Haematology 10 - Lymphoma 1: multidisciplinary Flashcards
What is multiple myeloma a malignancy of?
Plasma cells
Why do bacterial infections and autoimmune disorders increase lymphoma risk?
Constant antigenic stimulation
Why do viral infections increase lymphoma risk?
Direct viral integration of lymphocytes
Which lymphoma does Sjorgen’s syndrome increase risk of?
Marginal zone lymphoma of the parotid
Which lymphoma does Hashimoto’s syndrome increase risk of?
Marginal zone lymphoma of the thyroid
How is HTLV1 transmitted, and which cancer does it increase risk of?
A retrovirus that is transmitted at birth, and increases risk of adult T cell leukaemia lymphoma
Which type of cells are infected by EBV?
B cells
How are EBV-expressing B cells usually eliminated?
Cytotoxic T cell function
What type of lymphoma does h pylori infection predispose to?
Gastric MALT
Burkitt lymphoma expresses high level of c-myc oncoprotein, why?
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)
What are the 2 broad subtypes of Non-Hodgkins lymphoma?
B and T cell type
What are the subtypes of B cell NHL?
Low grade: follicular, small lymphocytic, marginal zone
High grade: diffuse large cell, Burkitt’s
Aggressive: mantle cell
What test can prove germinal centre origin of a lymphoma?
Positive staining for CD10 and bcl6
What is the classification of Burkitt’s lymphoma
High grade peripheral B cell lymphoma
What gene mutation is associated with follicular lymphoma?
t(14;18) - it causes overexpression of the bcl-2 gene
Which lymphoma typically has a ‘starry sky appearance’ on histology?
Burkitt’s lymohoma
Where does TCR gene recombination occur?
Bone marrow
What are the key enzymes involved in VDJ (TCR gene) recombination?
RAG1 and RAG2
What are the 2 methods of gene recombination in B cells?
Class switching
Somatic hypermutation
What is the key enzyme involved in B cell class switching?
Adenosine-induced deaminase
Which lymphoma are coeliac’s predisposed to?
EATL (enteropathy-associated t cell lymphoma)
What can PCR be used for in lymphoma diagnosis?
Identifying:
- Translocations
- TCR rearrangement
- IG gene rearrangement
What is the translocation t(11;14) diagnostic of?
Mantle cell lymphoma
What is the translocation of t(2;5) associated with?
A better prognosis for aplastic large cell lymphoma
Which lymphoma shows aberrant CD5 and cyclin D1 expression?
Mantle cell lymphoma
Which type of lymphoma can cause either a jaw or abdominal mass?
Burkitt’s lymphoma
Recall one good and one bad prognostic indicator in Burkitt’s lymphoma?
Good: germinal centre phenotype
Bad: p53 mutation
What is the grade of peripheral T cell lymphomas?
V aggressive
Which lymphoma is particularly common in Japan and the Caribbean?
Adult T cell leukaemia lymphoma
What is cutaneous T cell lymphoma known as?
Mycosis fungoides
Which age group tends to be affected by anaplastic large cell lymphoma?
Young adults
What is the t(2;5) translocation associated with?
Anaplastic large cell lymphoma
Which type of lymphoma is associated with ALK-1 expression?
Anaplastic large cell lymphoma
Which type of lymphoma is most likely to involve just one lymph node group?
Classical Hodgkin’s
Which type of granulocyte will be present within a classical Hodgkin’s lymphoma?
Eosinophil
Which type of lymphoma is associated with an isolated lymphadenopathy?
Nodular Lymphocyte predominant Hodgkin’s lymphoma
Recall the subtypes of classical Hodgkin’s lymphoma
Nodular sclerosing
Mixed cellularity
Lymphocyte rich/ depleted
Which type of Hodgkin’s lymphoma would show B cell rich nodules?
Nodular lymphocyte-predominant lymphoma
Which type of lymphoma stains positively for CD15 and CD30?
Hodgkin’s
What is the biggest risk of radiotherapy in hodgkin’s lymphoma for women?
Breast Ca
What is the translocation t(8;14) associated with?
Burkitt’s lymphoma
What is the best chemotherapy for Burkitt’s lymphoma?
Rituximab
What is the histological finding of “angular nuclei” pathognemonic for?
Mantle cell lymphoma
The Durie-Salmon staging system is used for which type of malignancy?
Multiple myeloma