B-cell NON-Hodgkin & Precursor B/T cell Leukemias/Lymphomas

Question 1

Leukemias involve cells in the?

Answer 1

Bone marrow/blood

Question 2

Lymphomas involve cells in the?

Answer 2

Lymph nodes

Question 3

Lymphoid neoplasias involve what cell types?

Answer 3

B and T cells

Question 4

What is the most common cancer of kids?

Answer 4

(ALL) = Acute Lymphoblastic Leukemia/Lymphoma

Question 5

Symptoms of Acute Lymphoblastic Leukemia/Lymphoma (ALL)?

Answer 5

SUDDEN onset:

• Fever
• Fatigue
• Pain
• Bleeding/Bruising
• Headache and Nausea

Question 6

Normally, a lymphoid stem cell creates?

Answer 6

B and T cells

Question 7

With Acute Lymphoblastic Leukemia/Lymphoma, mutations in the lymphoid stem cell cause what to accumulate?

Answer 7

Blasts!
“ Leukemic stem cells”
- Maturation arrest and self-renewal capacity

Question 8

Due to their densely packed nature, when attempting to aspirate out cells with Acute Lymphoblastic Leukemia/Lymphoma, how is it described?

Answer 8

Sludge-y

Question 9

How do the cells look with ALL (Acute Lymphoblastic Leukemia/Lymphoma)?

Answer 9

Dark, large and low cytoplasm

Question 10

What markers can be expressed for cells with ALL (Acute Lymphoblastic Leukemia/Lymphoma)?

Answer 10

TdT
B cells: CD19, CD20, CD10, PAX-5
T cells: anything below CD10

Question 11

What 4 factors will give a good prognosis for ALL (Acute Lymphoblastic Leukemia/Lymphoma)?

Answer 11

Age: 2-10
LOW peripheral WBC count
Hyperdiploidy
t(12;21)

Question 12

What factors will give a worse prognosis for ALL (Acute Lymphoblastic Leukemia/Lymphoma)?

Answer 12

Age < 2 or into adolescence/adulthood

HIGH peripheral WBC count

Question 13

What is the treatment for ALL (Acute Lymphoblastic Leukemia/Lymphoma)?

Answer 13

Intrathecal chemotherapy

Question 14

Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) is a type of?

Answer 14

B-cell NON-Hodgkin Leukemia/Lymphoma

Question 15

Patient population and symptoms with CLL/SLL (Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma)

Answer 15

Older patients, either Asymptomatic or Fatigued

Question 16

What does a peripheral smear show for CLL/SLL?

Answer 16

Lymphocytosis (increased lymphocytes)
Small and mature lymphocytes
Possibly smudge cells

Question 17

What Cluster Designations will be present with CLL/SLL?

Answer 17

CD19/20 AND CD5+

Question 18

CD19/CD20+ AND CD5+ could indicate?

Answer 18

CLL/SLL

Question 19

What is the Richter Transformation?

Answer 19

CLL/SLL transforming into an AGGRESSIVE tumor

Question 20

Mutations with ______ can cause the Richter Transformation of CLL/SLL

Answer 20

TP53 or MYC

Question 21

What translocation is involved with Follicular Lymphoma?

Answer 21

t(14;18)

= IgH gene next to BCL-2

Question 22

t(14;18) - IgH gene next to BCL-2

Answer 22

Follicular Lymphoma

Question 23

Symptoms of Follicular Lymphoma?

Answer 23

Painless lymphadenopathy

Question 24

Follicular Lymphoma may look similar to Follicular Hyperplasia. What is Follicular Lymphoma positive for that Follicular Hyperplasia is NOT?

Answer 24

BCL-2

Question 25

Follicular Lymphoma is graded 1-3. Grade 3 represents?

Answer 25

More large centroblasts

Question 26

Diffuse Large B cell Lymphoma has what physical sign?

Answer 26

Large masses in lymph node or spleen

Question 27

What are 2 types of Diffuse Large B cell Lymphoma?

Answer 27

1. Immunodeficiency related - Linked to EBV 2. Primary effusion lymphoma - HHV-8

Question 28

What is over expressed with Diffuse Large B cell Lymphoma?

Answer 28

BCL-6

Question 29

Over expression of BCL-6?

Answer 29

Diffuse Large B cell Lymphoma

Question 30

"starry sky" pattern

Answer 30

Burkitt Lymphoma

Question 31

What produces the "stars" in the "starry sky" pattern of Burkitt Lymphoma?

Answer 31

Tingible body macrophages

Question 32

What are tingible body macrophages present with Burkitt lymphoma?

Answer 32

They are clearing the cell debris produced from the EXTREMELY FAST growing tumor

Question 33

What translocation is present with Burkitt Lymphoma?

Answer 33

t(8;14) | - IgH gene next to MYC

Question 34

t(8:14) - IgH next to MYC

Answer 34

Burkitt Lymphoma

Question 35

What marker shows high proliferation index for Burkitt Lymphoma?

Answer 35

Ki-67

Question 36

What are 3 types of Burkitt Lymphoma?

Answer 36

1. Endemic African Burkitt Lymphoma - Mandibular growth and EBV present 2. HIV-related 3. Sporadic

Question 37

Mandibular growth and EBV present are often seen with?

Answer 37

Endemic African Burkitt Lymphoma

Question 38

What translocation is present with Mantle Cell Lymphoma?

Answer 38

t(11;14) - IgH gene next to Cyclin D1

Question 39

t(11;14) - IgH next to Cyclin D1

Answer 39

Mantle Cell lymphoma

Question 40

What physical sign may be present with Mantle cell lymphoma?

Answer 40

Lymphomatoid polyposis | - intestinal mucosal lesions

Question 41

Lymphomatoid polyposis may be present with?

Answer 41

Mantle cell lymphoma

Question 42

What 2 sites can Marginal Zone Lymphomas arise in?

Answer 42

Lymph nodes | Extra-nodal sites = MALT-omas

Question 43

Marginal zone lymphomas that arise in extra-nodal sites are associated with?

Answer 43

Chronic inflammation

Question 44

Gastric MALT-omas (marginal zone lymphomas) are associated with?

Answer 44

H. Pylori infection

Question 45

What physical sign is seen with Hairy cell leukemia?

Answer 45

Massive splenomegaly

Question 46

What markers are seen with Hairy Cell Leukemia?

Answer 46

CD25 | CD11c

Question 47

CD25 and CD11c could indicate?

Answer 47

Hairy Cell Leukemia

Question 48

If a dry tap on aspiration is seen, what could cause this?

Answer 48

Hairy cell leukemia due to the induction of fibrosis

Question 49

Neoplastic B cells have "hair like" projections with what leukemia?

Answer 49

Hairy cell Leukemia

Question 50

B cell NON-hodgkin leukemias/lymphomas are all diagnose well with?

Answer 50

Flow cytometry