Hodgkin and non-Hodgkin Lymphoma Flashcards
What are some common abnormal lymph node patterns seen in lymphomas?
Capsule may be thickened and fibrotic.
What are the basic principles for the WHO classification of lymphomas?
Morphology, immunophenotype, genetic findings, location, and age.
What are some common disease categories associated with lymphadenopathy?
Acute lymphoblastic leukemia, Mantle cell lymphoma, Follicular lymphoma, Hodgkin lymphoma, Burkitt lymphoma, CLL/SLL, Plasma cell myeloma.
What are three common B-cell markers?
CD19, CD22, and CD20. CD20 is present on mantle cells and germinal center cells.
What are the signs and symptoms of CLL/SLL?
Typically presents in older adults ~65 yo. Frequently asymptomatic, or with mild symptoms. CLL cells are smaller with little cytoplasm, SLL cells are larger with abundant cytoplasm and relaxed nucleoli.
What is the lymph node morphology and immunophenotyping of CLL/SLL?
Total loss of lymph node architecture. Cells are pre- or post-germinal center. Strongly positive for CD5, CD19, CD23. Weakly positive for CD20, Ig. Negative for CD10 (not germinal center B-cells), FMC7
What are the general features of follicular lymphoma?
Follicular lymphoma has a germinal center B-cell origin. 40% of adult lymphomas. Mostly adults ~60 y/o Male=Female. Patients often asymptomatic except for adenopathy, but 80% have widespread stage III or IV disease at diagnosis.
What is the lymph node morphology, immunophenotyping, and chromosomal rearrangement of follicular lymphoma?
Multiple neoplastic follicles are present in the lymph nodes, with varied sizes and presence in all portions of the node (cortex, paracortex, medulla). Positive for B-cell markers CD19, CD20, Germinal center markers BCL6, CD10, and anti-apoptosis BCL2. BCL2 presence is caused by translocationof BCL2 gene from Chrom 18 to IG heavy chain promoter on Chrome 14: t(14;18)(q32;q21). Negative for CD5 and CD23
What are the general features of Mantle Cell Lymphoma?
A Mantle Cell Lymphoma. Median age 60, Male 2:1 Female. Most cases present with stage III or IV with lymphadenopathy and hepatosplenomegaly. Moderately aggressive lymphoma, by comparison to most other small B-cell lymphomas.
What is the lymph node morphology, Immunophenotyping, and chromosomal rearrangement of Mantle Cell Lymphoma?
Total loss of lymph node architecture with diffuse infiltration of lymphoma cells. Positive for B-cell markers CD19, CD20. Positive for CD5 but negative for CD23, which are both positive in CLL/SLL. Negative for germinal center markers CD10, BCL6. Positive for cyclin D (BCL1). Cyclin D is present due to translocation of BCL1 gene from chrom 11 to Ig heavy chain promoter on chrome 14: t(11;14)(q13;q32).
What are the general features of Burkitt’s Lymphoma?
A Germinal Center lymphoma. Three types of BL: Endemic (Malaria belt, 95% associated with EBV), Sporadic (children or young adults, 30% association with EBC), and Immunodeficiency-related (Primarily in HIV patients, 40% EBV associated). Cells are medium sized, with deeply basophilic cytoplasm containing lipid vacuoles.
What is the lymph node morphology, immunophenotyping, and chromosomal rearrangement of Burkitt’s lymphoma?
Lymph nodes show “Starry Sky” pattern due to influx of lymphoma cells and isolated cells with large cytoplasms. Positive for B-cell markers CD19, CD20. Positive for germinal center B-cell markers CD10, BCL6. Negative for CLL/SLL markers CD5, CD23. Positive for MYC. Presence of MYC due to translocation of MYC gene from Chrom 8 to Ig Heavy chain promoter on Chrom 14: t(8;14)(q24;q32)
