Hodgkins Lymphoma- P Flashcards
what is lymphoma?
Neoplastic proliferation of lymphoid cells that forms a mass
- may arise from LN or extranodal tissue
Lymphoma can be divided into 2 groups what are they?
Hodgkins- 40%
Non-Hodgkins- 60%
NHL can be divided into 3 sizes of cells what are they?
Small B cells
Intermediate
Large B cell
What are the subclasses of small B cell NHL?
- follicular
- Mantle
- marginal zone
- Small lymphocytic lymphoma
What is follicular lymphoma?
Neoplastic proliferation of small B cells (CD20+) that form follicle like nodules
- presents late adulthood with painLESS LAD
Follicular lymphoma is driven by a translocation what is it? and what does it do?
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
What chromosome is Ig heavy chain located on?
14- since Ig it usually is proliferated many times.
What doe BCL-2 do?
inhibits Apoptosis by ramping up the integrity of the mitochondrial membrane
- Thus Cytochrome C isnt released as much to cause apop
Pts with follicular lymphoma are commonly asymptomatic. Those who are symptomatic are treated with?
Chemo or Rituximab (CD20 Ab)
Though most with follicular lymphoma are asymptomatic what is one large concern with this dz?
Progression to diffuse large B cell lymphoma
- presents with enlarging LN
How does one distinguish between follicular lymphoma nad reactive follicular hyperplasia?
- disruption of LN architecture (more follicles deep in the LN in FL)
- Lack of tingible body macs in germinal center
- BCL-2 expression in follicles
- Monoclonality
What is mantle cell lymphoma? When does the dz present?
Neoplastic proliferation of Small B cells (CD20+) that expands into the Mantle zone
- adjacent to follicles expansion
- late adulthood and painLESS LAD
Mantle cell lymphoma is driven by a translocation. what is it and how what does it cause?
t 11–>14
- Cyclin D 1 is found on chromosome 11
- leads to over expression of Cyclin D1
What is the purpose of Cyclin D1?
Phosphorylates regulators
- telling the cell cycle to GO
- Pushing and promotes from G1–>S Transition
What is marginal zone lymphoma?
Neoplastic prolif of small B cells (CD20+) that expands to the marginal zone
What is Marginal Zone lymphoma ass. with?
Chronic inflammation, like;
- Hashimoto thyroiditis
- Sjogren Syndrome
- H pylori gastritis
What is the significance of the Marginal zone?
- 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
What is MALToma?
Marginal zone lymphoma in mucosal sites
- can be regressed with treatment of H pylory
What is Burkitt lymphoma?
Neoplastic proliferation of INTERMEDIATE B cells (CD20+)
- ass with EBV
- Classical presents with extranodal mass in child or young adult
What 2 types of Burkitt lymphoma are there?
African- Jaw involvement
Sporadic- involves the Abdomen
What translocation drives Burkitt lymphoma?
T 8–>14
- C-myc translocation
- overexpressiong of oncogene which promotes cell growth
What is the characteristic of Burkitt lymphoma?
High mitotic index with a starry sky appearance under microscope
What is diffuse large B cells lymphoma?
Neoplastic proliferation of LARGE B cells (CD20+) that grow diffusely in sheets
What is significant about large B cell lymphoma?
Most common NHL Clinical aggressive (high grade)
How does a Large B cell lymphoma begin?
Sporadic
Translocation of a low grade lymphoma
When would a Large B cell lymphoma present in life?
Late adulthood as enlarging LN or extranodal mass
