Lymph Nodes (Syrbu) Flashcards
True or false: double negative T cells may sometimes escape the thymus and get into circulation before they have finished their selection process.
True! Syrbu said to make a note because this would probably be on the exam.
He also mentioned that as we age, something like 5% of T-cells in circulation are double positive T cells and that this is a normal morphological finding.
Which of these cell markers is incorrectly matched with its corresponding cell? A. CD19 - precursor and mature B cells B. CD20 - mature B cells C. CD34 - myeloid/lymphoid precursors D. CD10 - pan T-cell marker E. CD4/8 - cortical thymocytes
D. CD10 is a precursor B-cell and germinal center cell marker. CD3 is the pan T-cell marker.
these aggregations of lymphoid tissue in the ileum are covered by a special epithelium that contains microfold cells (M cells) which sample antigen directly from the lumen and deliver it to antigen-presenting cells
Peyer’s patches
Enlargement of ____ pulp in the spleen may be due to B cell lymphoma or leukemia, while ____ pulp enlargement is often due to congestion, leukemia or autoimmune processes.
white; red
____ is the acute and chronic inflammatory process of lymph nodes that occurs in response to a variety of pathogenic agents, including infection and drugs
lymphadenitis
this is the most common cause of benign adenopathy in children and is characterized by localized swelling of the lymph node that does not regress with antibiotic therapy
reactive lymphoid hyperplasia
Which of the following is NOT associated with reactive lymphoid hyperplasia?
A. Soft, tender, freely movable lymph nodes
B. Polarized follicles with tingible body macrophages
C. Common in children
D. High mitotic activity
E. Bcl2+ in germinal centers
E. In reactive lymphoid hyperplasia, germinal center B cells are CD20+, CD10+ and Bcl6+, but Bcl2-.
This is one way you distinguish lymphoid hyperplasia from lymphoma (which is bcl2+)
THIS WILL LIKELY BE ON THE TEST!
This test can be performed rapidly in the doctor’s office for infectious mononucleosis (due to EBV)
monospot test
this disease caused by the gram negative bartonella henselae can be identified histologically by necrotizing granulomas with PMNs
cat scratch lymphadenitis
this is the most common parasitic infection in the US, may present with either tender or painless lymph nodes that can persist up to 1 year
toxoplasma lymphadenitis
All of the following are characteristic of toxoplasma lymphadenitis EXCEPT:
A. Follicular hyperplasia
B. Granulomas
C. Clusters of epitheloid histiocytes (activated macrophages)
D. Absence of fibrosis
E. Monocytoid B cells
B. Toxoplasma lymphadenitis does not exhibit granulomas, necrosis, fibrosis, neutrophils or eosinophils.
All of the following are clinical features of lymphoma EXCEPT:
A. Fever
B. Single or non-contiguous lymph node involvement
C. Slow or rapid development
D. Painful lymphadenopathy
E. Extranodal involvement in approx 1/3 of cases
D. Lymphoma is usually associated with painless lymphadenopathy.
What is the etiology in 70-95% of follicular lymphoma cases?
Bcl-2 gene rearrangment, t(14;18)
Follicular lymphoma tends to be asymptomatic and often most patients (2/3) do not present until they are at least in stage 3.
30-40% of all non-Hodgkin lymphoma is this type, characterized by a rapidly enlarging, often asymptomatic mass at a nodal or extranodal site (e.g., skin, CNS, testis, bone, thyroid) and often results from t(14;18)
diffuse large B cell lymphoma (DLBCL)
*some patients have a history of low grade lymphoma with transformation and some have history of immunodeficiency
what is the immunophenotype of diffuse large b cell lymphoma? what drug can be used to treat this common but aggressive cancer?
CD19 and CD20; can be treated with rituximab
though a t(14;18) involving the Bcl-2 gene presents in about 20-30% of large diffuse b cell lymphomas, 70% are caused by a mutation in what gene?
Bcl-6
very aggresive type of lymphoma with a 24 hour doubling time, which may present as a jaw or orbital mass (Africa) or abdominal mass (US); also associated with immunodeficiency as seen in HIV or transplanted patients
Burkitt lymphoma
burkitt lymphoma is most often caused by this translocation
t(8;14)
low grade B cell lymphoma that makes up about 6% of non-hodgkin lymphoma in older adults (mostly males age 50-70) with extranodal involvement and leukemic presentation
mantle cell lymphoma; t(11;14)
lymphoma associated with H. pylori and only CD19 and CD20 markers
mantle zone lymphoma
lymphoma characterized by dinucleate reed sternberg cells, that is one of the most common malignancies in young people with a high cure rate (CD30+ CD15+ CD45-)
hodgkin lymphoma
*nodular sclerosis classical hodgkin lymphoma (NSCHL) is the most common subtype
All of the following are low grade lymphomas EXCEPT: A. follicular B. marginal cell C. diffuse large b cell lymphoma D. mantle zone E. small cell
C. Diffuse large B cell lymphoma is a high grade lymphoma, which is the type that is more curable. Another type of high grade lymphoma is burkitt lymphoma.
____ grade lymphomas occur most often in elderly people, very rarely in children, and are usually incurable
low grade
translocation associated with burkitt lymphoma
t(8;14), involving cMyc gene
*he says this will be on the exam
translocation associated with follicular lymphoma
t(14;18), involving bcl2
*he says this will be on the exam
translocation associated with mantle cell lymphoma
t(11;14), involving cyclin D1
*he says this will be on the exam
Which of the following lymphomas is INCORRECTLY matched with its translocation? A. CML - t(9;22) B. ALL - t(12;21) C. APML - t(12;19) D. Follicular lymphoma - t(14;18) E. Burkitt lymphoma - t(8;14) F. Mantle cell lymphoma - t(11;14)
C. Acute promyleocytic leukemia is caused by a t(15;17) and is characterized by butterfly or kidney shaped nuclei in a bone marrow aspirate; treated with ATRA.
Which of these lymphomas would be CD23+? A. CLL/SLL B. Follicular C. Mantle cell D. Burkitt E. Mantle zone
A
