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DIT Hematology > Hem 9 - Lymphoma > Flashcards

Hem 9 - Lymphoma Flashcards

1
Q

What is the difference b/w leukemia and lymphoma?

A

Leukemia: Mainly involves the bone marrow, and might spill over into the peripheral blood. Lymphoma: Tumors in the lymph nodes.

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2
Q

What makes a lymphoma a Hodgkin lymphoma? What are the symptoms of a Hodgkin lymphoma?

A

The presence of Reed-Sternberg cells (large cells with multiple or bilobed nuclei w/ prominent nucleoli and clearing around nucleoli “Owls eyes”. They are found in a single group of lymph nodes; extranodal involvement is rare. They are painless, nontender lymphadenopathy and nodes feel firm and rubbery.

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3
Q

What are constitutional B symptoms?

A

They are symptoms that present in lymphoma. They are the triad of Low-grade fever, night sweat, and weight loss.

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4
Q

What is the epidemiology of Hodgkin lymphoma?

A

It has a bimodal age distribution: 1st peak is around age 20, and the second is around age 65. It is generally more common in men (except the nodular sclerosing subtype).

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5
Q

What is Non-Hodgkin lymphoma?

A

Commonly does not have Reed-Sternberg cells. The are B-cell lymphomas and are widespread in different lymph nodes. Can be found in other tissues such as GI tract, thyroid or CNS. They have fewer constitutional symptoms. Certain types of non-Hodgkin lymphoma can be associated w/ HIV and immunosuppression.

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6
Q

The more Reed-Sternburg cells the worse..?

A

The prognosis.

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7
Q

What are the four different types of Hodgkin lymphoma?

A

Lymphocyte-predominant. Nodular sclerosing. Mixed cellularity type. Lymphocyte-depleted.

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8
Q

What is Lymphocyte-Predominant Hodgkin lymphoma?

A

It is the least common of Hodgkin lymphomas. However, it has the best prognosis. It is a lymphoma where Lymphocytes predominate. Tends to occur in younger males.

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9
Q

What is Nodular sclerosing Hodgkin lymphoma?

A

The most common type, has a good prognosis (has more lymphocytes than Reed-Sternberg cells). There are bands of collagen, sclerosis, and fibrosis in biopsy. This lymphoma is surprising because men and women have closely equal incidence. Mainly seen in young adults.

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10
Q

Which type of Hodgkin lymphoma is the most common?

A

Nodular sclerosing.

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11
Q

Which type of Hodgkin lymphoma is the second most common?

A

Mixed cellularity type.

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12
Q

What is Mixed cellularity type Hodgkin lymphoma?

A

It is the second most common type, has lymphocytes and Reed-Sternberg cells. Does not have a good prognosis.

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13
Q

What is Lymphocyte depleted type Hodgkin lymphoma?

A

Has a very poor prognosis. Lymphocytes are depleted compared to Reed-Sternberg cells.

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14
Q

What is Diffuse large B-cell lymphoma?

A

It is the most common type of Non Hodgkin lymphoma in adults (25% of cases). Seen in elderly. 30% of cases are due to t(14;18).

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15
Q

Which type of lymphoma is the most common in adults? In children?

A

Adults: Diffuse large B-cell lymphoma. Children: Lymphoblastic lymphoma.

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16
Q

What is Follicular lymphoma?

A

A Non Hodgkin lymphoma, more than 90% have t(14;18).

17
Q

What is Burkitt lymphoma?

A

A Non Hodgkin lymphoma, associated w/ t(8;14)[Burkitt: the B is an 8 and the t’s are 14.]. It activates the c-Myc oncogene. Causes the classic starry sky appearance on biopsy; sheets of solid lymphocytes (the sky) and macrophages sprinkled (stars) that have ingested a bunch of the tumor cells. There are 3 different forms (endemic, sporadic form, and immunodeficiency-associate Burkitt lymphoma).

18
Q

What is the endemic form of Burkitt lymphoma?

A

Found mostly in Africa. Associated w/ EBV infection, it causes unilateral enlargement of the mandible.

19
Q

What is Mantle cell lymphoma?

A

A Non Hodgkin lymphoma, it is associated w/ t(11;14) disrupts the regulation of cyclin D, so the cells can go right into S phases very quickly.

20
Q

What is small lymphocytic lymphoma?

A

A Non Hodgkin lymphoma, it is the lymphoma equivalent of CLL.

21
Q

What is Marginal cell MALToma?

A

A Non Hodgkin lymphoma, it is associated w/ Sjogren syndrome, Hashimoto thyroiditis, H.pylori. MALT is mucosa associated lymphoid tissue typically seen in the gut.

22
Q

What is Adult T-cell lymphoma.

A

Caused by HTLV-1. (Human T lymphocyte Virus-1). It is an aggressive cutaneous type of lymphoma.

23
Q

What is Mycosis fungoides?

A

A cutaneous T cell lymphoma. It can cause Sezary syndrome: When the malignant T cell lymphomas leave the skin lesions into the blood stream.

24
Q

What is Intestinal T-cell lymphoma?

A

AKA Enteropathy-associated T-cell lymphoma. It is associated w/ long term celiac disease.

25
Q

Compare the age distribution of those affected by Hodgkin lymphoma to those affected by non-Hodgkin lymphoma.

A

Hodgkin lymphoma: Bimodal distribution: one peak in the young (around age 20) and a 2nd peak in the old (around age 65). NHL: Much more variable: some types predominant in the young, some in the middle age, and some in the elderly.

26
Q

What form of lymphoma is described by the following: Most common lymphoma in the US.

A

Diffuse large B cell lymphoma.

27
Q

What form of lymphoma is described by the following: Reed-Sternberg cells.

A

Hodgkin Lymphoma.

28
Q

What form of lymphoma is described by the following: particularly associated w/ EBV.

A

Burkitt lymphoma.

29
Q

What form of lymphoma is described by the following: associated w/ long-term celiac disease.

A

Intestinal T-cell lymphoma.

30
Q

What form of lymphoma is described by the following: “starry-sky parttern” due to phagocytosis of apoptotic tumor cells.

A

Burkitt lymphoma.

31
Q

What form of lymphoma is described by the following: lymphoma equivalent of CLL.

A

Small lymphocytic Lymphoma.

32
Q

What form of lymphoma is described by the following: associated w/ Sjogren syndrome, Hashimoto thyroiditis, and H.pylori.

A

Marginal cell MALToma.

33
Q

RFF: Cancer most commonly associated w/ a noninfectious fever.

A

Hodgkin lymphoma.

34
Q

RFF: Sheets of lymphoid cells, w/ a “starry sky” appearance.

A

Burkitt lymphoma.

35
Q

RFF: Large B cells w/ bilobed nuclei and prominent “Owl’s eye inclusion”.

A

They are the Reed-Sternberg cells seen in Hodgkin lymphoma.

DIT Hematology (11 decks)

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