic large cell lymphoma

syndrome related to mycosis fungoides

A

sezary syndrome : generalized exofoliate erythroderma, tumor cell in peripheral blood

44
Q

75-7. mycosis fungoides, peripheral T cell lymphoma, anaplastic large cell lymphoma

definition of peripheral T cell lymphoma

A

heterogenous group of T cell lymphoma

45
Q

75-7. mycosis fungoides, peripheral T cell lymphoma, anaplastic large cell lymphoma

characteristics of peripheral T cell lymphoma (2)

A

15% of adult NHL

aggressive, poor response to therapy

46
Q

75-7. mycosis fungoides, peripheral T cell lymphoma, anaplastic large cell lymphoma

definition of anaplastic large cell lymphoma

A

group of non-Hodgkin lymphomas in which aberrant T cells proliferate uncontrollably

47
Q

75-7. mycosis fungoides, peripheral T cell lymphoma, anaplastic large cell lymphoma

characteristics of anaplastic large cell lymphoma (4)

A

mostly in lymph node
large pleomorphic cells express CD30 T cell markers
aggressive
good response to chemotherapy

48
Q

75-8. Hodgkin lymphoma

definition of hodgkin lymphoma

A

neoplastic proliferation of Reed-Sternberg cell

49
Q

75-8. Hodgkin lymphoma

about Reed Sternberg cell (5)

A 
large B cell
multiple nuclei
prominent nucleoli
secrete cytokine : cause fever, chills, weight loss, night sweats
positive for CD15 and CD30
50
Q

75-8. Hodgkin lymphoma

location of hodgkin lymphoma

A

single or chain of lymph node

51
Q

75-8. Hodgkin lymphoma

types of hodgkin lymphoma (5)

A 
nodular sclerosis HL
lymphocyte rich HL
mixed cellularity HL
lymphocyte depleted HL
lymphocyte predominance HL
52
Q

75-8. Hodgkin lymphoma

characteristics of nodular sclerosis HL (3)

A

most common type of HL
enlarged cervical / mediastinal lymph node
usually in young adult, female

53
Q

75-8. Hodgkin lymphoma

morphology of nodular sclerosis HL (2)

A

lymph node is divided by sclerosis

presence of lacunar cell

54
Q

75-8. Hodgkin lymphoma

characteristics of lymphocyte rich HL (2)

A

best prognosis onf HL

low number of atypical cells

55
Q

75-8. Hodgkin lymphoma

characteristics of mixed cellularity HL (3)

A 
most common HL of elderly
male predominance
abundant eosinophil (Reed Sternberg cell produce IL-5)
56
Q

75-8. Hodgkin lymphoma

characteristics of lymphocyte depleted HL (3)

A

low number of lymphocyte
most aggressive HL
usually seen in elderly and HIV positive individual

57
Q

75-8. Hodgkin lymphoma

characteristics of lymphocyte predominant HL (4)

A

shows lymphohistiocytic variant Reed Sternberg cell (popcorn cell)
express B cell marker (CD20)
don’t express CD15, C30 (RS cell marker)
isolated cervical or axillary lymphadenopathy

58
Q

75-8. Hodgkin lymphoma

pathogenesis of HL

A

EBV infection

59
Q

75-8. Hodgkin lymphoma

staging of Hodkin lymphoma

A

Ann arbor classification (1 to 4)

Pathology finish (30 decks)

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