Lecture 11: Non-Hodgkin's Lymphoma Flashcards
What is a non-hodgkin’s lymphoma?
Essentially every lymphoma case that isn’t Hodgkin’s lymphoma. This makes them much more common than Hodgkin’s lymphoma, making up around 85% of all lymphoma cases. These lymphomas are extremely heterogeneous.
How does the WHO classify types of non-Hodgkin’s lymphoma?
There are 3 main groups:
- Precursor B-cell NHL.
- B-cell NHL
- T-cell/NK NHL.
However, each of these groups consists of other conditions:
Precursor B-cell NHL: 2 recognised lymphoblastic lymphoma.
B-cell Neoplasms: 10
T cell/NL: 10
Each of these sub-groups can also have variations leading to around 60 unique conditions.
What is Burkitt’s lymphoma?
A precursor B-cell NHL. It accounts for around 50% of all juvenile NHL cases, but some can manifest later on in life.
There are 3 variants:
- Endemic
- Sporadic
- Immunodeficient
Endemic and immunodeficient cases are often associated with EBV.
What is the link between malaria and EBV?
Malaria significantly increases patient susceptibility to EBV. It does this by downregulating TNF-a, IL-6, MCP-1, and upregulating IL-10 in sporozoite stage.
In blood stage, parasite can induce expression of sFGL, normally produced by Treg cells, and is an immunosuppressant.
TNF-a and IL-6 are pro-inflammatory cytokines with large system wide effects.
MCP-1 (monocyte chemoattractant protein-1) attracts monocytes and macrophages.
IL-10 is a potent anti-inflammatory cytokine.
What is c-myc?
What is the association of c-myc with Burkitt’s?
In Burkitt’s lymphoma, c-myc activation is present in most cases, around 70-80%.
The most common translocation is t(8;14) (q24;132). This places the c-myc gene next to the IGH (immunoglobulin heavy chain) enhancer/promoter. This results in the over-expression of c-myc. This translocation is present in 85% of
other 15%
How can Burkitt’s lymphoma be histologically identified?
How can immunohistochemistry be used in Burkitt’s lymphoma identification?
What treatments are available fro Burkitt’s lymphoma?
What is rituximab?
What is follicular lymphoma?
Why is it called follicular lymphoma?
What age is follicular lymphoma more common in?
What genes and mutations cause the formation of follicular lymphoma?
What are malignant transformations?
