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Lymphoma Flashcards

1
Q

General B symptoms

A

Weight loss
Fever
Night sweats

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2
Q

Types of low-grade/indolent NHL

A

Follicular lymphoma
Mantle cell lymphoma
Marginal zone lymphoma
Small lymphocytic lymphoma
Lymphoplasmacytic lymphoma

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3
Q

Most common low-grade NHL

A

Follicular lymphoma

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4
Q

Types of high-grade/aggressive NHL

A

Diffuse large B cell lymphoma
Burkitt lymphoma
Peripheral T cell lymphoma

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5
Q

Most common high-grade NHL

A

DCBCL

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6
Q

Cell of origin of follicular lymphoma

A

Germinal center B cells

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7
Q

Prognosis of follicular lymphoma

A

Incurable, median survival of 7-9 years

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8
Q

Treatment of follicular lymphoma

A

Cytotoxic drugs
anti-CD20 antibody (rituximab)

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9
Q

Translocation associated with follicular lymphoma

A

t(14;18)
IGH;BCL2

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10
Q

Lymph node biopsy characteristics in follicular lymphoma

A

Nodular growth pattern
Centrocytes and centroblasts

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11
Q

Characteristics of centrocytes

A

Small cells with angular cleaved nuclei

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12
Q

Characteristics of centroblasts

A

Larger cells with open chromatin, several nucleoli, and modest cytoplasm

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13
Q

Indicated by a higher number of centroblastic cells in follicular lymphoma

A

More aggressive course

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14
Q

Immunophenotype in follicular lymphoma cells

A

CD19+
CD20+
CD10+
BCL2+ –> in most cases

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15
Q

Cancer that arises in lymph nodes, spleen, and extra-nodal tissues

A

Marginal zone lymphoma

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16
Q

Lymphoepithelial lesions description and associated cancer

A

Homing of malignant B cells to the epithelium

Marginal zone lymphoma

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17
Q

Beginning of marginal zone lymphoma and its cells of origin

A

Polyclonal immune reaction - chronic inflammation

Memory B cells

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18
Q

Cells of origin of mantle cell lymphoma

A

Naive B cell in mantle zone in men over 50

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19
Q

Histologic characteristics of mantle cell lymphoma

A

Vaguely nodular or diffuse pattern
Commonly involves bone marrow

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20
Q

Immunophenotyping of mantle cell lymphoma

A

CD20+
CD19+
CD5+
sIgM
IgD
Cyclin D1

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21
Q

Translocation associated with mantle cell lymphoma

A

t(11;14)
cyclin D;IgH

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22
Q

Clinical presentation of DCBCL

A

Rapidly enlarging mass at nodal or extra-nodal site
Most common nodal site is Waldeyer ring
Most common extra-nodal site is GI tract
Infrequently involves spleen or bone marrow

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23
Q

Genetic mutations associated with DCBCL

A

Dysregulation of BCL6

t(14;18) with overexpression of BCL2

MYC mutation

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24
Q

Cell types in DCBCL microscopy

A

Large cells
Centroblasts
Immunoblasts
Multinucleated giant cells and highly anaplastic cells

