Hodgkins Lymphoma

Question 1

generally occurs at multiple nodal sites and its spread to other lymphoid or extranodal sites is random

Answer 1

non‐Hodgkin Lymphoma (NHL)

Question 2

stage: constitutional symptoms of fever, night sweats, weight loss

Answer 2

B

Question 3

CD15 and CD30 negative

Answer 3

Lymphocyte predominant

Question 4

usually no fevers night sweats

Answer 4

stage I or II

Nodular sclerosis and lymphocyte predominant

Question 5

generally will arise in a single lymph node chain and will spread to adjacent sites in a contiguous pattern

Answer 5

Hodgkin Lymphoma (HL)

Question 6

The lacunar cells express (1)

Answer 6

CD15, CD30 and PAX5 a pan B‐cell marker; nodular sclerosis

Question 7

a variant of the Reed‐Sternberg cell which shows a large clear space surrounding the nucleus

Answer 7

lacunar cell; refers to nodular sclerosis

Question 8

CD15, CD30 and PAX5 a pan B‐cell marker

Answer 8

lacunar cells; nodular sclerosis

also seen in mixed cellularity, lymphocyte rich and lymphocyte depletion

Question 9

constitutional B symptoms - weight loss, night sweats, fever

Answer 9

Mixed cellularity and lymphocyte depletion stage III or IV

Question 10

promotes survival and proliferation of lymphocytes along with survival of germinal B‐cells that would normally be destined to undergo apoptosis but instead produce Reed‐Sternberg cells

Answer 10

NF‐Κb activation

Question 11

stage: one side of diaphragm

Answer 11

stage II

Question 12

shows characteristic nodules surrounded by bands of collagenous tissue and containing mixtures of lymphoid cells, inflammatory cells and lacunar cells

Answer 12

nodular sclerosis

Question 13

It is interesting to note that (1) in (2) have striking resemblance to Reed‐Sternberg cells again suggesting the role of (3) in the pathogenesis of HL

Answer 13

1. EBV infected B‐cells 2. infectious mononucleosis 3. EBV

Question 14

older patients and in HIV+ patients of any age

Answer 14

Lymphocyte depleted

Question 15

(1) has also been shown to be effective in treatment with much less toxicity

Answer 15

1. Anti CD30

Question 16

only rarely shows Reed‐Sternberg cells

Answer 16

lymphocyte predominant

Question 17

typical B‐cell markers CD20 and BCL6

Answer 17

Lymphocyte predominant

Question 18

(1) is a significant part of the pathogenesis in HL. It is believed to occur from (2)

Answer 18

1. NF‐Κb activation( a transcription factor) 2. EBV infection

Question 19

Reed‐Stern berg cells are easily found and they are set in a rich inflammatory background of lymphocytes, plasma cells and numerous eosinophils

Answer 19

mixed cellularity

Question 20

Fever, night sweats, constitutional B symptoms

Answer 20

mixed cellularity

Question 21

How to diagnosis HL

Answer 21

Physical exam for lymph nodes

CT scan to stage disease

bone marrow biospy

Question 22

Liver, spleen and bone marrow involvement may also occur

Answer 22

nodular sclerosis

Question 23

features a multilobed nucleus resembling a popcorn kernel and is called a “popcorn cell”

Answer 23

lymphocyte predominant

Question 24

stage: single lymph node region

Answer 24

stage I

Question 25

stage: disseminated

Answer 25

IV

Question 26

stage: both sides of diaphragm

Answer 26

stage III

Question 27

may transform to DLBCL

Answer 27

Lymphocyte predominant

Question 28

Nodular infiltrate lymphocytes and macrophages

Answer 28

Lymphocyte predominant

Question 29

treatment for low stage disease

Answer 29

radiation therapy

Question 30

stage: asymptomatic

Answer 30

A

Question 31

presents usually as a mass in the cervical, supraclavicular or commonly the mediastinal area in young adolescents

Answer 31

Nodular Sclerosis type HL

Question 32

Stereotypic spread of HL

Answer 32

nodal –> splenic –> bone marrow

Question 33

can develop second malignancies of lung, breast cancer or even melanoma

Answer 33

radiation therapy for low stage disease

Question 34

germinal center or post germinal center BCells in origin

Answer 34

Reed‐Sternberg cell

Question 35

second malignancies such as Acute Myeloid Leukemia

Answer 35

chemotherapy for advanced Stage III or Stage IV disease

Question 36

Reed‐Sternberg cell

Answer 36

Hodgkin Lymphoma (HL) cell with owl eye nucleus

Question 37

Most of the tumor will consist of mixtures of inflammatory cells such as (1) in Hodgkin Lymphoma (HL)

Answer 37

1. lymphocytes, plasma cells and frequently numerous eosinophils