Hodgkin Lymphoma Flashcards
The average age at diagnosis of HL is _____ years
32
What are the characteristic features that differentiate HL from NHL? (3)
- HL spreads from one lymph node to the next lymph node (contiguous spread)
- Lymph nodes involved are easily accessible in HL
- Reed-Sternberg cells are present w/ a non-neoplastic background of lymphocytes and granulocytes.
_____% of the cells in HL are reactive lymphocytes and other white cells
90%
Reed-Sternberg cells are derived from ______________ cells
germinal center or postgerminal center B
Name the types of HL
- Nodular sclerosis
- Mixed cellularity
- Lymphocyte-rich
- Lymphocyte depletion
- Lymphocyte predominance
______________ subtype is not included in the classical form because it has a different kind of RS cell
Lymphocyte predominance
How do we know that RS cell is derived from a B cell?
RS cells show 2 things
V(D)J recombination
Somatic hypermutation
Activation of the transcription factor ________is a common event in classical HL
NF-κB
NF-κB may be activated either by _____ infection
EBV
EBV+ tumor cells express ____________, a protein encoded by EBV genome that upregulates NF-KB activity
latent membrane protein-1
Activation of NF-κB may occur in EBV-tumors as a result of acquired loss-of-function mutations in ___________, which are both negative regulators of NF-κB
IκB or A20
What is the whole concept of HL?
t is hypothesized that activation of NF-κB rescues “crippled” germinal center B cells that cannot express Igs from apoptosis, setting the stage for the acquisition of other unknown mutations that collaborate to produce Reed-Sternberg cells
EBV-infected B cells resembling Reed-Sternberg cells are found in the lymph nodes of individuals with ____________________
infectious mononucleosi
What are the cytokines and chemokines made by RS cells?
IL-5 IL-10 M-CSF Eotaxin Immunomodulatory factor galectin 1
Eosinophils and T cells express ligands that activate the _____ and ______ receptors found on Reed-Sternberg cells, producing signals that up-regulate NF-κB
CD30
CD40
_____________ cells are aneuploid and possess diverse clonal chromosomal aberrations
Reed-Sternberg
What are the characteristics of RS cells
45μm in diameter
Multiple nuclei or a single nucleus with multiple nuclear lobes
Large inclusion-like nucleoli about the size of a lymphocyte (5 to 7μm)
_________ variants contain a single nucleus with a large inclusion-like nucleolus
Mononuclear
Lacunar cells are seen in the __________ subtype
nodular sclerosis
How does a lacunar cell look like?
Delicate, folded, or multilobate nuclei Abundant pale cytoplasm that is often disrupted during the cutting of sections, leaving the nucleus sitting in an empty hole
Reed-Sternberg cells undergo a peculiar form of cell death in which the cells shrink and become pyknotic, a process described as _____________
mummification
What are the features of lymphohisticytic variant?
Polypoid nuclei
Inconspicuous nucleoli
Moderately abundant cytoplasm
The classical Reed-Sternberg cells are positive for _____, ____, _____, and negative for other B cell markers, T cell markers and CD45
PAX5
CD15
CD30
What is the microscopic picture of nodular sclerosis subtype of HL?
Lacunar cells present
Collagen deposition
Lymphocytes, histiocytes, macrophages, eosinophils common
Few RS cells
