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DMD 5247 > Bikman - Lymphoma > Flashcards

Bikman - Lymphoma Flashcards

1
Q

What is a prominent feature of lymphoma?

A

Lymphadenopathy

Can also happen with simple infections

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2
Q

What are the two types of lymphomas?

A

Hodgkin

Non-Hodgkin

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3
Q

What are characteristics of non-Hodgkin?

A
  • Malignant proliferation of lymphoid cells in peripheral lymph nodes
  • Skips around
  • Extranodal involvement is common
  • Many subtypes
  • Most are B cell
  • > 40yo
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4
Q

What are characteristics of Hodgkin?

A
  • Younger patients
  • Good prognosis
  • Contiguous spread
  • Five subtypes
  • Reed-Sternberg cells
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5
Q

What are symptoms of non-Hodgkin lymphoma?

A
  • Painless, firm lymphadenopathy
  • Extranodal manifestations, such as gingival and palatal lesions
  • “B” symptoms: weight loss, night sweats, fever
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6
Q

In which lymphoma might you find gingival and/or palatal lesions?

A

non-Hodgkin’s (extranodal manifestations)

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7
Q

What are the two types of non-Hodgkin lymphomas?

A

Low-Grade

  • Older patients
  • Indolent (incurable)
  • Small, mature cells
  • Non-destructive

High-Grade

  • Younger patients
  • Aggressive (curable?)
  • Large, distinct cells
  • Destructive
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8
Q

What is the most notable difference between non-Hodgkin and Hodgkin lymphoma?

A

The Reed-Sternberg cells in Hodgkin lymphoma - these spread in a contiguous manner, so it’s easier to get rid of

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9
Q

What are the 4 different types of low-grade non-Hodgkin lymphomas?

A
  • Small lymphocytic lymphoma
  • Malt lymphoma
  • Follicular lymphoma
  • Mycosis fungoides
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10
Q

What are the 3 different types of high-grade non-Hodgkin lymphomas?

A
  • Large cell lymphoma
  • Lymphoblastic lymphoma
  • Burkitt lymphoma
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11
Q

What are the features of small lymphocytic lymphoma?

A

Low-grade non-Hodgkin

  • Small, mature lymphocytes
  • Same thing as CLL
  • CD5+
  • Long course; infections are lethal

Expanding in the lymph nodes, rather than the blood

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12
Q

What are the features of malt lymphoma?

A

Low-grade non-Hodgkin

  • Occurs in Mucosa-Associated Lymphoid Tissue
  • Associated with H. pylori
  • Caught early, can be cured with antibiotics
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13
Q

What are the features of follicular lymphoma?

A

Low-grade non-Hodgkin

  • Follicular pattern (diffuse later)
  • Small cleaved cell “centroblast”
  • Grade 1-3 (based upon how many centroblasts you see)

Translocation at 14, 18 - bcl2

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14
Q

What are the different stages of follicular lymphoma?

A
  1. Single node
  2. Two or more nodes on the same side of the diaphragm
  3. Lymph nodes on both sides of diaphragm
  4. Diffuse extranodal involvement
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15
Q

What is the survival rate in the different stages of follicular lymphoma?

A

1 & 2 - 90% 5 year survival

3 & 4 - 40% 5 year survival

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16
Q

Follicular lymphoma: A & B?

A 
A = no additional symptoms
B = weight loss, night sweats, fever
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17
Q

What lymphoma are centroblasts characteristic of?

A

Follicular lymphoma (low-grade non-Hodgkin)

18
Q

What are features of mycosis fungoides/sezary syndrome?

A

Low-grade non-Hodgkin

  • Skin lesions - lymphocytes causing cutaneous tumors
  • Blood involvement
  • Cerebriform lymphocytes - cleaves in lymphocytes
  • T-cell immunophenotype
  • *T-cell expansion
19
Q

What are features of large cell lymphoma?

A
  • Large B cells
  • Extranodal involvement
  • Grows rapidly
  • Bad prognosis (spreads rapidly)
20
Q

What are features of lymphoblastic lymphoma?

