Chapter 11- Non-Hodgkin Lymphoma/Leukemia (NHL) Flashcards
Acute lymphoblastic
leukemia/lymphoma (ALL)
Pathologic Cells
MC pre-B cells, but pre-T cells are possible (lymphoma)
Acute lymphoblastic
leukemia/lymphoma (ALL)
Patients
Children and adolescents
a) Pre-B cells: age 4
b) Pre-T cells: age
15-20
Acute lymphoblastic
leukemia/lymphoma (ALL)
Unique Features
Aggressive, represents 80% of childhood leukemia diagnosis.
Marrow suppression with
pancytopenia is common, bone pain, generalized lymphadenopathy, fever,
hepatosplenomegaly
Acute lymphoblastic
leukemia/lymphoma (ALL)
Prognosis
Improved prognosis: females, age 2-10
Most (80%) cured following chemotherapy
Chronic lymphocytic
leukemia (CLL) /small
lymphocytic lymphoma (SLL)
Pathologic Cells
Mature B cells
Chronic lymphocytic
leukemia (CLL) /small
lymphocytic lymphoma (SLL)
Patients
Older adults, average age at diagnosis is age 60, males are twice as likely to develop CLL
Chronic lymphocytic
leukemia (CLL) /small
lymphocytic lymphoma (SLL)
Unique Features
Most common leukemia of
adults.
Indolent course, commonly associated with immune abnormalities (hypogammaglobulinemia).
CLL is more common than SLL and primarily involves marrow
SLL = < 4,000 lymphocytes/μL and involves lymph nodes
Displaces normal marrow and produces pancytopenia
Chronic lymphocytic
leukemia (CLL) /small
lymphocytic lymphoma (SLL)
Prognosis
Variable life expectancy, median is 4-6 years after diagnosis
Follicular lymphoma
Pathologic Cells
Mature B cells
Follicular lymphoma
Patients
Adults > age 50
Follicular lymphoma
Unique Features
t(14,18), abnormal BCL2 gene that promoted B cell survival, 40% of non-Hodgkin lymphomas, may transition to
diffuse large B cell lymphoma (DLBCL), painless generalized
lymphadenopathy, centrocytes
Follicular lymphoma
Prognosis
Median survival is 7-9 years after diagnosis, incurable
Prognosis is much worse with DLBCL transition: ~1 year
Mantle cell lymphoma
Pathologic Cells
Mature B cells
Mantle cell lymphoma
Patients
Adults > age 50,
males
Mantle cell lymphoma
Unique Features
t(11;14), cyclin D1 dysfunction,
abnormal B cells are found in mantle zones of lymph nodes
Mantle cell lymphoma
Prognosis
Median survival is 3-5 years after diagnosis, incurable
Diffuse large B cell lymphoma
Pathologic Cells
Mature B cells
Diffuse large B cell lymphoma
Patients
Most commonly
adults (age 60), but
is also 15% of
lymphomas in kids
Diffuse large B cell lymphoma
Unique Features
Most common lymphoma of adults, aggressive, large cellular morphology
Diffuse large B cell lymphoma
Prognosis
Rapidly fatal without Tx.
(chemotherapy), 80% go into remission with chemo., 50% of
those treated are eventually cured
Burkitt lymphoma
Pathologic Cells
Mature B cells
Burkitt lymphoma
Patients
Children in Africa
Burkitt lymphoma
Unique Features
Once of the fastest growing tumors, extranodal sites are
commonly involved (e.g.
mandible, maxillae), past EBV infection is a risk factor, “starry sky” cellular appearance, MYC gene mutations
Burkitt lymphoma
Prognosis
Most patients are cured following aggressive chemotherapy
Multiple myeloma
Pathologic Cells
Plasma cells
Multiple myeloma
Patients
Older adults, average Dx. is age 70, males, individuals of African descent
Multiple myeloma
Unique Features
Progressive features, myeloma nephrosis from Bence-Joens proteins, M-spike, “punched out” osteolytic lesions of the
vertebrae and calvaria,
pathologic fracture, bone pain, hypercalcemia, anemia
Multiple myeloma
Prognosis
Survival is 4-6 years after diagnosis,
incurable
