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Block 7 Week 1 > Lymph Nodes, Lymphomas and Related Tumors-Parks > Flashcards

Lymph Nodes, Lymphomas and Related Tumors-Parks Flashcards

1
Q

What are the three types of things you should be thinking about if you see an enlarged lymph node?

A
  1. benign, reactive lymph nodes
  2. non-hodgkins lymphomas (NHLs)
  3. Hodkins lymphoma
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2
Q

If you have enlarged preauricular nodes (drain scalp and skin) what is your differential diagnosis?

A

scalp infections, mycobacterial infection

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3
Q

What are the malignancies associated with preauricular nodes?

A

skin neoplasm, lymphomas, head and neck squamos cell carcinoma

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4
Q

If you have enlarged posterior cervical nodes (drain scalp, neck and upper thoracic skin) what is your differential diagnosis?

A

scalp infections, mycobacterial infections

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5
Q

If you have enlarged supraclavicular nodes (drains GI tract, GU tract pulmonary) what is your differntial diagnosis?

A

abdominal/thoracic neoplasms, thyroid/laryngeal disease, mycobacterial/fungal infections

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6
Q

If you have enlarged submandibular nodes (drain oral cavity) what is your differential diagnosis?

A

mononucleosis, upper respiratory, viral/bacterial infections, myocbacterial infections, toxoplasm, cytomegalovirus, dental disease, rubela

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7
Q

What are the malignancies associated with enlarged submandibular nodes?

A

squamos cell carcinoma of the head and neck, lymphomas and leukemia

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8
Q

If you have enlarged anterior cervical nodes (drain larynx, tongue, oropharynx, anterior neck) what is your differential diagnosis?

A

mononucleosis, upper respiratory, viral/bacterial infections, myocbacterial infections, toxoplasm, cytomegalovirus, dental disease, rubela

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9
Q

The (blank) areas are very common locations to find lymphadenopathy because there are so many structures to undergo inflammation, infection and neoplasia.

A

head & neck

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10
Q

Which would you rather have, a reactive or a neoplastic lymph node?

A

reactive!

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11
Q

When will you get reactive lymphadenitis?

A

draining sore throats, either strep or viral

draining skin wounds.

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12
Q

Reactive lymphadenitis is a type of (blank) nonspecific lymphadenitis

A

acute

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13
Q

In benign reactive hyperplasia (chronic nonspecific lymphadenitis) what are the three things that happen?

A

follicular hyperplasia
oaracortical hyperplasia
sinus histiocytosis

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14
Q

In benign reactive hyperplasia, what will you see in germinal centers?

A

expansion so B cells are being activated/stimulated

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15
Q

What causes B cell hyperplasia? What causes T cell hyperplasia?

A

bacteria

viruses

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16
Q

What is this:
16 y/o female has major tiredness, sore throat and fever. She is found to have a bilateral cervical adenopathy and mild splenomegaly

A

mono

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17
Q

In mono even though it affects your B cells you will get (blank) hyperplasia

A

T cell

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18
Q

With cancers, 2 processes can occur in regional draining lymph nodes, what are they?

A

1) metastasis

2) no metastasis but Reactive Changes- Sinus histiocytosis

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19
Q

If you have sinus histiocytosis, do you have breast cancer?

A

no

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20
Q

What is commonly found in lymph nodes draining breast cancer and other cancers? This finding does not mean that there is metastatic carcinoma. It is a reaction.

A

sinus histiocytosis

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21
Q

(blank) can cause cervical lymphadenopathy

A

Bartonelli hensley

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22
Q

(blank) are primary cancer while metastatic carcinoma is secondary

A

lymphoma

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23
Q

T or F

All lymphomas are malignant

A

T

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24
Q

Lymphomas and leukemias come from the same (blank)

A

stem cell in the bone marrow

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25
Q

What differs between lymphomas and leukemias?

A
  • lymphomas are in masses

- while leukemias involved the bone marrow and peripheral blood (leukemias)

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26
Q

What color are lymphomas?

A

white :)

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27
Q

With (blank) you can get lymphomas in the brain

A

AIDS/HIV

** people with AIDS/HIV have an increased incidence of lymphomas***

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28
Q

What are the 2 types of lymphomas?