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25
Characteristics of immunoblasts
Vesicular nucleus Single, central, prominent nucleus Abundant basophilic cytoplasm
26
Immunophenotyping of DCBCL
CD19+ CD20+ Variable germinal center B cell markers: BCL6, CD10, BCL2
27
General treatment of DCBCL
Intensive chemotherapy regimens Stem cell transplant in relapse
28
Special types of DCBCL
Immunodeficiency associated large B cell lymphoma Primary effusion lymphoma Mediastinal B cell lymphoma
29
Associated characteristics of immunodeficiency associated large B cell lymphoma
Advanced HIV Allogeneic bone marrow transplantation Associated with EBV infection
30
HHV-4
EBV
31
Associated characteristics of primary effusion lymphoma
Affects pleural cavity, peritoneum, and/or pericardium Kaposi sarcoma Immunosuppressed pts
32
HHV-8
Karposi sarcoma/KSHV
33
Associated characteristics of mediastinal B cell lymphoma
More common in young women Spreads to abdominal viscera and/or CNS
34
Cancer strongly associated with EBV in endemic type
Burkitt lymphoma
35
Types of Burkitt lymphoma
African/endemic Sporadic/non-endemic AIDS-related
36
Molecular pathogenesis of Burkitt lymphoma
All MYC translocations t(8;14) - MYC;IgH t(2;8) - Ig kappa light chain;MYC t(8;22) - MYC;Ig lambda light chain
37
Clinical sign of endemic Burkitt lymphoma
Mandibular mass
38
Prognosis of endemic Burkitt lymphoma
Very aggressive tumor that responds well to intensive chemotherapy
39
Microscopy of Burkitt lymphoma
Moderate amount of deeply basophilic cytoplasm with numerous lipid vacuoles Typical starry sky pattern High mitotic activity and numerous apoptotic cells Macrophages with cytoplasm containing nuclear debris
40
Explanation of starry sky pattern
Numerous, pale, tingible-body macrophages with ingested nuclear debris in a background of deep blue neoplastic cells
41
Immunophenotyping of Burkitt lymphoma
CD10+ CD20+ CD22+ Positive for monoclonal surface immunoglobulin CD5- CD10+ BCL6+
42
Classic types of HL
Nodular sclerosis Mixed cellularity Lymphocyte rich Lymphocyte depletion
43
Non-classic type of HL
Nodular lymphocyte predominant (NLP)
44
Characteristics of Reed-Sternberg cells
Bilobed (owl-eye) nucleus Large, inclusion-like nucleoli Abundant cytoplasm
45
HL where RS cells are most common
Mixed cellularity type
46
RS cell imunophenotype
Co-expression of CD15 and CD30 Negative for CD45, sIg, common B antigens, and common T antigens
47
Common B lineage markers
CD19 CD20 CD22 CD79a
48
EBV infection is mostly associated with what type of HL
Mixed cellularity type
49
Mechanism of EBV infection leading to HL
Activates NFkB Preventing apoptosis
50
Functional property of RS cells
Release cytokines
51
Cytokines released by RS cells
IL-5 IL-10 M-CSF Chemokines
52
Purpose of IL5 released by RS cells
Infiltration of eosinophils
53
Purpose of M-CSF released by RS cells
Induces accumulation of macrophages and granulocytes
54
Specific characteristics of nodular sclerosis HL
Bands of collagen around lymphoid cell aggregate nodule CD45 negative Lacunar cells
55
Histology of lacunar cells
Folded/multilobed nucleus surrounded by an empty space
56
Immunophenotype of nodular sclerosis HL
CD15 and CD30 positive RS cells Negative for EBV
57
Prognosis of nodular sclerosis HL
Excellent
58
HL with a biphasic distribution
Mixed cellularity
59
Morphology of mixed cellularity HL
Lymph node is diffusely effaced by a heterogenous infiltrate Associated with EBV
60
Immunophenotype of mixed cellularity HL
Classic RS cells positive for CD15 and CD30
61
HL associated with primarily young male pts
Nodular lymphocyte predominant
62
Typical presentation in nodular lymphocyte predominant HL
Cervical or axillary lymphadenopathy Not associated with EBV
63
Morphology of nodular lymphocyte predominant HL
Nodular infiltrates of small lymphocytes admixed with macrophages LH variant RS cells with multilobed nucleus
64
Popcorn cells
LH variant RS cells with multilobed nucleus
65
Immunophenotype of LH variant RS cells
Express B cells markers, like CD20 Negative for CD15 and CD30
66
Stage I of Ann Arbor classification
Involvement of single lymph node region or a single extralymphatic organ/site
67
Stage II of Ann Arbor classification
Involvement of 2+ lymph node regions on same side of diaphragm OR localized involvement of an extralymphatic organ or site
68
Stage III of Ann Arbor classification
Involvement of lymph node regions on both sides of diaphragm With or without localized involvement of an extralymphatic organ or site
69
Stage IV Ann Arbor classification
Diffuse involvement of one or more extralymphatic organs or sites With or without lymphatic involvement
70
A or B meanings in Ann Arbor classification
Absence (A) or presence (B) of symptoms --> fever, night sweats, weight loss
71
Disease associated with HTLV-1 infection
Adult T-cell leukemia or lymphoma
72
Endemic areas for HTLV-1
Southern Japan West Africa Caribbean basin
73
Pathogenesis of HTLV-1 associated T cell lymphoma
HTLV-1 encodes Tax which activates NFkB NFkB prevents apoptosis
74
Clinical presentation of adult T-cell leukemia
Skin lesions - plaques/nodules Generalized lymphadenopathy Hepatosplenomegaly
75
Prognosis of of adult T-cell leukemia/lymphoma
Rapidly progressive, aggressive disease
76
Smear histology of T cell leukemia/lymphoma
Peripheral blood lymphocytosis Cells with multilobulated nuclei
77
Clover leaf or flower cells
Cell with multilobulated nuclei
78
Cause of mycosis fungoides
Tumor of CD4+ helper cells that home to the skin
79
Most common cutaneous T cell lymphoma
Mycosis fungoides
80
Three stages of mycosis fungoides lesions
Erythematous patches - inflammatory premycotic stage Plaque stage Tumor stage
81
Skin histology in mycosis fungoides
Epidermotropism - propensity of lymphocytes to colonize epidermis Atypical lymphocytes palisade along dermal-epidermal junction
82
Mycosis fungoides with blood infiltration
Sezary syndrome
83
Immunophenotype of Sezary cells
CD4+ CD8- Aberrant loss of pan T cell markers
84
Histology of Sezary cells
Hyper-convoluted cerebriform nuclei

HML II (15 decks)

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