Hodgkins Lymphoma- P

Question 1

what is lymphoma?

Answer 1

Neoplastic proliferation of lymphoid cells that forms a mass
- may arise from LN or extranodal tissue

Question 2

Lymphoma can be divided into 2 groups what are they?

Answer 2

Hodgkins- 40%

Non-Hodgkins- 60%

Question 3

NHL can be divided into 3 sizes of cells what are they?

Answer 3

Small B cells
Intermediate
Large B cell

Question 4

What are the subclasses of small B cell NHL?

Answer 4

1. follicular
2. Mantle
3. marginal zone
4. Small lymphocytic lymphoma

Question 5

What is follicular lymphoma?

Answer 5

Neoplastic proliferation of small B cells (CD20+) that form follicle like nodules
- presents late adulthood with painLESS LAD

Question 6

Follicular lymphoma is driven by a translocation what is it? and what does it do?

Answer 6

t 14–>18

• Chromosome 18 is home to the BLC-2 gene which we know inhibits Apop
• Since it translocated to a chromosome that is very much more active than 18 BLC-2 is over expressed

Question 7

What chromosome is Ig heavy chain located on?

Answer 7

14- since Ig it usually is proliferated many times.

Question 8

What doe BCL-2 do?

Answer 8

inhibits Apoptosis by ramping up the integrity of the mitochondrial membrane
- Thus Cytochrome C isnt released as much to cause apop

Question 9

Pts with follicular lymphoma are commonly asymptomatic. Those who are symptomatic are treated with?

Answer 9

Chemo or Rituximab (CD20 Ab)

Question 10

Though most with follicular lymphoma are asymptomatic what is one large concern with this dz?

Answer 10

Progression to diffuse large B cell lymphoma

- presents with enlarging LN

Question 11

How does one distinguish between follicular lymphoma nad reactive follicular hyperplasia?

Answer 11

1. disruption of LN architecture (more follicles deep in the LN in FL)
2. Lack of tingible body macs in germinal center
3. BCL-2 expression in follicles
4. Monoclonality

Question 12

What is mantle cell lymphoma? When does the dz present?

Answer 12

Neoplastic proliferation of Small B cells (CD20+) that expands into the Mantle zone

• adjacent to follicles expansion
• late adulthood and painLESS LAD

Question 13

Mantle cell lymphoma is driven by a translocation. what is it and how what does it cause?

Answer 13

t 11–>14

• Cyclin D 1 is found on chromosome 11
• leads to over expression of Cyclin D1

Question 14

What is the purpose of Cyclin D1?

Answer 14

Phosphorylates regulators

• telling the cell cycle to GO
• Pushing and promotes from G1–>S Transition

Question 15

What is marginal zone lymphoma?

Answer 15

Neoplastic prolif of small B cells (CD20+) that expands to the marginal zone

Question 16

What is Marginal Zone lymphoma ass. with?

Answer 16

Chronic inflammation, like;

1. Hashimoto thyroiditis
2. Sjogren Syndrome
3. H pylori gastritis

Question 17

What is the significance of the Marginal zone?

Answer 17

• Ln’s don’t usually have marginal zones
• formed when there is activation of cells by the germinal center from inflammation
• classic is from chronic inflammation

Question 18

What is MALToma?

Answer 18

Marginal zone lymphoma in mucosal sites

- can be regressed with treatment of H pylory

Question 19

What is Burkitt lymphoma?

Answer 19

Neoplastic proliferation of INTERMEDIATE B cells (CD20+)

• ass with EBV
• Classical presents with extranodal mass in child or young adult

Question 20

What 2 types of Burkitt lymphoma are there?

Answer 20

African- Jaw involvement

Sporadic- involves the Abdomen

Question 21

What translocation drives Burkitt lymphoma?

Answer 21

T 8–>14

• C-myc translocation
• overexpressiong of oncogene which promotes cell growth

Question 22

What is the characteristic of Burkitt lymphoma?

Answer 22

High mitotic index with a starry sky appearance under microscope

Question 23

What is diffuse large B cells lymphoma?

Answer 23

Neoplastic proliferation of LARGE B cells (CD20+) that grow diffusely in sheets

Question 24

What is significant about large B cell lymphoma?

Answer 24

Most common NHL
Clinical aggressive (high grade)

Question 25

How does a Large B cell lymphoma begin?

Answer 25

Sporadic

Translocation of a low grade lymphoma

Question 26

When would a Large B cell lymphoma present in life?

Answer 26

Late adulthood as enlarging LN or extranodal mass