Hodgkin's Lymphoma Flashcards
Describe the pathway of where normal B lymphocyte development occurs [4]
B cells:
- Bone marrow
- Blood (as niave B-lymphocytes)
- Lymphoid tissue (e.g. spleen / LNs / liver); devell
- (back to the) Bone Marrow and become plasma cells
Describe the process of normal T cell development [4]
Through which process do T lymphocytes make new TCR for antigens [1]
T cells actively mutate their DNA via VDJ recombination to make a unique T cell receptor for new antigens as immature T cells
Describe the process of somatic hypermutation [2]
B cells transit in peripheral blood to germinal centres
May detect an antigen, but often this is not specific, so they undergo somatic hypermutation.
- Rapid and aggressive mutation of DNA to try and improve specificity and recognition of their receptor for the antigen
- Go back to bone marrow, become plasma cells and make specific antibodies
Which of the following areas during B cell development is where B cells start the ability to make immunoglobulins
Bone marrow
Blood
Lymphoid tissue
Marrow
Which of the following areas during B cell development is where B cells start the ability to make immunoglobulins
Bone marrow
Blood
Lymphoid tissue
Marrow
During B-lymphocyte development, cells start to make antibodies in the lymphoid tissue, before they move back to bone marrow.
What Ig do they make in the lymphoid tissues?
IgA
IgG
IgM
IgE
IgD
During B-lymphocyte development, cells start to make antibodies in the lymphoid tissue, before they move back to bone marrow.
What Ig do they make in the lymphoid tissues?
IgA
IgG
IgM
IgE
IgD
State where the following generally occur: [4]
State for the following if they’re generally aggressive or slow [4]
- ALL
- CLL
- Lymphomas
- Myelomas
ALL:
- Bone marrow
- Aggressive
CLL:
- Blood
- Slow
Lymphomas:
- Lymphoid tissue
- Agrresive (high grade); slow (low grade)
Myelomas:
- BM
- Slow
Whats the general rules about prognosis and chance of cure for aggressive or slow diseases? [2]
Aggressive:
- Rapidly fatal
- Chance of cure
Low grade:
- Grow slowly
- Much harder to cure
How can you work out if a lymphoma is aggressive or low grade?
Low grade lymphomas quite often have pathological descriptions of the cells (e..g follicular lymphoma)
High grade lymphomas are named
For lymphomas, what type of testing do you normally perform for
- Diagnostic test
- Prognostic test
- Staging test
Diagnostic test:
- Biopsy; morphology; phenotyping tests
- Sometimes supported by cytogenetic / molecular
Prognostic test:
- Cytogenetic test
Staging test:
- Usually imaging
Describe what is meant by lymphoma [1]
What are the two classifications of lymphoma? [2]
Type of cancer affecting the lymphocytes inside the lymphatic system
Cancerous cells proliferate inside the lymph nodes, causing the lymph nodes to become abnormally large (lymphadenopathy)
Two classifications:
* Hodgkin’s lymphoma (a specific disease)
* Non-Hodgkin’s lymphoma (which includes all other types)
State and explain which organs are commonly affected in chronic lymphomas [3]
Lymphadenopathy
Splenomegaly
Hepatomegaly
Because they’re all germinal centres - which is and important stage in developement in lymphomas
Also get B-symptoms
How do you differentiate between leukaemia and lymphoma from a FBC? [1]
Leukaemias tend to have high circulating serum WCCs
Lymphomas tend not to have circulating cells; have solid tumours; enlarged LN with high WCC
How do you differentiate between Hodgkin’s & non-Hodgkin’s lymphoma? [1]
Hodgkin’s lymphoma is differentiated from non-Hodgkin’s lymphoma based on its histological appearance of huge multinucleated lymphocytes called Reed-Sternberg cells.
The infection of which pathogen is linked to / often precedes HL? [1]
Epstein-Barr Virus
State 4 risk factors for HL [4]
EBV
Immunosuppression:
* Organ transplantation
* Immunosuppressant therapies
* Patients with HIV
Autoimmune conditions
* rheumatoid arthritis
* systemic lupus erythematosus
* sarcoidosis
Familial
Which autoimmune conditions increase the liklihood of HL? [3]
- rheumatoid arthritis
- systemic lupus erythematosus
- sarcoidosis