High Grade

Question 1

Cyclin d1 gene

Answer 1

T(11:14)

Question 2

I hc of primary mediastinal lymphoma

Answer 2

Weak CD30, absent CD 15
B cell antigens- 20, 22, 79a, 19
Distinguish from sarcoma melanoma thy moms and semanoma with HMB45 keratin(melanoma), keratin, placental leukocyte alp

Question 3

Burkitts translocation

Answer 3

8:14

Question 4

3 types of burkitts

Answer 4

Endemic
Sporadic
AIDS assoc

Question 5

EBV+ DLBCL, NOS definition

Answer 5

All age groups, immunodéficitaire and immunocompetent
Better os than initially thought
NOS is to highlight that there are other more specific entities with neoplastic EBV+ large B cells, such as lymphomatoid granulomatosis.

Question 6

Dlbcl w irf4/mum1 re arrangement

Answer 6

Site- Head and neck region including Waldeyer’s ring
• Limited disease stage
• Age- Mostly childhood and young adulthood (mean about 30 years) but older individuals have been reported.
• Morphology- Diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma (FL) grade 3 or a combination
• IHC- strong expression of IRF4/MUM1 and BCL6 and lack both PRDM1/BLIMP1 expression and t(14;18)/BCL2 breaks
• CD5 (~30%, cases are usually CD10-), BCL2 (~60%), CD10 (~60%) can be expressed. By Hans algorithm- can be classified as GCB or Non-GCB
• On cytogenetics- 95% demonstrate chromosomal alterations with an average of 6/ case
• FISH- for IRF4/ MUM1 breakapart- as rearrangement is cryptic
• BCL6 and MYC breaks have been described.

Question 7

Main DDx for T cell/histiocyte rich dlbcl

Answer 7

Modular lymphocyte predominant Hodgkin’s lymphoma

Question 8

How does t 8:14 lead to NYC overproduction in bl

Answer 8

This translocation brings MYC under the control of IgH enhancer elements, resulting in its constitutive expression.

Question 9

Lymphomatoid granulomatosis

Answer 9

Fever- waxing and waning
Almost all have lung involvement
Skin lesions 50%
Haemoptysis
Kidney, cns, git, head and neck

Question 10

What does myc do?

Answer 10

metabolism, protein synthesis, differentiation, stem- cell renewal, stress response, messenger RNA (mRNA) regulation, and microRNA regulation

Question 11

How does myc induce tumorigenesis

Answer 11

proliferation
, induces genomic instability
amplifies the transcrip- tional program already in place.

Question 12

What is BCL6

Answer 12

transcription factor that orchestrates the germinal center reaction and suppresses MYC and BCL2 expression in normal GCB cells,

Question 13

LG dx

Answer 13

Grading sim to follicular but use EBV+y cells- grade < 5%