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Boards.CP.Heme > Hodgkin Lymphoma > Flashcards

Hodgkin Lymphoma Flashcards

1
Q

Classic Hodgkin Lymphoma (CHL):

  • Incidence
  • Characteristic cell
  • Clinical presentation (2)
A
  • Bimodal; 15-35/>50 y/o
  • Reed-Sternberg cells (+ variants)
  • Localized lymphadenopathy
  • “B” symptoms
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2
Q

What is true regarding Lacunar Cells?

A

Formal fixation induced retraction artifact

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3
Q

Classic Hodgkin Lymphoma (CHL) - Immunophenotype:

-Negative for (5)

A
  • CD20*
  • CD45
  • bcl-6
  • ALK
  • EMA

*10-20% of cases express CD20

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4
Q

_______ Nodular Sclerosis CHL is an aggressive form of CHL, that often presents at a High stage with _______, composed of sheets of RS cells and RS variants; may undergo focal _______.

A

Syncytial Nodular Sclerosis CHL is an aggressive form of CHL, that often presents at a high stage with bulky mediastinal disease, composed of sheets of RS cells and RS variants; may undergo focal necrosis.

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5
Q

What CHL subtype is the 2nd MC?

A

Mixed Cellularity (MC) - 25%

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6
Q

Classic Hodgkin Lymphoma (CHL) - Immunophenotype:

-Positive for (6)

A
  • CD15
  • CD30
  • fascin
  • IRF4/MUM1
  • PAX5 (weak)
  • EBV Ags (LMP-1/EBER1/2)
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7
Q

Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) - Morphology:

  • Architecture
  • Characteristic cell
  • Precursor lesion
A
  • Nodular proliferation
  • L&H cells *(RS cells - Rare/Absent)
  • Progressive transformation of GCs
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8
Q

Classic Hodgkin Lymphoma (CHL) - BM Involvement:

  • Definition
  • Overall %
  • Highest in what subtype/population (2)
A

Atypical mononuclear CD30+ cell in appropriate background

  • 10% overall
  • Lymphocyte Depleted (50%)/HIV-associated (60%)
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9
Q

In CHL, the background lymphocytes are predominantly what?

A

T-cells

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10
Q 
Lymphocyte Rich (LR) CHL - Immunophenotype:
-Negative for (5)
A
  • CD20*
  • CD45
  • bcl-6
  • ALK
  • EMA

*10-20% of cases express CD20

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11
Q

What are L&H cells?

A

Lymphocytic and Histiocytic cells

  • “Popcorn cells”
  • Large, vesicular convoluted nucleus
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12
Q

All of the CHL subtypes spread via contiguous lymphatic sites, except for what?

A

Lymphocyte Depleted CHL

-Noncontiguous spread

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13
Q

L&H cells - Immunophenotype:

-Positive for (5)

A

L&H cells - Positive IHC:

  • CD20
  • CD45
  • bcl-6
  • EMA
  • surface Ig (sIg)
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14
Q 
Mixed Cellularity (MC) CHL:
-Histology
A

Diffuse proliferation of lymphocytes, eosinophils, histiocytes and plasma cells
-varying numbers of RS cells and mononuclear Hodgkin cells

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15
Q

What lymph nodes are most commonly involved in CHL?

-2nd?

A

Cervical

-Mediastinum (2nd)

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16
Q 
Lymphocyte Rich (LR) CHL - Immunophenotype:
-Positive for (6)
A
  • CD15
  • CD30
  • fascin
  • IRF4/MUM1
  • PAX5 (weak)
  • EBV Ags (LMP-1/EBER1/2)
17
Q 
Mixed Cellularity (MC) CHL:
-Population (2)
A
  • Underdeveloped countries

- HIV infected patients

18
Q

Nodular Sclerosis (NS) CHL:

  • Location
  • Architecture
  • Characteristic Cells (2)
A
  • Mediastinum (MC)
  • Nodular proliferation w/ bands of sclerosis
  • RS Cells/Lacunar Cells
19
Q

What is the most common subtype of CHL?

-Percentage?

A

Nodular Sclerosis (70%)

20
Q

Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL): (3)

A
  • Meshwork of Follicular Dendritic cells (CD21+/CD23+)
  • Predominance of CD20+ B cells
  • Wreath of CD3+/CD57+ T cells
21
Q

What is the most common site for Lymphocyte Depleted (LD) CHL?

A

Retroperitoneum

22
Q

CHL Subtypes - %EBV+

  • Nodular Sclerosis
  • Mixed Cellularity
  • Lymphocyte Rich
  • Lymphocyte Depleted
A

CHL Subtypes - %EBV+

  • NS (25%)
  • MC (75%)
  • LR (50%)
  • LD (50%)
23
Q

Lymphocyte Depleted (LD) CHL:

  • Incidence
  • Presentation/behavior
  • RS cell types (#/hpf)
A
  • Incidence increases with Age
  • Higher stage/Aggressive
  • Classic RS cells/Pleomorphic (>15 hpf)
24
Q 
Lymphocyte Rich (LR) CHL is similar to what?
-How is it differentiated?
A

Nodular Lymphocyte Predominant HL (NLPHL)

-Immunophenotype same as CHL

25
Q

L&H cells - Immunophenotype:

-Negative for for (5)

A

L&H cells - Negative IHC:

  • CD15
  • CD30
  • OCT2
  • BOB1
  • EBV

Boards.CP.Heme (15 decks)

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