Lymphoid Disorders Flashcards

1
Q

location of B cell maturation

A

bone marrow

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2
Q

Immunophenotype of B cells

A
  • CD19, CD20, CD10
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3
Q

Immunophenotype of T cells

A
  • CD3, CD4, CD5
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4
Q

Location of B & T cells w/ in the spleen

A
  • cortex = B cells

- paracortex = T cells

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5
Q

Reactive lymphadenitis/lymphadenopathies morphology

A
  • follicular (nodular)
  • sinus
  • diffuse
  • granulomatous
  • necrotizing
  • mixed
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6
Q

Reactive lymphoid hyperplasia

A
  • most common in children
  • lymph nodes: tender, soft, freely movable
  • polarized follicles
  • tingible body macrophages, high mitotic activity
  • Bcl-2 NEGATIVE in germinal centers*
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7
Q

Infectious Mononucleosis Lymphadenitis

A
  • induced by EBV
  • primarily effects adolescents
  • REED STERNBERG CELLs
  • positive monospot test, EBV-specific antigens
  • mixed (diffuse/follicular) lymph node pattern
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8
Q

Cat Scratch lymphadenitits

A
  • contact with cats
  • unilateral lymphadenitis
  • necrotizing granulomas w/ PMN cells
  • positive silver stain
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9
Q

Toxoplasma lyphadenitis

A
  • most common parasitic infection in US
  • POSTERIOR CERVICAL lymphadenitis
  • fetal toxoplasmosis as a result of transplacental infection possible
  • IgM>1:80 is diagnostic
  • absence of necrosis
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10
Q

Reactive lymphoid hyperplasia Bcl-2 result

A

RLH the germinal center cells are Bcl-2 NEGATIVE

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11
Q

Children & young adult lymphoid neoplasia

A
  • hodgkin & burkitt lymphomas
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12
Q

Important clinical features of lymphomas

A
  • enlarge, PAINLESS lymphadenopathy

- B symptoms frequent (fever, chills, NIGHT SWEATS)

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13
Q

Lymphoproliferative disorders

A

lymphoma & leukemia

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14
Q

Lymphomas

A

Hodgkin & Non-Hodgkin

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15
Q

Most common lymphomas

A
  • Diffuse large B cell lymphoma: 30.6%

- Follicular lymphoma: 22.1%

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16
Q

Follicular lymphoma

A
  • Adults
  • asymptomatic LN enlargement
  • back to back follicles
  • grade1/2 = 15 centroblasts
  • 2/3 of patients present with > Stage III disease*
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17
Q

Follicular lymphoma: immunophenotype

A
  • CD10 & Bcl-2 postitive

- Bcl 2 gene rearragement: t(14;18)

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18
Q

Follicular lymphoma summary

A
  • adults: 6th decade
  • lymph nodes: firm, mottled, non movable
  • no polarization
  • no tingible body marcrophages, low mitotic activity
  • Bcl 2 positive germinal centers, t(14;18)
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19
Q

Diffuse large B cell lymphoma

A
  • most common type of lymphoma
  • clinically aggresive
  • potentially curable w/ chemo w/ anti CD20(rituximab) & BMT
  • germinal B cell type (GBC) has better prognosis than non GBC type
20
Q

Burkitt lymphoma/leukemia (BL): features and prognosis

A
  • endemic BL: presents as jaw/orbit masses
  • most present with advanced stage
  • curable with aggressive chemo
21
Q

BL - aggressiveness

A

BL very aggressive: dividing time is 24 hours

22
Q

BL immunophenotype

A
  • positive for CD10

- negative for Bcl-2

23
Q

BL cytogenetics

A

typically t(8:14)

24
Q

Mantle cell lymphoma (MCL) - features

A
  • older adults w/ M:F ratio of 3:1

- usually is stage III or IV with extranodal involvement

25
Q

MCL - cytogenetics

A
  • positive for CD5
  • t(11:14)
  • cyclin D1 (Bcl-1)
26
Q

Prognosis of MCL

A
  • despite high tumor response to Tx(80-95%) overall survival is 3-4 yrs
  • factors: growth pattern, morphology, proliferation index
27
Q

Marginal Zone lymphoma (MZL)

A
  • indolent
  • associated with Helicobacter pylori infection
  • Immunophenotype: CD19 & CD20 ONLY**
28
Q

Morphology of MZL

A
  • scattered large cells are always present
29
Q

Hodgkin lymphoma: most common type

A

Nodular sclerotic classic hodgkins lymphoma

30
Q

Treatment for nodular lymphocyte predominant hodgkins lymphoma

A

surgery

31
Q

Stats for NSCHL

A
  • prevelance: 70% (of hodgkins lymphomas)
  • age: 28
  • M:F ratio 1:1
32
Q

Clinical features of HL

A
  • responds well to chemo

- CD30, CD15 positive & CD45 negative

33
Q

HL morphology

A

Reed-Sternberg cell

34
Q

Dianosis of HL

A
  • will not diagnose from FNA
35
Q

HL prevelance

A
  • bimodal age curve showing peak at 15-35 years and second peak after 60 years
36
Q

Chronic lymphocytic leukemia/small lymphocytic leukemia: lymph findings

A
  • diffuse tissue infiltration by small, round neoplastic lympoctyes
37
Q

Transformation of CLL/SLL

A
  • CLL/SLL transformation to DLBCL: RICHTER TRANSFORMATION

- decreased survival: 6-8 months

38
Q

CLL/SLL immunophenotype

A
  • coexpression of CD5, CD23
39
Q

Most common translocations

A
  1. follicular lymphoma: t(14;18) Bcl-2
  2. burkitt lymphoma: t(8;14) c-MYC
  3. mantle cell lymphoma: t(11;14) cyclin D1
40
Q

CLL/SLL immunophenotype

A

CD5+, CD20+, CD23+

41
Q

FL immunophenotype

A

CD10+, CD20+

42
Q

MCL immunophenotype

A

CD5+, CD20+

43
Q

Burkitt immunophenotype

A

CD10+, CD20+

44
Q

MZL immunophenotype

A

CD20+

45
Q

Location of T cell maturation

A
  • thymus

- undergo negative/positive selection