Krafts- Hodgkin and Non-Hodgkin Lymphoma

Question 1

What are the major differences between non-hodgkin and hodgkin lymphoma?

Answer 1

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

Question 2

What is the most common cause of benign lymphadenopathy?

Answer 2

BENIGN rxn to infection

Question 3

What is the most common malignant cause of lymphadenopathy?

Answer 3

Metastatic carcinoma

Question 4

What are the characteristics of benign lymph nodes under the microscope?

Answer 4

Secondary follicles
germinal centers
mantle zones
tingible body macrophages present

Question 5

How would you differentiate from follicular hyperplasia and follicular lymphoma?

Answer 5

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

Question 6

Germinal centers are the result of…..

Answer 6

B cell response to an immune stimulus

Question 7

How does benign interfollicular hyperplasia differ from benign follicular hyperplasia?

Answer 7

Expanded area between follicles
mixture of cells
partial effacement

Question 8

Benign interfollicular hyperplasia is the result of….

Answer 8

T cell response to an immune stimulus

Question 9

What are the 4 types of low grade NHL?

Answer 9

Small lymphocytic lymphoma
Malt lymphoma
Follicular lymphoma
Mycosis fungoides

Question 10

What are the three types of high grade lymphoma?

Answer 10

Large cell lymphoma
Lymphoblastic lymphoma
Burkitt lymphoma

Question 11

What is the lymphoma that we don’t know where to place but is probably high?

Answer 11

Mantle cell lylmphoma

Question 12

What is non-hodgkin lymphoma?

Answer 12

Malignant proliferation of lymphoid cells (blasts OR mature cells) in LNs

Question 13

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?

Answer 13

NHL!

B sxs

Question 14

What is the best predictor of prognosis for NHL?

Answer 14

LN and level of metastesis

STAGE

which depends on LOCATION

Question 15

What are the differences between low and high grade NHL tumors?

Answer 15

Low: older, indolent, small mature cells, non-destructive

High: children, aggressive, big ugly cells, destructive

Question 16

SLL is the same things as _______. It is characterized by_____________.

Answer 16

CLL!

small mature lymphocytes….like it says in the name.

Question 17

SLL targets what cells and what CD marker?

Answer 17

B cell lesion

CD5+ (This is WIERD b/c it’s usually a T cell marker)

Question 18

You see a pt diagnosed w/ SLL. The course of this disease is likely to be long_______and death will likely be from______.

Answer 18

LONG

INFECTION

Question 19

What type of information can CLL undergo? Prognosis?

Answer 19

Richter transformation–> poor prognosis

Question 20

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.

Answer 20

MALT LYMPHOMA

helicobacter pylori

Marginal zone lymphoma (these lymphomas have “marginal zone patterns”)

Question 21

t(11,14) does what and causes what type of lymphoma?

Answer 21

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!

Question 22

Mantle cell lymphoma is characterized by what two features……Is it aggressive?

Answer 22

Mantle zone pattern
small angulated lymphocytes

YES it is aggressive

Question 23

t(14;18) is associated w/ what type of lymphoma?

Answer 23

Follicular lymphoma!

Same deal as mantle. Codes for IgH and bcl-2—so this anti-apoptotic factor is overly expressed.

Question 24

If you saw a “butt cell” you would know it’s what type of cancer……

Answer 24

Follicular lymphoma

Question 25

What do the follicles of follicular lymphoma look like? What stain will mark B cells in a LN?

Answer 25

Back to back follicles that have infiltrated a capsule so there are some fat cells. Can be mixed or large cell. CD20 stain

Question 26

What stages are associated w/ follicular lymphoma and what are the correlated grades?

Answer 26

I-small cells, better prognosis II- small and large cells III- larger cells, worse prognosis

Question 27

What lymphoma mimics psoriasis/eczema early on then progressively forms mushroom like lesions?

Answer 27

Mycosis fungoides! Does this have blood involvement? YES

Question 28

If you saw cerebriform lymphocytes on a slide, you would think_________immediately.

Answer 28

MYCOSIS FUNGOIDES

Question 29

Mycosis fungoides has what sort of immunophenotype?

Answer 29

T cell

Question 30

What are the characteristics of diffuse large cell lymphoma?

Answer 30

LARGE B cells> BAD prognosis Grows rapidly> extranodal involvement

Question 31

Lymphoblastic leukemia is the same as________. What are the two types and which one is worse?

Answer 31

ALL B and T T in Teenage males w/ Thymic masses is WORSE.

Question 32

WHat do you see in Lymphoblastic lymphoma?

Answer 32

Lymphoblasts in diffuse patterns.

Question 33

If you saw a child w/ a fast growing extranodal mass (either in the mandible or abdominal area) you'd thing it was.....

Answer 33

Burkitt lymphoma!

Question 34

What translocation is assoicated w/ Burkitt?

Answer 34

t(8;14)-----c-myc gets put next to IgH then overexpressed and cell grows like CRAZY.

Question 35

What pattern is associated w/ Burkitt's? YOU SHOULD REALLY KNOW THIS.

Answer 35

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

Question 36

Japan/Carribean basin, HTLV, hypercalemia......makes you think of:

Answer 36

Adult T cel leukemia/lymphoma of course! VERY AGGRESSIVE **cells look flowery

Question 37

What are the 5 types of hodgkin lymphoma?

Answer 37

Nodular lymphocyte ``` Classical: Nodular sclerosis lymphocyte rich mixed cellularity lymphocyte depletion ```

Question 38

Why does hodgkin lymphoma often have a good prognosis?

Answer 38

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.

Question 39

If you see an angry owl cell (Reed sternberg) you AUTOMATICALLY know that it's.....

Answer 39

Hodgkin lymphoma

Question 40

How do you treat HL? What is the prognosis? What is the danger?

Answer 40

Surgery, chemo, radiation Prognosis depends on stage Second malignancies

Question 41

What is the "new kind" of HL and who is it commonly seen in?

Answer 41

Nodular lymphocyte Asymptomatic young males w/ cervical lymphadenopathy.

Question 42

Popcorn cells are associated w/ what more common HL?

Answer 42

Nodular lymphocyte HL

Question 43

What is the most common subtype of HL and it's distinguishing characteristic?

Answer 43

Nodular sclerosis HL Lacunar cells

Question 44

Mixed cellularity HL is bad because.....On a slide you'd see.....

Answer 44

it usually is disseminated at presentation. Classic RS cells and a mixture of background cells.

Question 45

What is an uncommon HL that also has popcorn cells and is usually localized at presentation?

Answer 45

lymphocyte rich HL

Question 46

What HL has a collagen or reticulin background, classic RS cells, is RARE, and is often disseminated at presentation?

Answer 46

Lymphocyte depletion HL