Hodgkin Lymphomas Flashcards
acute leukemia morphology
immature cells (blasts)
chronic leukemia morphology
mature or maturing cells
acute leukemia cellular mechanism
maturation arrest
chronic leukemia cellular mechanism
increased proliferation or decreased apoptosis
acute leukemia clinical symptoms
bone marrow failure leads to bleeding, infections, fatigue
chronic leukemia clinical symptoms
nonspecific: organ infiltration, leukocytosis, late marrow failure
neoplastic cell in hodgkin lymphomas
reed sternburg cell: binucleated cell with prominent eosinophilic inclusion like nuclei. owl eyes
epidemiology of hodgkin lymphoma
uncommon, bimodal age curve (15-35 and 50+), both sexes evenly
clinical presentation of HL
painless lymphadenopathy (mostly cervical), fever, night sweats, weight loss, infections
pattern of HL spread
unifocal, contiguous, lymphatic spread. doesn’t jump around. goes in order
characteristic of HL lymph node biopsy
less than 1% of cells will be reed stern burg cells. 99% are reactive, nonmalignant cellular infiltrate
origin of HL neoplasms
B cells from germinal center
classical HL
nodular sclerosis, mixed cellularity, lymphocyte depletion or enrichment. diffuse or nodular growth.
immunophenotype of classic HL
CD15+ (mature myeloid antigen)
CD30+ (not lineage specific)
PAX5+ (B cell)
nodular lymphocyte prodominant HL
only about 5% of HLs. nodular growth, popcorn like cells with small lymphocytic background
tage 1
one region
stage 2
two regions but on same side of diaphragm
stage 3
both sides of diaphragm. but confined to lymphatic system
stage 4
disseminated beyond lymphatics
hodgkin prognosis
function of stage, but typically 80% survival
definition of HL
lymphoma that contains a minority of neoplastic Reed-Sternburg cells and a much larger, pleomorphic background of non-neoplastic, reactive inflammatory cells
staging the disease
to determine how far the disease has disseminated throughout the body
EBV
herpes virus. might be causative or might be an epiphenomenon.
HL and NFkB
constitutive activity in HL. likely protects the cell from the hostile environment of the germinal center
B symptoms
constitutive symptoms (night sweats, fever, weight loss)
what is needed to diagnose?
a whole, intact, excisional lymph node biopsy
requirements to definitively diagnose HL
RS cell, presence of appropriate milieu of inflammatory cell background, nodal architecture effacement
most common type of classic HL
nodular sclerosis
difference between therapeutic decisions in HL vs NHL
HL: based essentially on stage rather than classification
treatment of early stage HL
abbreviated course of combination chemotherapy followed by involved field radiotherapy
treatment of late stage HL
chemotherapy with radiotherapy sometimes
