B-cell NON-Hodgkin & Precursor B/T cell Leukemias/Lymphomas Flashcards
Leukemias involve cells in the?
Bone marrow/blood
Lymphomas involve cells in the?
Lymph nodes
Lymphoid neoplasias involve what cell types?
B and T cells
What is the most common cancer of kids?
(ALL) = Acute Lymphoblastic Leukemia/Lymphoma
Symptoms of Acute Lymphoblastic Leukemia/Lymphoma (ALL)?
SUDDEN onset:
- Fever
- Fatigue
- Pain
- Bleeding/Bruising
- Headache and Nausea
Normally, a lymphoid stem cell creates?
B and T cells
With Acute Lymphoblastic Leukemia/Lymphoma, mutations in the lymphoid stem cell cause what to accumulate?
Blasts!
“ Leukemic stem cells”
- Maturation arrest and self-renewal capacity
Due to their densely packed nature, when attempting to aspirate out cells with Acute Lymphoblastic Leukemia/Lymphoma, how is it described?
Sludge-y
How do the cells look with ALL (Acute Lymphoblastic Leukemia/Lymphoma)?
Dark, large and low cytoplasm
What markers can be expressed for cells with ALL (Acute Lymphoblastic Leukemia/Lymphoma)?
TdT
B cells: CD19, CD20, CD10, PAX-5
T cells: anything below CD10
What 4 factors will give a good prognosis for ALL (Acute Lymphoblastic Leukemia/Lymphoma)?
Age: 2-10
LOW peripheral WBC count
Hyperdiploidy
t(12;21)
What factors will give a worse prognosis for ALL (Acute Lymphoblastic Leukemia/Lymphoma)?
Age < 2 or into adolescence/adulthood
HIGH peripheral WBC count
What is the treatment for ALL (Acute Lymphoblastic Leukemia/Lymphoma)?
Intrathecal chemotherapy
Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) is a type of?
B-cell NON-Hodgkin Leukemia/Lymphoma
Patient population and symptoms with CLL/SLL (Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma)
Older patients, either Asymptomatic or Fatigued
What does a peripheral smear show for CLL/SLL?
Lymphocytosis (increased lymphocytes)
Small and mature lymphocytes
Possibly smudge cells
What Cluster Designations will be present with CLL/SLL?
CD19/20 AND CD5+
CD19/CD20+ AND CD5+ could indicate?
CLL/SLL
What is the Richter Transformation?
CLL/SLL transforming into an AGGRESSIVE tumor
Mutations with ______ can cause the Richter Transformation of CLL/SLL
TP53 or MYC
What translocation is involved with Follicular Lymphoma?
t(14;18)
= IgH gene next to BCL-2
t(14;18) - IgH gene next to BCL-2
Follicular Lymphoma
Symptoms of Follicular Lymphoma?
Painless lymphadenopathy
Follicular Lymphoma may look similar to Follicular Hyperplasia. What is Follicular Lymphoma positive for that Follicular Hyperplasia is NOT?
BCL-2
Follicular Lymphoma is graded 1-3. Grade 3 represents?
More large centroblasts
Diffuse Large B cell Lymphoma has what physical sign?
Large masses in lymph node or spleen
What are 2 types of Diffuse Large B cell Lymphoma?
- Immunodeficiency related
- Linked to EBV - Primary effusion lymphoma
- HHV-8
What is over expressed with Diffuse Large B cell Lymphoma?
BCL-6
Over expression of BCL-6?
Diffuse Large B cell Lymphoma
“starry sky” pattern
Burkitt Lymphoma
What produces the “stars” in the “starry sky” pattern of Burkitt Lymphoma?
Tingible body macrophages
What are tingible body macrophages present with Burkitt lymphoma?
They are clearing the cell debris produced from the EXTREMELY FAST growing tumor
What translocation is present with Burkitt Lymphoma?
t(8;14)
- IgH gene next to MYC
t(8:14) - IgH next to MYC
Burkitt Lymphoma
What marker shows high proliferation index for Burkitt Lymphoma?
Ki-67
What are 3 types of Burkitt Lymphoma?
- Endemic African Burkitt Lymphoma
- Mandibular growth and EBV present - HIV-related
- Sporadic
Mandibular growth and EBV present are often seen with?
Endemic African Burkitt Lymphoma
What translocation is present with Mantle Cell Lymphoma?
t(11;14) - IgH gene next to Cyclin D1
t(11;14) - IgH next to Cyclin D1
Mantle Cell lymphoma
What physical sign may be present with Mantle cell lymphoma?
Lymphomatoid polyposis
- intestinal mucosal lesions
Lymphomatoid polyposis may be present with?
Mantle cell lymphoma
What 2 sites can Marginal Zone Lymphomas arise in?
Lymph nodes
Extra-nodal sites = MALT-omas
Marginal zone lymphomas that arise in extra-nodal sites are associated with?
Chronic inflammation
Gastric MALT-omas (marginal zone lymphomas) are associated with?
H. Pylori infection
What physical sign is seen with Hairy cell leukemia?
Massive splenomegaly
What markers are seen with Hairy Cell Leukemia?
CD25
CD11c
CD25 and CD11c could indicate?
Hairy Cell Leukemia
If a dry tap on aspiration is seen, what could cause this?
Hairy cell leukemia due to the induction of fibrosis
Neoplastic B cells have “hair like” projections with what leukemia?
Hairy cell Leukemia
B cell NON-hodgkin leukemias/lymphomas are all diagnose well with?
Flow cytometry