Exam 3 - CLL, Non-HL, Plasma Cell Disorders, and Hodgkin Lymphoma

Question 1

Plasma Cell Myeloma age and characteristics

Answer 1

50y.o
CRAB
Increased plasma cells
Lytic bone lesions
M protein

Question 2

M protein in Plasma Cell Myeloma

Answer 2

> 30 IgG, >25IgA

Question 3

Plasma Cell Myeloma smear findings

Answer 3

reuleaux formation

Monoclonal antibodies

Question 4

Monoclonal gammopathy of undetermined significance (MGUS)

Answer 4

PCM w/out bone lesions
NO CRAB
M protein (lower than PCM)
Precursor to PCM

Question 5

Solitary Plasmacytoma of Bone

Answer 5

Localized tumor (not in bone marrow)
Monoclonal plasma cells
Single bone lesion of monoclonal plasma cells
NO CRAB, M Protein, Normal polyclonal

Question 6

Extra Osseous Plasmacytoma

Answer 6

Localized tumors outside bone
Respiratory tract
NO CRAB, M Protein

Question 7

Types of Hodgkin’s Lymphoma

Answer 7

Nodular Lymphocyte Predominant
Classical Nodular Sclerotic
Classical Mixed Cellularity
Classical Lymphocyte Rich
Classical Lymphocyte Depleted

Question 8

Cell type affected in HL and CD markers

Answer 8

Germinal Center B-Cells
Reed-Sternberg Cells (ring cells double nuclei)
CD30, CD15

Question 9

Germinal Center markers

Answer 9

BCL6

CD10

Question 10

B Cell markers

Answer 10

CD19, CD22, CD23
CD 20 (mature)

Question 11

T Cell markers

Answer 11

CD3, CD4/8, CD5, CD7

Question 12

Non-HL Lymphoid Neoplasms

Answer 12

CLL/SLL
Follicular Lymphoma
Mantle Cell Lymph
Burkitt's Lymphoma
Diffuse Large B-Cell Lymphoma

Question 13

Nodular Sclerotic CHL

Answer 13

Thick fibrotic network
Above diaphragm
Tickened LN capsule - lots of collagen
Lacunar cells
Eosinophils and EBV

Question 14

Mixed Cellularity CHL

Answer 14

Below or both sides diaphragm
No collagen (no fibrosis)
Lacunar cells

Question 15

Lymphocyte Depleted CHL

Answer 15

Anaplastic and bizarre RS cells

Question 16

Chronic Lymphocytic Lymphoma and Small Lymphocytic Lymphoma

Answer 16

Mature B-Cell
CLL = blood
SLL = LN
Lymphocytosis

Question 17

CLL/SLL smear and markers

Answer 17

smudge and basket cells
prolymphocytes
effacement of nodal architectyure
CD5, CD19, CD23
Good prog: CD38-, ZAP70-

Question 18

CLL/SLL Cytogenetics

Answer 18

Deletion 13q14, 11q22, 17p13

Trisomy 12

Question 19

Follicular Lymphoma (FL)

Answer 19

60y.o
Germinal center B cells
Centrocytes
Centroblasts

Question 20

FL smear and markers

Answer 20

Effacement of nodal architecture
Uniform and close together
No light/dark zones
No tingible body macrophages
BCL2+, CD19, CD20
CD10, BCL6

Question 21

FL Cytogenetics

Answer 21

t(14;18)

Question 22

Reactive Follicular Hyperplasia

Answer 22

Loose follicles
Polymorphic
Prominent mantle zones
Polarized follices
Tingible body macrophages
BCL2-

Question 23

Mantle Cell Lymphoma characteristics, markers, cytogenetics

Answer 23

60y.o
B-cells (resemble centrocytes)
BCL1+
CD19, CD20
CD5
CD23-, CD10-, BCL6-
t(11;14)
Effacement and aggressive

Question 24

Burkitt’s Lymphoma types

Answer 24

Endemic (EBV+, jaw) - younger
Sporadic (ileocecal, GI) - older kids
Immunodeficient (AIDS)

Question 25

Burkitt’s Lymphoma smear

Answer 25

Total effacement
Starry sky
Lipid vaculoes
Squared off borders (basophilic cytoplasm)

Question 26

Burkitt’s Lymphoma markers and cytogenetics

Answer 26

MYC
CD19, CD20
BCL2, CD5, CD23, TdT all negative
t(8;14)

Question 27

Diffuse Large B-cell Lymphoma

Answer 27

Most common
64y.o
Subtypes: morphology, location, gene expression profiling
Complete effacement all light
Coagulative necrosis
CD19, CD20