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Path Y > Haematology - Lymphoma 1: multidisciplinary > Flashcards

Haematology - 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 (MALT)
High grade: diffuse large B cell, mantle cell
Aggressive: Burkitts

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13
Q

What test can prove germinal centre origin of a lymphoma?

A

Positive staining for CD10 and bcl6
seen in Follicular lymphoma

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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

due to (macrophages containing dead apoptotic tumor cells).

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17
Q

Where does TCR gene recombination occur?

A

Bone marrow

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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

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20
Q

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

A

Adenosine-induced deaminase

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21
Q

Which lymphoma are coeliac’s predisposed to?

A

small cell EATL (enteropathy-associated t cell lymphoma)

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22
Q

What can PCR be used for in lymphoma diagnosis?

A

Identifying:

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

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

A

Mantle cell lymphoma

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24
Q

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

A

A better prognosis for aplastic large cell lymphoma

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25
Which lymphoma shows aberrant CD5 and cyclin D1 expression? who is commonly affected
Mantle cell lymphoma MANtle = middle aged man
26
Which type of lymphoma can cause either a jaw or abdominal mass?
Burkitt's lymphoma
27
Recall one good and one bad prognostic indicator in diffuse large B cell lymphoma?
Good: germinal centre phenotype Bad: p53 mutation
28
What is the grade of peripheral T cell lymphomas?
V aggressive
29
Which lymphoma is particularly common in Japan and the Caribbean? What infection is it linked to
Adult T cell leukaemia lymphoma HTLV-1 (human T-cell lymphotropic virus 1)
30
What is cutaneous T cell lymphoma known as?
Mycosis fungoides
31
Which age group tends to be affected by anaplastic large cell lymphoma?
Young adults
32
What is the t(2;5) translocation associated with?
Anaplastic large cell lymphoma
33
Which type of lymphoma is associated with ALK-1 expression?
Anaplastic large cell lymphoma ALK -1 = better prognosis
34
Which type of lymphoma is most likely to involve just one lymph node group?
Classical Hodgkin's
35
Which type of granulocyte will be present within a classical Hodgkin's lymphoma?
Eosinophil
36
Which type of lymphoma is associated with an isolated lymphadenopathy?
Nodular Lymphocyte predominant Hodgkin's lymphoma
37
Recall the subtypes of classical Hodgkin's lymphoma
Nodular sclerosing Mixed cellularity Lymphocyte rich/ depleted
38
Which type of Hodgkin's lymphoma would show B cell rich nodules?
Nodular lymphocyte-predominant lymphoma
39
Which type of lymphoma stains positively for CD15 and CD30?
Classical Hodgkin's
40
What is the biggest risk of radiotherapy in hodgkin's lymphoma for women?
Breast Ca
41
What is the translocation t(8;14) associated with?
Burkitt's lymphoma
42
What is the best chemotherapy for Burkitt's lymphoma?
Rituximab
43
The Durie-Salmon staging system is used for which type of malignancy?
Multiple myeloma
44
define lymphoma
neoplastic (malignant tumour) of lymphoid cells
45
give lymphoma of the skin
mycosis fundoides
46
is NHL or HL more common
NHL (80%)
47
give 4 types of lymphoid malignancy
ALL NHL (B lineage NHL (T & NK lineage Hodgkin
48
what cells in the mantle zone
nave unstimulated B cells
49
what cells in germinal centre
B cells APCs this is where B cells which bind antigen epitopes are selected and activated
50
CD19 and CD20 are markers of what cells
B
51
CD3 and CD5 are markers of what cell
T
52
SLL/CLL is positive for what 2 markers
CD5 CD23
53
burrkitt's lymphoma may be caused by what infection
EBV
54
give 4 types of T cell NHL
anapaestic large cell adult T cell leukaemia lymphoma (ATLL) enteropathy associated T cell cutaneous T cell
55
what cells are seen in histology of classical HL
reed sterberg (binucleate cells)
56
nodular lymphocyte predominant lymphoma is positive & negative for what markers
+ve for CD20 -ve for CD30 and CD15 (which are seen in classical)
57
of the HL, which of the two subtypes are more common
``` Classical HL (95%) nodular lymphocyte predominant (5%) ```
58
of the NHLs, which of the two lineages are more common
``` B cell (80%) T cell (20%) ```
59
which HL does not have an association wi HBV unlike the others
nodular lymphocyte predominant
60
give 2 differences of nodular lymphocyte predominant and classical HL
classical = EBV association, not in NLP classical = CD30 and CD15, not in NLP classical = see eosinophils and macrophages, not in NLP NLP can transform to a NHL

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