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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
Q

Which lymphoma shows aberrant CD5 and cyclin D1 expression? who is commonly affected

A

Mantle cell lymphoma
MANtle = middle aged man

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 diffuse large B cell 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? What infection is it linked to

A

Adult T cell leukaemia lymphoma
HTLV-1 (human T-cell lymphotropic virus 1)

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

Anaplastic large cell lymphoma

33
Q

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

A

Anaplastic large cell lymphoma
ALK -1 = better prognosis

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

39
Q

Which type of lymphoma stains positively for CD15 and CD30?

A

Classical Hodgkin’s

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

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

A

Multiple myeloma

44
Q

define lymphoma

A

neoplastic (malignant tumour) of lymphoid cells

45
Q

give lymphoma of the skin

A

mycosis fundoides

46
Q

is NHL or HL more common

A

NHL (80%)

47
Q

give 4 types of lymphoid malignancy

A

ALL
NHL (B lineage
NHL (T & NK lineage
Hodgkin

48
Q

what cells in the mantle zone

A

nave unstimulated B cells

49
Q

what cells in germinal centre

A

B cells
APCs
this is where B cells which bind antigen epitopes are selected and activated

50
Q

CD19 and CD20 are markers of what cells

A

B

51
Q

CD3 and CD5 are markers of what cell

A

T

52
Q

SLL/CLL is positive for what 2 markers

A

CD5
CD23

53
Q

burrkitt’s lymphoma may be caused by what infection

A

EBV

54
Q

give 4 types of T cell NHL

A

anapaestic large cell
adult T cell leukaemia lymphoma (ATLL)
enteropathy associated T cell
cutaneous T cell

55
Q

what cells are seen in histology of classical HL

A

reed sterberg (binucleate cells)

56
Q

nodular lymphocyte predominant lymphoma is positive & negative for what markers

A

+ve for CD20
-ve for CD30 and CD15 (which are seen in classical)

57
Q

of the HL, which of the two subtypes are more common

A 
Classical HL (95%) 
nodular lymphocyte predominant (5%)
58
Q

of the NHLs, which of the two lineages are more common

A 
B cell (80%) 
T cell (20%)
59
Q

which HL does not have an association wi HBV unlike the others

A

nodular lymphocyte predominant

60
Q

give 2 differences of nodular lymphocyte predominant and classical HL

A

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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