Haematological Malignancy

Question 1

Immune system centres

Answer 1

Primary
Secondary
Tertiary

Question 2

Primary immune centre

Answer 2

Marrow

Thymus

Question 3

Secondary immune centre

Answer 3

Lymphoid follicles and T zone
Spleen
GI

Question 4

Tertiary immune centre

Answer 4

Genital tract
Skin
T cells patrol surfaces

Question 5

Blood cell development

Answer 5

Stem cell–> Myeloid and lymphoid stem cells

I. Myeloid Pathway

Myeloid stem cell to

1. Red blood cells
2. Platelets
3. Myeloblasts –> granulocytes (eosoniphil, neutrophil, basophil)

II. Lymphoid pathway

Lymphoid stem cell--> lymphoblast 
Lymphoblast to 
1. B-cells
2. T-cells
3. Natural killer cells

Question 6

B cell formation site

Answer 6

Marrow

Question 7

B cell maturation site

Answer 7

Marrow

Question 8

T cell formation site

Answer 8

Marrow

Question 9

T cell maturation site

Answer 9

Thymus

Question 10

Layers of B lymphoid follicles

Answer 10

Germinal cell - B cells activated
Mantle zone - naive B cells reside
Marginal zone - memory B cells reside

Question 11

Maturation of naive B cells

Answer 11

Antigen presentation to them
Somatic Hyper Mutation
Differentiate to Memory B cells or Plasma cells

Question 12

Plasma cells

Answer 12

Produce antibodies

Question 13

MALT

Answer 13

Mucosa Associated Lymphoid Tissue

Question 14

MALT definition

Answer 14

Site for local immunity

Question 15

Subsequent process following antigen presentation to gut

Answer 15

1) M cells on epithelium take up antigen
2) Dendritic cells pick up antigen and present to T cells
3) T cells activate B cells
4) B cells migrate to mesenteric lymph node
5) Plasma cells to tissue via endothelial venules
6) Plasma cells secrete IgA

Question 16

Grade of a tumour

Answer 16

Appearance under microscope

Cell morphology

Question 17

Stage of tumour

Answer 17

Invasion of tumour

Question 18

EBV associated lymphoma

Answer 18

Burkit

Hodgkin

Question 19

HTLV1 associated lymphoma

Answer 19

T cell non Hodgkin lymphoma

Question 20

Human Herpes virus 8 associated lymphoma

Answer 20

Kaposi sarcoma

Plasma cell malignancy

Question 21

Hep C associated lymphoma

Answer 21

B cell non Hodgkin lymphoma

Question 22

B cell neoplasm classification

Answer 22

1) Central - B lymphoblastic lymphoma/leukaemia

2) Peripheral

Question 23

Peripheral B cell neoplasms

Answer 23

1) Pre-germinal centre (GC) neoplasm
2) GC neoplasm
3) Post-GC neoplasm

Question 24

Pre-germinal centre neoplasm

Answer 24

Mantle cell lymphoma

Question 25

Germinal centre neoplasms

Answer 25

Follicular lymphoma
Hodgkin lymphoma
Burkit lymphoma

Question 26

Post-germinal centre neoplasms

Answer 26

MALT lymphoma

Myeloma

Question 27

T cell neoplasm classification

Answer 27

I. T-lymphoblastic lymphoma/leukaemia

II. Peripheral (mature) T cell/ natural killer cell lymphoma/leukaemia

Question 28

CD4 T cells

Answer 28

Respond to MHC-II

Help B cells produce antibodies

Question 29

MHC-II location

Answer 29

Found on antigen presenting cells

Question 30

CD8 T cells

Answer 30

Respond to MHC-I

Kills foreign cells (unlucky Kav)

Question 31

MHC-I location

Answer 31

Found on all self cells

Question 32

Hodgkin lymphoma definition

Answer 32

Nodal enlargement + B symptoms

Question 33

Hodgkin lymphoma epidemiology

Answer 33

Very young

Very old

Question 34

Hodgkin lymphoma associated virus

Answer 34

EBV

Question 35

Hodgkin lymphoma histology

Answer 35

Reed sternberg cells (malignant cells)

Inflammatory infiltrate

Question 36

Features of Reed sternberg cells

Answer 36

Large atypical, binucleated cells

Prominent red nucleolus