Lymph nodes and Lymphomas - Parks Flashcards
Acute nonspecific lymphadenitis can be caused by (bacteria/viruses/both)
both
T/F: diffuse hyperplasia of the lymph node can be a non-malignant finding
true, in reactive nodes
what are the three types of reactive hyperplasia of a lymph node?
- follicular hyperplasia
- paracortical hyperplasia
- sinus histiocytosis (increased macrophages)
If given the choice of a lymph node or a skin rash to biopsy, which should you do and why?
lymph node, will give you more information than the skin rash and will be conclusive the first time
Bacteria cause (B/T) cell stimulation while viruses cause (B/T) cell stimulation
BACTERIA = B cell
Virus is T cell
Paracortical hyperplasia is caused by expansion of what cell type?
T cells
germinal center or cortical hyperplasia is caused by expansion of what cell type?
B cell
T/F: in cancer, it is possible to have reactive changes to a lymph node without the presence of a met
true
T/F: all lymphoid neoplasms are malignant
true
(leukemia/lymphomas) form masses
lymphomas
(leukemia/lymphoma) are diseases of the peripheral blood
leukemia
(leukemia/lymphoma) involves the bone marrow
leukemia
What are the most common sites of extranodal involvement in lymphomas? Where does it go if you have AIDS?
Spleen, liver, and bone marrow
Goes to brain in AIDS
(B/T) cell lymphoma is the most common type of NHL
B cell; 80%
What are the two most common types of lymphoma?
DLBCL and follicular lymphoma
Where in the body do the B cell maturation steps happen?
In the lymph node; naive B cells leave the bone marrow and mature in the node
What is light chain restriction?
When only one light chain variety is produced by a myeloma plasma cell
If on flow you see that you are working with half lambda and half kappa chains, you know you are working with a (mono/poly)clonal population
polyclonal
Describe the gross anatomical difference between DLBCL and follicular lymphoma?
DLBCL: DIFFUSE; just see lots of B cell proliferation all through the marrow and nodes
Follicular; see a lymph node just chalk fucking full of germinal centers
T/F: follicular hyperplasia includes high levels of apoptosis
true! actively selecting for B cells with the highest affinity for binding
csomal translocations in B cell lymphomas involves the movement of BCL2 next to the (blank) locus leading to stabilization of the mito membrane and prevention of apoptosis
IGVH
Is DLBCL or follicular lymphoma the most common type?
follicular is most common
DLBCL is caused by the dysregulation of BCL (2/6)
BCL 6
BCL 6 is a DNA binding transcriptional (activator/repressor)
repressor
Overexpression of BCL 6 leads to what three things?
- no germinal center dev (hence diffuse appearance)
- impaired B cell differentiation
- no apoptosis
Which CD marker is found in DLBCL?
CD20
What are the two MOAs of rituximab?
complement mediated lysis (CDC), and ADCC (Ab depedent cell cytotox)
EBV induced Burkitt’s lymphoma is (intra/extra) nodal
extranodal
Is the African or Sporadic type Burkitt’s lymphoma extranodal? which is in the retroperitoneum?
African = extranodal sporadic= retroperitoneum
What types of pts are at high risk of latent EBV infection?
HIV
T/F: in ALL forms of Burkitt’s there is a csomal translocation
true
what gene is moved to be next to IGVH in burkitt’s lymphoma?
c-MYC
What is the role of c-myc?
participates in many cell processes including proliferation and apoptosis
Is DLBCL or follicular lymphoma aggressive?
DLBCL
What T cell lymphoma homes to the skin in older people?
Mycosis fungoides
What T cell lymphoma shoes epidermotropism?
mycosis fungoides
Mycosis fungoides can cause (blank) syndrome once it gets into the blood, as seen by cells with cerebroform nuclei
Sezary syndrome
What is the characteristic cell of hodgkin’s lymphoma that shows with a “mirror image’ nuclei/
Reed sternberg cells
What is the role of NF-kB in HL?
turns genes on that promote lymphocyte proliferation and survival
What is the most common form of HL?
Nodular sclerosing
T/F: all types of HL activate NF-kB
true
Which form of HL has the best prognosis? The worst?
Best: lymphocyte predominant
worst: lymphoctye depleted
What T cell does HL suppress?
Th1 cells
Suppression of Th1 cells by HL leads to T cell (blank) and infection with what two organisms?
T cell anergy leading to TB and listeria infections
What are the background cells in mixed cellularity HL?
eosinophils and lymphocytes
what is the major cell type in lymphocyte depleted HL?
reed sternberg cells
Which lymph nodes are commonly involved in HL?
Bilateral hilar and mediastinal
A yellow lymph node with white striping tells you what?
Yellow is the HL and the white striping is the scarring (sclerosis)
Are normal lymph nodes flat or round?
flat
Popcorn Reed Sternberg cells are seen in what variant of HL?
Lymphocyte predominant
T/F: Hepatic involvement in HL always indicates splenic involvement
true
(HL/NHL) moves in a linear, stepwise, predictable fashion
HL
What are the three B symptoms?
Fevers, night sweats, and wt. loss
How many of the three symptoms do you need to be class B HL?
2 out of 3
T/F: TB is common in HL
true
A negative skin test to a common ag like candida would indicate what about T cell function?
anergy
T/F: you can also see B symptoms in NHL
true