A

non-hodgkins lymphoma

Hodgkins Lymphoma

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29
Q

Non-hodgkins lymphoma primarily affects (blank) cells

A 
B cells (80%)
T cells (20%)
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30
Q

T or F

Most lymphomas are B cell

A

T

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31
Q

What is another name for lymphoplasmacytic lymphoma?

A

waldenstroms macroglobulinemia

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32
Q

most lymphomas are coming out of the (blank) because this is where B cell maturation occurs

A

germinal center

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33
Q

If you have a lymphoma and run it through flow cytometry you will get (blank)

A

light chain restriction (i.e one type of light chain cuz you have monoclonal population)….either all kappa or all lambda

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34
Q

(blank) population is reactive.

(blank) population is malignant

A

polyclonal

monoclonal

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35
Q

What is the most common lymphoma?

A

diffuse large B cell lymphoma

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36
Q

What is the second most common lymphoma?

A

Follicular pattern

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37
Q

The t(blank; blank) chromosomal translocation is a model for several translocations in lymphomas that result in juxtaposition of a cellular proto-oncogene with immunglobulins or T cell receptor genes.

A

14;18

38
Q

The t(14;18) chromosomal translocation is a model for several translocations in lymphomas that result in juxtaposition of a cellular proto-oncogene with immunglobulins or T cell receptor genes. THe (blank) gene on chromosome 18 is translocated to chromosome 14 directly adjacent to immunoglobulin heavy chain gene.

A

Bcl-2

39
Q

With follicular hyperplasia you see a lot of (blank)

A

apoptosis

40
Q

In follicular hyperplasia what is the chromosomal abnormality?

A

you translocate BCL2 in front of the IGH (heavy chain) which is an intense promotor thus creating a shit ton of BLC2 (therefore inhibition of apoptosis and increased proliferation)

41
Q

How come BCL2 inhibits apoptosis?

A

because it stabilizes the mitochondrial membrane inhibiting cytochrome C release and thus you cannot get apoptosis

42
Q

In DLBCL you have dysregulation of (Blank) which results in overexpression of it.

A

BCL-6

43
Q

What will dysresgulation (overexpression) of BCL-6 get you in DLBCL?

A

No germinal cell formation
imparied B cell diff,
no apoptosis

44
Q

B cells have (Blank) that retuximab (a monoclonal antibody) attacks

A

CD20

45
Q

retuximab can attach to CD20 and cause (Blank) and (blank)

A

complement mediated lysis and ADCC (antibody dependent cell mediated cytotoxicity)

46
Q

What are the three types of Burkitt’s Lymphomas?

A

African (endemic) type
Sporadic (nonedemic) type
HIV associated type

47
Q

Almost all Burkitts lymphomas are caused by (blank)

A

EBV

48
Q

What is this:

Almost all latently infected with EBV> Most african cases in “malarial belt”. Extra-nodal. (think head and neck)

A

African (endemic) type Burkitt’s lymphoma

49
Q

Why type of burkitts lymphoma will you see in America?

A

Sporadic (nonedemic) type

50
Q

What is this:

15-20% latent infection with EBC. Retroperitoneum. (think abdomen)

A

Sporadic (nonedemic) type Burkitt’s lymphoma

51
Q

Of the people who have HIV associated Burkitt’s lymphoma, what percent are caused by latent EBV?

A

25%

52
Q

What is the chromosomal abnormality associated with Burkitt’s lymphoma?

A

Myc Oncogene translocated next to Ig heavy chain locus resulting in increased MYC protein (between chromsome 8 and 14)

53
Q

(blank) participates in many cell processes including proliferation and apoptosis.

A

C-myc

54
Q

(blank) is usually an aggressive lymphoma, as opposed to (blank) which may take years to cause problems.

A

DLBCL

follicular lymphoma

55
Q

With (blank) we started seeing aggressive B cell lymphomas of the brain and are highly assocated with EBV

A

HIV

56
Q

In HIV, EBV turns into a (blank) virus

A

oncogenic

57
Q

(blank) is a T lymphoma in which the skin is the primary site. The cutaneous manifestations of mycosis fungoides are protean like those of leukemia cutis. The premycotic stage is characterized by skin.

A

Mycosis Fungoides

58
Q

What age group do you see mycosis fungoides?

A

old people

59
Q

If you see nests in the epidermis, what disease process is occuring?

