Krafts- Hodgkin and Non-Hodgkin Lymphoma Flashcards
What are the major differences between non-hodgkin and hodgkin lymphoma?
NON: more common, risk increases w/ age, skips around body, many subtypes, mostly B cell
HODG: less common, young adults and elderly, predictable and contiguous spread, 4 subtypes, Reed-sternberg cells
What is the most common cause of benign lymphadenopathy?
BENIGN rxn to infection
What is the most common malignant cause of lymphadenopathy?
Metastatic carcinoma
What are the characteristics of benign lymph nodes under the microscope?
Secondary follicles
germinal centers
mantle zones
tingible body macrophages present
How would you differentiate from follicular hyperplasia and follicular lymphoma?
Follicular hyperplasia:
Large irregular follicles w/ space between them
Mixture of cells in germinal centers
tingible macrophages
Follicular lymphoma:
uniform sizes of germinal centers
packed in
show fat inside lymph node
Germinal centers are the result of…..
B cell response to an immune stimulus
How does benign interfollicular hyperplasia differ from benign follicular hyperplasia?
Expanded area between follicles
mixture of cells
partial effacement
Benign interfollicular hyperplasia is the result of….
T cell response to an immune stimulus
What are the 4 types of low grade NHL?
Small lymphocytic lymphoma
Malt lymphoma
Follicular lymphoma
Mycosis fungoides
What are the three types of high grade lymphoma?
Large cell lymphoma
Lymphoblastic lymphoma
Burkitt lymphoma
What is the lymphoma that we don’t know where to place but is probably high?
Mantle cell lylmphoma
What is non-hodgkin lymphoma?
Malignant proliferation of lymphoid cells (blasts OR mature cells) in LNs
A pt presents w/ painless, firm lymphadenopathy w/ extranodal manifestations. They also have experienced significant weight loss, night sweats and feer.
This is characteristic of….
What is the name of his last sxs?
NHL!
B sxs
What is the best predictor of prognosis for NHL?
LN and level of metastesis
STAGE
which depends on LOCATION
What are the differences between low and high grade NHL tumors?
Low: older, indolent, small mature cells, non-destructive
High: children, aggressive, big ugly cells, destructive
SLL is the same things as _______. It is characterized by_____________.
CLL!
small mature lymphocytes….like it says in the name.
SLL targets what cells and what CD marker?
B cell lesion
CD5+ (This is WIERD b/c it’s usually a T cell marker)
You see a pt diagnosed w/ SLL. The course of this disease is likely to be long_______and death will likely be from______.
LONG
INFECTION
What type of information can CLL undergo? Prognosis?
Richter transformation–> poor prognosis
What cancer can be cured if you catch it early and tx it with antibiotics? What is it caused by? This falls under what type of lymphoma?
This cancer is also named after one of my dad’s favorite treats.
MALT LYMPHOMA
helicobacter pylori
Marginal zone lymphoma (these lymphomas have “marginal zone patterns”)
t(11,14) does what and causes what type of lymphoma?
This translocation codes for cylcin D1 and IgH. When you put this gene next to the heavy chain it is expressed A LOT in lymphocytes.
What does cyclin D to?
Helps cells to grow and pass through check points
Mantle cell lymphoma!
Mantle cell lymphoma is characterized by what two features……Is it aggressive?
Mantle zone pattern
small angulated lymphocytes
YES it is aggressive
t(14;18) is associated w/ what type of lymphoma?
Follicular lymphoma!
Same deal as mantle. Codes for IgH and bcl-2—so this anti-apoptotic factor is overly expressed.
If you saw a “butt cell” you would know it’s what type of cancer……
Follicular lymphoma
What do the follicles of follicular lymphoma look like? What stain will mark B cells in a LN?
Back to back follicles that have infiltrated a capsule so there are some fat cells. Can be mixed or large cell.
CD20 stain
What stages are associated w/ follicular lymphoma and what are the correlated grades?
I-small cells, better prognosis
II- small and large cells
III- larger cells, worse prognosis
What lymphoma mimics psoriasis/eczema early on then progressively forms mushroom like lesions?
Mycosis fungoides!
Does this have blood involvement?
YES
If you saw cerebriform lymphocytes on a slide, you would think_________immediately.
MYCOSIS FUNGOIDES
Mycosis fungoides has what sort of immunophenotype?
T cell
What are the characteristics of diffuse large cell lymphoma?
LARGE B cells> BAD prognosis
Grows rapidly> extranodal involvement
Lymphoblastic leukemia is the same as________. What are the two types and which one is worse?
ALL
B and T
T in Teenage males w/ Thymic masses is WORSE.
WHat do you see in Lymphoblastic lymphoma?
Lymphoblasts in diffuse patterns.
If you saw a child w/ a fast growing extranodal mass (either in the mandible or abdominal area) you’d thing it was…..
Burkitt lymphoma!
What translocation is assoicated w/ Burkitt?
t(8;14)—–c-myc gets put next to IgH then overexpressed and cell grows like CRAZY.
What pattern is associated w/ Burkitt’s?
YOU SHOULD REALLY KNOW THIS.
Starry-sky pattern
Dark blue sky in tumor cells in the bone marrow. The “stars” are tingible macrophages chewing up debri from rapidly turning over cells.
**occasionally involves the blood
Japan/Carribean basin, HTLV, hypercalemia……makes you think of:
Adult T cel leukemia/lymphoma of course!
VERY AGGRESSIVE
**cells look flowery
What are the 5 types of hodgkin lymphoma?
Nodular lymphocyte
Classical: Nodular sclerosis lymphocyte rich mixed cellularity lymphocyte depletion
Why does hodgkin lymphoma often have a good prognosis?
It has a predictable and contiguous spread so it’s possible to remove a LN and stop the metastasis. It’s also typically found in younger pts.
If you see an angry owl cell (Reed sternberg) you AUTOMATICALLY know that it’s…..
Hodgkin lymphoma
How do you treat HL? What is the prognosis? What is the danger?
Surgery, chemo, radiation
Prognosis depends on stage
Second malignancies
What is the “new kind” of HL and who is it commonly seen in?
Nodular lymphocyte
Asymptomatic young males w/ cervical lymphadenopathy.
Popcorn cells are associated w/ what more common HL?
Nodular lymphocyte HL
What is the most common subtype of HL and it’s distinguishing characteristic?
Nodular sclerosis HL
Lacunar cells
Mixed cellularity HL is bad because…..On a slide you’d see…..
it usually is disseminated at presentation.
Classic RS cells and a mixture of background cells.
What is an uncommon HL that also has popcorn cells and is usually localized at presentation?
lymphocyte rich HL
What HL has a collagen or reticulin background, classic RS cells, is RARE, and is often disseminated at presentation?
Lymphocyte depletion HL
