HEMA 2 LEC - Mature B Cell Lymphomas Part 1 Flashcards

1
Q

Type of lymphoma

• Derived from various stages of B cell differentiation

A

MATURE B CELL LYMPHOMAS

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2
Q

Type of lymphoma

All produce monoclonal light chain Ig, clonal Ig gene rearrangements, or both

A

MATURE B CELL LYMPHOMAS

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3
Q

Type of lymphoma

Most common subtypes: follicular lymphoma and B cell lymphoma

A

MATURE B CELL LYMPHOMAS

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4
Q

• Accumulation of small lymphoid cells in PB, BM, lymphoid organs

A

Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

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5
Q

type of lymphocytic leukemia or lymphoma presents mostly in PB and BM

A

CLL

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6
Q

type of lymphocytic leukemia or lymphoma presents mostly in LN

A

SLL

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7
Q

Morphology
• Soccer-ball : small lymphoid cells with coarse chromatin, absent or subtle nucleoli, scant cytoplasm

A

CLL

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8
Q

Morphology

Prolymphocytes (up to 55% of cells)

A

CLL

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9
Q

Morphology

Lymphoid cells with cleaved nuclei

A

CLL

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10
Q

FAB CLassification of CLL

>90% small mature lymphocytes,

A

Typical CLL

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11
Q
  • Smudge cells (disintegrated lymphoid cells) – unique feature
  • BM: nodular, diffuse, interstitial infiltrates of small lymphoid cells
A

CLL

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12
Q
  • Effacement of normal nodal architecture by a diffuse proliferation of small, round lymphoid cells (Pathognomonic)
  • Pseudofollicles/growth or proliferation centers
A

SLL

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13
Q

Used to distinguish CLL/SLL from mantle cell lymphoma: (5)

A

CD23, LEF1, absence of FMC7, cyclin D1, SOX11

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14
Q

What condition

A

• Monoclonal B-cell lymphocytosis:

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15
Q

• Asymptomatic at diagnosis, 1st indication: lymphocytosis

A

CLL/SLL

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16
Q

Two Divisions of CLL:

indolent, median survival: 24 years

A

Mutated IVGH (Ig heavy chain)

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17
Q

Two Divisions of CLL:

aggressive, median survival: 8 years

A

Unmutated IVGH

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18
Q

5% of patients of CLL/SLL patients develop _____ high-grade diffuse large B cell lymphoma with survival of

A

Richter syndrome

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19
Q

> 55% of circulating lymphoid cells have prolymphocyte morphology

A

prolymphocytic leukemia

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20
Q

Pathognomonic cell of B cell PLL:

A

prolymphocyte of medium size, round nucleus, distinct punched out nucleolus

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21
Q

LN involvement more common in what type of PLL (B or T cell)

A

T cell

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22
Q

how to distinguish B CELL PLL from CLL/SLL

A

To distinguish from CLL/SLL: cell size (2x normal) and prominent central nucleolus (PUNCHED OUT)

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23
Q
  • BM: interstitial and/or nodular proliferation of prolymphocytes
  • Infiltrated white and red splenic pulp
A

B CELL PLL

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24
Q
  • BM: small to medium size neoplastic cells with round or irregular nuclei, resembling Sezary cells
  • Cytoplasmic blebbing
A

T CELL PLL

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25
Q

high incidence of mutation in TP53 what subclass of PLL

A

B cell PLL

26
Q

Treatment for PLL

A

monoclonal Ab against CD52

27
Q

Definition

Small B lymphocytes with abundant cytoplasm and fine/hairy cytoplasmic projections

A

Hairy Cell Leukemia

28
Q

Cell of origin of HCL

A

peripheral b cell of post-germinal center stage (memory B cell)