A

mycosis fungoides

60
Q

THe mycosis fungoides cells have (blank)

A

epidermotropism

61
Q 
In mycosis fungoides;
the nucleus is (blank)
chromatin is (blank)
nucleolus is (bank)
cytoplasm is (blank)
A

irregular, convoluted
dense
indistinct
scant

62
Q

What kind of nuclei appearance do sezary cells (mycosis fungoides) have?

A

cerebriform

63
Q

What kind of nuclei appearance does HTLV1 have?

A

clover leaf floret

64
Q

When mycoides fungoides gets into the blood stream you get (blank) cells

A

sezary

65
Q

When mycoides fungoides gets into the blood stream you get (blank) cells

A

sezary

66
Q

Is hodgkins lymphoma a B cell or a T cell lymphoma?

A

B cell lymphoma

67
Q

Hodgkins lymphoma is assoicated with (blank) cells.

A

Classic Reed-Sternberg cell

68
Q

What are the 2 most common hodgkins lymphomas?

A

Nodular sclerosis (70%) and Mix cellularity (20%)

69
Q

In nodular sclerosis, is it common to have EBV

A

no

70
Q

In mix-cellularity hodkins lymphoma is it common to have EBV?

A

yes (70%)

71
Q

(blank) in hodgkins lymphoma turns on genes which promote lymphocyte proliferation and survival

A

NF-kB

72
Q

What are the four classifcal forms of hodgkins lymphoma?

A

nodular sclerosis
mix-cellularity
lymphocyte-rich
lymphocyte depletion

73
Q

What is the nonclassical form of hodgkins lymphoma?

A

Lymphocyte-predominate (L and H variants of RS cells)

not associated with EBV

74
Q

What type of hodgkins lymphoma has the best survival rate?

What has the worst?

A

lymphocyte predominate

lymphocyte depletion

75
Q

Reed sternberg cells secrete a lot of (Blank) which turn on fibroblasts and cause scarring, bring in plasma and eosinophils

A

cytokines

76
Q

What do reed sternberg cels suppress to cause cutaneous anergy and make you more suceptible to TB and listeria?

A

TH1 and cytotoxic T cell response

77
Q

Night sweats are a clinical sign of (blank)

A

hodgkins lymphoma

78
Q

Is it “usual or unusual” for nodular sclerosis to involve the mediastinum and hilar lymph nodes?

A

usual

79
Q

Normal lymph nodes are (round/flat)?

A

flat, if you see a round one, you should be worried

80
Q

where do you see popcorn cells?

A

in ymphocyte predominant, L and H varient hodgkins lymphoma

81
Q

90% of the time, hodgkins lymphoma that has a primary tumor in the cervical lymph nodes will first go to the hilar/mediastinum and then to ….?

A

spleen!!!!

82
Q

In hodgkins lymphoma you have (blank) spread

A

contiguous

83
Q

How do you stage hodgkins?

A

1-4…. restricted to one are (1), 2 areas (2), both sides of the diaphragm (3), extranodal (4)

84
Q

What is this:
more frequent involvement of multiple peripheral nodes
noncontiguous spread
waldeyer ring and mesenteric nodes commonly involved
extranodal involvement common

A

non-hodgkin lymphoma

85
Q

What is this:
more often localized to a single axial group of nodes (cervical, mediastinal, para-aortic)
orderly spread by contiguity, mesenteric nodes and waldeye ring rarely involved, extranodal involvment uncommon.

A

Hodgkin lymphoma

86
Q

If you are in an A category what does that mean.

A

no symptoms

therefore B means you have symptoms

87
Q

If you have a B catergory lymphoma what does this mean?

A

you have fever, night sweats, and unexplained weight loss

88
Q

If a patient has one or more of the above (fevers, night sweats or weight loss exceeding 10% body weight over 6 months) then they are (blank). If these are Absent then they are (blank).

A

B

A

89
Q

Where do you find marginal zone lymphomas?

A

in MALT and chronically inflammed tissue like H pylori gastritis.

90
Q

How do you treat marginal zone lymphomas?

A

antibiotics leads to regression (remain localized for long periods)

91
Q

(blank) is TB involving the lymph nodes of the head and neck

A

Scrofula

Block 7 Week 1 (10 decks)

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