A
  • Typical patient: teenage male with mediastinal mass

- Same as ALL

21
Q

What are features of Burkitt lymphoma?

A

High-grade non-Hodgkin

  • Children, young adults
  • Strong ethnic (African) preference
  • Fast-growing, extranodal mass
  • Starry sky pattern (same as B-cell ALL)
  • Genetics
  • – Highly associated with c-myc gene translocation
  • – Tumor cells often infected with EBV

Translocation between chromosomes 8, 14

22
Q

Which lymphoma has a translocation between chromosomes 8, 14?

A

High grade, non-Hodgkin

Burkitt

23
Q

What are some features of Hodgkin lymphoma?

A
  • Large lymph nodes
  • Younger patients (~30yo)
  • Good prognosis
  • Contiguous spread (often involves abdominal organs)
  • Can be a consequence of EBV
  • Reed-Sternberg cells (multi-nucleated giant cells)
  • 5 subtypes
24
Q

What lymphomas can be caused by EBV?

A
  • Hodgkin, as a consequence of EBV

Burkitt’s tumor cells are INFECTED with RBV

25
Q

What are the different subtypes of Hodgkin lymphoma?

A
  1. Nodular sclerosis
  2. Mixed cellularity
  3. Lymphocyte rich
  4. Lymphocyte depleted
  5. Lymphocyte predominance
26
Q

Which of the 5 subtypes of Hodgkin lymphomas are classified as classic and why?

A

1-4 due to morphologic and immunophentotypic similarities

27
Q

Which of the 5 subtypes of Hodgkin lymphomas are classified as non-classic and why?

A

5

28
Q

Which of the 5 subtypes of Hodgkin lymphomas are the most common?

A
  1. Nodular sclerosis
  2. Mixed cellularity
  3. Lymphocyte predominance
29
Q

What is nodular sclerosis?

A

Hodgkin

  • One of the most common
  • Collagen splitting tumors into distinct nodes; lymph nodes are hardening
  • Reed-Sternberg cells are called “lacunar cells”
30
Q

What is mixed cellularity?

A

Hodgkin

  • One of the most common
  • RS cells surrounded by eosinophils, lymphocytes, histiocytes
31
Q

What is lymphocyte predominance?

A

Hodgkin

  • One of the most common
  • Nodules contain predominately small lymphocytes with histiocytes and RS cells
32
Q

What are features of multiple myeloma?

A
  • Malignant proliferation of plasma cells
  • Monoclonal gammopathy
  • Decreased normal immunoglobulins
  • Osteolytic lesions - bone loss
33
Q

What are manifestations of multiple myeloma?

A
  • Weakness
  • Infections
  • Renal failure
  • Bone pain
  • Hypercalcemia
  • Bence-Jones proteins in urine
34
Q

What is multiple myeloma?

A

Expansion of plasma cells. Very involved with producing antibodies.

35
Q

What are features of multiple myeloma?

A
  • Malignant proliferation of plasma cells
  • Monoclonal gammopathy
  • Decreased normal immunoglobulins
  • Osteolytic lesions
36
Q

What are manifestations of multiple myeloma?

A
  • Weakness
  • Infections
  • Renal failure (excess Ca2+)
  • Bone pain
  • Hypercalcemia
  • Bence-Jones proteins in urine
37
Q

In what myeloma might you find Bench-Jones proteins in the urine?

A

Multiple myeloma

38
Q

Multiple myeloma acronym?

A

CRAB

C - Ca2+ elevation
R - Renal failure
A - Anemia
B - Bone lytic lesions

39
Q

Multiple myeloma treatment?

A

Chemo and radiation
Bone marrow transplant

20% 5yr survival (with chemo)

40
Q

Which of the following lymphomas usually involve abdominal organs and is closely linked to the Epstein-Barr virus?

A. Non-Hodgkin lymphoma
B. Hodgkin lymphoma
C. Mantle Cell lymphoma
D. Burkitt's lymphoma
E. Follicular lymphoma
A

B. Hodgkin lymphoma

DMD 5247 (7 decks)

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