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Heme/Lymph > Lymphadenopathy Study Guide > Flashcards

Lymphadenopathy Study Guide Flashcards

1
Q

Lymph nodes may become enlarged, termed lymphadenopathy, in two kinds of processes. What are they?

A

reactive and neoplastic

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2
Q

What causes reactive lymphadenopathy and what does does the histology look like?

A

Causes:

  1. Infectious: Infectious mononucleosis, Cat scratch, Others
  2. Autoimmune

Histology:

  1. Follicular hyperplasia: B cell expansions
  2. Paracortical hyperplasia: T cell expansions
  3. Sinus histiocytosis
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3
Q

What are the two major sub-classes of lymphoma?

A

Non-Hodgkin lymphomas and Hodgkin lymphomas

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4
Q

What are the two sub-classes of Non-Hodgkin lymphomas?

A

Mature B cell vs mature T cell

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5
Q

What are the mature B cell lymphomas?

A

a. Follicular lymphoma
b. Mantle cell lymphoma
c. Diffuse large B cell lymphoma (DLBCL)
d. Burkitt lymphoma
e. Extranodal marginal zone lymphoma

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6
Q

What are the mature T cll lymphomas?

A

a. Peripheral T-cell lymphoma
b. Extranodal NK/T-cell lymphoma
c. Anaplastic large cell lymphoma

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7
Q

What causes Burkitt lymphoma?

A

Translocations involving c-MYC and immunoglobulin loci, usually t(8; 14) but may be t(2;8) or t(8;22)

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8
Q

Who gets Burkitt lymphoma?

A

Adolescents or young adults withrapidly growing extranodal masses (ileocecum)

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9
Q

What course does Burkitt’s take?

A

Aggressive.

uncommonly presents as “leukemia”; 3 variants: endemic (EBV associated),
sporatic, and
immunosuppression-related (EBVassociated

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10
Q

What are the CD markers for Burkitts?

A

CD10(+)
CD19(+)
CD20(+)

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11
Q

What causes Diffuse large B-cell lymphoma?

A

Diverse chromosomal rearrangements

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12
Q

Who gets Diffuse large B-cell lymphoma?

A

All ages, but most common in adults

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13
Q

What is the course of Diffuse large B-cell lymphoma?

A

Aggressive.

often appears as a rapidly growing mass/lymphadenopathy

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14
Q

What are the CD markers for Diffuse large B-cell lymphoma?

A

CD19(+)

CD20(+)

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15
Q

What causes Extranodal

marginal zone lymphoma (MALToma)?

A

t(11;18) is the most common abnormality observed in gastric MALTomas, creating MALT1-IAP2 fusion genes

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16
Q

Who gets MALToma?

A

Arises in the lymphoid tissue of mucosal/epithelial-based sites in adults

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17
Q

What the clinical course of MALToma?

A

Indolent.

tend to be localized; most frequent sites of involvement include:
gastric, orbital, thyroid, lung; may be observed in association with chronic infections or inflammatory diseases

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18
Q

What are the CD markers for MALToma?

A

CD5(-)
CD10(-)
CD19(+)
CD20(+)

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19
Q

What causes follicular lymphoma?

A

t(14;18) creating BCL2-IgH fusion gene or less commonly BCL6 rearrangements

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20
Q

Who gets follicular lymphoma?

A

Adults with generalized lymphadenopathy, frequent retroperitoneal involvement

21
Q

What is the clinical course of follicular lymphoma?

A

usually slow growth however 40% transform to a more aggressive lymphoma

22
Q

What are the CD markers for follicular lymphoma?

A

CD5(-)
CD10(+)
CD19(+)
CD20(+)

23
Q

What causes mantel cell lymphoma?

A

t(11;14) creating cyclinD1-IgH fusion gene

24
Q

Who gets mantle cell lymphoma?

A

Older males with disseminated disease;

frequent GI involvement

25
Q

What is the course of mantle cell lymphoma?

A

moderately aggressive

26
Q

What are the CD markers for mantle cell lymphoma?

A

CD5(+)
CD10(-)
CD19(+)
CD20(+)

27
Q

What are the Mature T/NK cell lymphomas?

A

a. Peripheral T-cell lymphoma
b. Extranodal NK/T-cell lymphoma
c. Anaplastic large cell lymphoma

28
Q

What is the cell of origin in Peripheral T-cell

lymphoma?

A

helper T cell

29
Q

What mutation causes Peripheral T-cell

lymphoma?

A

No specific chromosomal abnormality

30
Q

What are the clinical features of peripheral t cell lymphoma?

A

Aggressive.

Mainly older adults; usually presents with lymphadenopathy

31
Q

What is the cell of origin for Anaplastic large-cell lymphoma?

A

cytotoxic t cell

32
Q

What is the mutation that causes Anaplastic large-cell lymphoma?

A

Rearrangements of ALK gene

33
Q

What are the clinical features of Anaplastic large-cell lymphoma?

A

Aggressive.

Children and young adults, usually with lymph node and soft-tissue disease

34
Q

What is the cell of origin in Extranodal NK/T-cell lymphoma?

A

NK-cell (common) or cytotoxic T cell (rare)

35
Q

What is the mutation that leads to Extranodal NK/T-cell lymphoma?

A

EBV-associated; no specific chromosomal abnormality

36
Q

What is the clinical course of Extranodal NK/T-cell lymphoma?

A

Aggressive.

Adults with destructive extranodal masses, most commonly sinonasa

37
Q

What are the two types of hodgkin lymphoma?

A

Classical Hodgkin lymphoma and Nodular lymphocyte predominate Hodgkin lymphoma (NLPHL)

38
Q

Who gets classical hodgkins?

A

Adolescents/younger adults

39
Q

What sites are involved in classical hodgkins?

A

Mediastinum, cervical

40
Q

What do the cells look like in classical hodgkins?

A

Reed Sternberg cells in the background of reactive inflammatory cells (eosinophils, neutrophils), “lacunar” cells, nodules and sclerosis in a subset

41
Q

What are the CD markers of classical hodgkins?

A

CD15(+)
CD30(+)
CD20(-)
CD45(-)

42
Q

What is the cell of origin for classical hodgkins?

A

B cell

43
Q

What is the clinical course of classical hodgkins?

A

moderately aggressive.

Contiguous, predictable spread

44
Q

Who gets Nodular lymphocyte predominate Hodgkin lymphoma (NLPHL)?

A

Middle-age adults

45
Q

What sites are involved in Nodular lymphocyte predominate Hodgkin lymphoma (NLPHL)?

A

Cervical, axillary

46
Q

What do the cells look like in Nodular lymphocyte predominate Hodgkin lymphoma (NLPHL)?

A

Nodular collections of “popcorn” cells admixed with lymphocytes

47
Q

What are the CD markers in Nodular lymphocyte predominate Hodgkin lymphoma (NLPHL)?

A

CD15(-)
CD30(-)
CD20(+)
CD45(+)

48
Q

What is the cell of origin in Nodular lymphocyte predominate Hodgkin lymphoma (NLPHL)?

A

B cell

49
Q

What are the clinical course of Nodular lymphocyte predominate Hodgkin lymphoma (NLPHL)?

A

Indolent.

Frequent relapses

Heme/Lymph (10 decks)

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