29
Q

Found in BM and red pulp of spleen, RARE LN involvement

A

HCL

30
Q

Inc in reticulin fibers

A

HCL

31
Q

Expression of CD11c, CD25, CD103, TRAP

A

HCL

32
Q

most specific markers; differentiates HCL from splenic marginal zone lymphoma

A

CD123, Annexin A1

33
Q

In MIDDLE aged

A

HCL

34
Q

Signs of this disease are splenomegaly and pancytopenia

A

HCL

35
Q

Definition

• Medium-sized lymphoid cell with irregular nuclear outlines derived from follicular mantle zone

A

Mantle Cell Lymphoma

36
Q

• Main site of presentation of MCL

A

LN

37
Q

replacement of normal nodal architecture with a diffuse proliferation of monotonous, medium-sized lymphoid cells with irregular nuclear outlines

A

MCL

38
Q

irregular nuclear outlines

A

MCL

39
Q

PB involvement may mimic PLL

A

MCL

40
Q

this cytogenetic abnormality is a defining feature of mantle cell lymphoma

A

t(11;14)

41
Q

proto-oncogene involved in the regulation of G1 to S phase progression

A

Cyclin D1 (BCL1)

42
Q

constitutively expressed through its translocation to the immunoglobulin heavy chain gene, t(11;14)

A

Cyclin D1 (BCL1)

43
Q

Origin of Follicular lymphoma

A

Germinal center B cells

44
Q

Morphology

• Numerous closely spaced follicles

A

Follicular Lymphoma

45
Q

Morphology

Neoplastic proliferation may extend into the perinodal adipose tissue

A

Follicular Lymphoma

46
Q
  • Mantle zone and polarization are not present

* Neoplastic follicles with medium-sized lymphoid cells with angular or indented nuclei

A

Follicular Lymphoma

47
Q

• Cytologically similar to centrocytes, with a variable admixture of large lymphoid cells

A

Follicular Lymphoma

48
Q

• Prognostic significance: relative proportion of medium-sized and large lymphoid cells

A

Follicular Lymphoma

49
Q

grade of FL

rare scattered large lymphocytes

A

grade 1-2

50
Q

grade of FL

numerous centroblasts

A

Grade 3

51
Q

Neoplastic cells express BCL-2 protein

A

Follicular lymphoma

52
Q

responsible for the decreased sensitivity to apoptosis in follicular lymphoma
allows the accumulation of neoplastic lymphocytes

A

BCL-2 protein

53
Q

The expression of BCL-2 by follicular lymphoma cells is due to the _______, which places the BCL2 gene under a promoter of the immu noglobulin heavy chain gene

A

t(14;18)(q32;q21)

54
Q

This cytogenetic abnormality is present in 95% of follicular lymphoma

A

t(14;18)(q32;q21)

55
Q

3 subtypes of Marginal Zone Lymphoma of MALT

A

1) nodal, 2) extranodal, 3) splenic

56
Q

heterogenous neoplastic proliferation, small and medium lymphocytes, plasma cells, scattered large lymphoid cells

A

Extranodal Marginal Zone Lymphoma of MALT

57
Q

Associated with autoimmune conditions (e.g., Sjögren syndrome, Hashimoto thyroiditis) or previous infections (Helicobacter pylori gastritis or hepatitis C)

A

Extranodal Marginal Zone Lymphoma of MALT

58
Q

Characteristic feature: lymphoepithelial lesions

A

Extranodal Marginal Zone Lymphoma of MALT

59
Q

helpful feature in diagnosing marginal zone lymphoma when there is a significant residual reactive component

A

CD43 antigen

60
Q

• 30% of cases show a translocation involving apoptosis-inhibitor gene API2 and the MLT gene, the t(11;18)(q21;q21).

A

Extranodal Marginal Zone Lymphoma of MALT

61
Q

API2 and the MLT gene, the t(11;18)(q21;q21)

What lymphoma

A

Extranodal Marginal Zone Lymphoma of MALT

62
Q

most common site of Extranodal Marginal Zone Lymphoma of MALT

A

GIT