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Year 5 - Pathology ICSM1 > Haematology 10 - Lymphoma 1: multidisciplinary > Flashcards

Haematology 10 - Lymphoma 1: multidisciplinary Flashcards

1
Q

What is multiple myeloma a malignancy of?

A

Plasma cells

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2
Q

Why do bacterial infections and autoimmune disorders increase lymphoma risk?

A

Constant antigenic stimulation

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3
Q

Why do viral infections increase lymphoma risk?

A

Direct viral integration of lymphocytes

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4
Q

Which lymphoma does Sjorgen’s syndrome increase risk of?

A

Marginal zone lymphoma of the parotid

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5
Q

Which lymphoma does Hashimoto’s syndrome increase risk of?

A

Marginal zone lymphoma of the thyroid

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6
Q

How is HTLV1 transmitted, and which cancer does it increase risk of?

A

A retrovirus that is transmitted at birth, and increases risk of adult T cell leukaemia lymphoma

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7
Q

Which type of cells are infected by EBV?

A

B cells

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8
Q

How are EBV-expressing B cells usually eliminated?

A

Cytotoxic T cell function

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9
Q

What type of lymphoma does h pylori infection predispose to?

A

Gastric MALT

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10
Q

Burkitt lymphoma expresses high level of c-myc oncoprotein, why?

A

Recombination error: on chromosome 14
IgH promotor usually promotes Ig heavy chain production
Mutation in IgH promoter –> c-myc promotion
Mutation is t(8;14)

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11
Q

What are the 2 broad subtypes of Non-Hodgkins lymphoma?

A

B and T cell type

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12
Q

What are the subtypes of B cell NHL?

A

Low grade: follicular, small lymphocytic, marginal zone
High grade: diffuse large cell, Burkitt’s
Aggressive: mantle cell

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13
Q

What test can prove germinal centre origin of a lymphoma?

A

Positive staining for CD10 and bcl6 (Follicular, DLBCL, Burkitts lymphomas)

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14
Q

What is the classification of Burkitt’s lymphoma

A

High grade peripheral B cell lymphoma

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15
Q

What gene mutation is associated with follicular lymphoma?

A

t(14;18) - it causes overexpression of the bcl-2 gene

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16
Q

Which lymphoma typically has a ‘starry sky appearance’ on histology?

A

Burkitt’s lymohoma

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17
Q

Where does TCR gene recombination occur?

A

Thymus

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18
Q

What are the key enzymes involved in VDJ (TCR gene) recombination?

A

RAG1 and RAG2

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19
Q

What are the 2 methods of gene recombination in B cells?

A

Class switching

Somatic hypermutation

20
Q

What is the key enzyme involved in B cell class switching and somatic hypermutation?

A

Activation-induced cytidine deaminase (AID)

21
Q

Which lymphoma are coeliac’s predisposed to?

A

EATL (enteropathy-associated t cell lymphoma)

22
Q

What can PCR be used for in lymphoma diagnosis?

A

Identifying:

  1. Translocations
  2. TCR rearrangement
  3. IG gene rearrangement
23
Q

What is the translocation t(11;14) diagnostic of?

A

Mantle cell lymphoma

24
Q

What is the translocation of t(2;5) associated with?

A

A better prognosis for anaplastic large cell lymphoma (T-cell NHL)

(Typically in young boys)

(2 types of ALCL- cutaneous (skin lumps,lesions etc, and systemic (more aggressive)

ALK-1 protein expression

25
Q

Which lymphoma shows aberrant CD5 and cyclin D1 expression?

A

Mantle cell lymphoma

26
Q

Which type of lymphoma can cause either a jaw or abdominal mass?

A

Burkitt’s lymphoma

27
Q

Recall one good and one bad prognostic indicator in Burkitt’s lymphoma?

A

Good: germinal centre phenotype
Bad: p53 mutation

28
Q

What is the grade of peripheral T cell lymphomas?

A

V aggressive

29
Q

Which lymphoma is particularly common in Japan and the Caribbean?

A

Adult T cell leukaemia lymphoma

30
Q

What is cutaneous T cell lymphoma known as?

A

Mycosis fungoides

31
Q

Which age group tends to be affected by anaplastic large cell lymphoma?

A

Young adults

32
Q

What is the t(2;5) translocation associated with?

A

Good prognosis in anaplastic large cell lymphoma (cells typically cd30+)

33
Q

Which type of lymphoma is associated with ALK-1 expression?

A

Anaplastic large cell lymphoma

34
Q

Which type of lymphoma is most likely to involve just one lymph node group?

A

Classical Hodgkin’s

35
Q

Which type of granulocyte will be present within a classical Hodgkin’s lymphoma?

A

Eosinophil

36
Q

Which type of lymphoma is associated with an isolated lymphadenopathy?

A

Nodular Lymphocyte predominant Hodgkin’s lymphoma

37
Q

Recall the subtypes of classical Hodgkin’s lymphoma

A

Nodular sclerosing
Mixed cellularity
Lymphocyte rich/ depleted

38
Q

Which type of Hodgkin’s lymphoma would show B cell rich nodules?

A

Nodular lymphocyte-predominant lymphoma

popcorn cells on blood film/histology

39
Q

Which type of lymphoma stains positively for CD15 and CD30?

A

Hodgkin’s
-ve for CD20
Also typically have reed-sternberg cells (Owl-eyes)
Hodgkin’s typically associated with EBV (except for nodular lymphocyte predominant)

40
Q

What is the biggest risk of radiotherapy in hodgkin’s lymphoma for women?

A

Breast Ca

41
Q

What is the translocation t(8;14) associated with?

A

Burkitt’s lymphoma

42
Q

What is the best chemotherapy for Burkitt’s lymphoma?

A

Rituximab

43
Q

What is the histological finding of “angular nuclei” pathognemonic for?

A

Mantle cell lymphoma

44
Q

The Durie-Salmon staging system is used for which type of malignancy?

A

Multiple myeloma

45
Q

What CD markers do CLL/Small lymphocytic lymphoma stain for

A

CD5, CD19, CD23

(CD5 should never be seen in a normal mature b-cell)

CLL/SLL can transform into higher grade lymphoma (Richter transformation)

46
Q

what malignancy are clover-leaves/flower cells pathognomic of

A

Adult T Cell Leukaemia/Lymphoma

47
Q

Anaplastic large cell lymphoma CD marker

A

typically positive for CD30

Year 5 - Pathology ICSM1 (85 decks)

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