Krafts Week 4 ("Must Know") Flashcards
Immunophenotype of CLL
Positive for:
B-cell antigens (CD20)
T-cell antigen (CD5)!**
Negative for:
TdT – marker for lymphoblasts… we’re talking about mature cells
Hairy Cell Leukemia
Hairy cells
Splenomegaly without lymphadenopathy
Pancytopenia – due to marrow fibrosis –> dry aspiration of marrow tap
TRAP + (FLOW is now replacing…)
Prolymphocytic Leukemia
Prolymphocytes – real, but elusive cell.
Splenomegaly without lymphadenopathy
Rare
Aggressive
Laboratory: high WBC,
and low Hgb and
platelet count
Large Granulated Lymphocyte Leukemia
Large granulated lymphocytes
T-cell
Neutropenia
Long survival
Causes of lymphadenopathy…
Most common cause overall: benign reaction to infection
Most common malignant cause: metastatic carcinoma
Benign Follicular Hyperplasia
Large, irregular follicles
Mixture of cells in germinal centers
Tingible body macrophages
B-cell response to some immune stimulus
Benign Interfollicular Hyperplasia
Expanded area between follicles
Mixture of cells
Partial effacement – lymph node is not completely gone… still has normal anatomical features
T-cell response to some immune stimulus
Non-Hodgkin Lymphoma
Malignant proliferation of lymphoid cells (blasts or mature cells) in lymph nodes
Skips around – in body – unpredictable
Many subtypes
Most are B cell
Small Lymphocytic Lymphoma
Small mature lymphocytes
Same thing as CLL
B-cell lesion, but CD5+ (weird!)
Long course; death from infection
Can transform into high grade lymphoma (all types)
Marginal Zone Lymphoma
Marginal zone pattern… in the spleen.
Malt (mucosa associated lymphoid tissue) lymphoma is a common type
Driven somehow by Helicobactor pylori
give antibiotics against Helicobacter pylori…
Mantle Cell Lymphoma
Mantle zone pattern
Small angulated lymphocytes
t(11;14) – cyclin D1 is close to IgH… so now D1 is express at much higher levels
More aggressive
Follicular Lymphoma
Follicular pattern (later diffuse)
Small cleaved cell, mixed or large cell
Blood “butt-cells” – deeply clefted nuclei Grade 1, 2, or 3
Small, big, biggest cells. Grade 3 has the worst prognosis
t(14;18) - IgH and bcl-2… (bcl-2 is anti-apoptotic)
Mycosis Fungoides/Sézary Syndrome
Skin lesions
Pautrier microabscess
Blood involvement
Cerebriform lymphocytes – name of these cells, creased nuclei
T-cell immunophenotype
(Lymphoma/leukemia)
Diffuse Large-Cell Lymphoma
Large B cells (usually)– high grade
Extranodal involvement
Grows rapidly –>
Bad prognosis
Lymphoblastic Lymphoma
Two types: B and T
Lymphoblasts in diffuse pattern
Same as ALL
T-lymphoblastic lymphoma
often in teenage male with mediastinal mass
