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HML II > Lymphoma > Flashcards

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
Q

Characteristics of immunoblasts

A

Vesicular nucleus
Single, central, prominent nucleus
Abundant basophilic cytoplasm

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26
Q

Immunophenotyping of DCBCL

A

CD19+
CD20+
Variable germinal center B cell markers: BCL6, CD10, BCL2

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27
Q

General treatment of DCBCL

A

Intensive chemotherapy regimens
Stem cell transplant in relapse

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28
Q

Special types of DCBCL

A

Immunodeficiency associated large B cell lymphoma

Primary effusion lymphoma

Mediastinal B cell lymphoma

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29
Q

Associated characteristics of immunodeficiency associated large B cell lymphoma

A

Advanced HIV
Allogeneic bone marrow transplantation
Associated with EBV infection

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30
Q

HHV-4

A

EBV

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31
Q

Associated characteristics of primary effusion lymphoma

A

Affects pleural cavity, peritoneum, and/or pericardium
Kaposi sarcoma
Immunosuppressed pts

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32
Q

HHV-8

A

Karposi sarcoma/KSHV

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33
Q

Associated characteristics of mediastinal B cell lymphoma

A

More common in young women
Spreads to abdominal viscera and/or CNS

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34
Q

Cancer strongly associated with EBV in endemic type

A

Burkitt lymphoma

35
Q

Types of Burkitt lymphoma

A

African/endemic
Sporadic/non-endemic
AIDS-related

36
Q

Molecular pathogenesis of Burkitt lymphoma

A

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
Q

Clinical sign of endemic Burkitt lymphoma

A

Mandibular mass

38
Q

Prognosis of endemic Burkitt lymphoma

A

Very aggressive tumor that responds well to intensive chemotherapy

39
Q

Microscopy of Burkitt lymphoma

A

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
Q

Explanation of starry sky pattern

A

Numerous, pale, tingible-body macrophages with ingested nuclear debris in a background of deep blue neoplastic cells

41
Q

Immunophenotyping of Burkitt lymphoma

A

CD10+
CD20+
CD22+
Positive for monoclonal surface immunoglobulin
CD5-
CD10+
BCL6+

42
Q

Classic types of HL

A

Nodular sclerosis
Mixed cellularity
Lymphocyte rich
Lymphocyte depletion

43
Q

Non-classic type of HL

A

Nodular lymphocyte predominant (NLP)

44
Q

Characteristics of Reed-Sternberg cells

A

Bilobed (owl-eye) nucleus
Large, inclusion-like nucleoli
Abundant cytoplasm

45
Q

HL where RS cells are most common

A

Mixed cellularity type

46
Q

RS cell imunophenotype

A

Co-expression of CD15 and CD30

Negative for CD45, sIg, common B antigens, and common T antigens

47
Q

Common B lineage markers

A

CD19
CD20
CD22
CD79a

48
Q

EBV infection is mostly associated with what type of HL

A

Mixed cellularity type

49
Q

Mechanism of EBV infection leading to HL

A

Activates NFkB
Preventing apoptosis

50
Q

Functional property of RS cells

A

Release cytokines

51
Q

Cytokines released by RS cells

A

IL-5
IL-10
M-CSF
Chemokines

52
Q

Purpose of IL5 released by RS cells

A

Infiltration of eosinophils

53
Q

Purpose of M-CSF released by RS cells

A

Induces accumulation of macrophages and granulocytes

54
Q

Specific characteristics of nodular sclerosis HL

A

Bands of collagen around lymphoid cell aggregate nodule

CD45 negative

Lacunar cells

55
Q

Histology of lacunar cells

A

Folded/multilobed nucleus surrounded by an empty space

56
Q

Immunophenotype of nodular sclerosis HL

A

CD15 and CD30 positive RS cells

Negative for EBV

57
Q

Prognosis of nodular sclerosis HL

58
Q

HL with a biphasic distribution

A

Mixed cellularity

59
Q

Morphology of mixed cellularity HL

A

Lymph node is diffusely effaced by a heterogenous infiltrate

Associated with EBV

60
Q

Immunophenotype of mixed cellularity HL

A

Classic RS cells positive for CD15 and CD30

61
Q

HL associated with primarily young male pts

A

Nodular lymphocyte predominant

62
Q

Typical presentation in nodular lymphocyte predominant HL

A

Cervical or axillary lymphadenopathy

Not associated with EBV

63
Q

Morphology of nodular lymphocyte predominant HL

A

Nodular infiltrates of small lymphocytes admixed with macrophages
LH variant RS cells with multilobed nucleus

64
Q

Popcorn cells

A

LH variant RS cells with multilobed nucleus

65
Q

Immunophenotype of LH variant RS cells

A

Express B cells markers, like CD20
Negative for CD15 and CD30

66
Q

Stage I of Ann Arbor classification

A

Involvement of single lymph node region or a single extralymphatic organ/site

67
Q

Stage II of Ann Arbor classification

A

Involvement of 2+ lymph node regions on same side of diaphragm OR localized involvement of an extralymphatic organ or site

68
Q

Stage III of Ann Arbor classification

A

Involvement of lymph node regions on both sides of diaphragm
With or without localized involvement of an extralymphatic organ or site

69
Q

Stage IV Ann Arbor classification

A

Diffuse involvement of one or more extralymphatic organs or sites
With or without lymphatic involvement

70
Q

A or B meanings in Ann Arbor classification

A

Absence (A) or presence (B) of symptoms –> fever, night sweats, weight loss

71
Q

Disease associated with HTLV-1 infection

A

Adult T-cell leukemia or lymphoma

72
Q

Endemic areas for HTLV-1

A

Southern Japan
West Africa
Caribbean basin

73
Q

Pathogenesis of HTLV-1 associated T cell lymphoma

A

HTLV-1 encodes Tax which activates NFkB
NFkB prevents apoptosis

74
Q

Clinical presentation of adult T-cell leukemia

A

Skin lesions - plaques/nodules
Generalized lymphadenopathy
Hepatosplenomegaly

75
Q

Prognosis of of adult T-cell leukemia/lymphoma

A

Rapidly progressive, aggressive disease

76
Q

Smear histology of T cell leukemia/lymphoma

A

Peripheral blood lymphocytosis
Cells with multilobulated nuclei

77
Q

Clover leaf or flower cells

A

Cell with multilobulated nuclei

78
Q

Cause of mycosis fungoides

A

Tumor of CD4+ helper cells that home to the skin

79
Q

Most common cutaneous T cell lymphoma

A

Mycosis fungoides

80
Q

Three stages of mycosis fungoides lesions

A

Erythematous patches - inflammatory premycotic stage

Plaque stage

Tumor stage

81
Q

Skin histology in mycosis fungoides

A

Epidermotropism - propensity of lymphocytes to colonize epidermis

Atypical lymphocytes palisade along dermal-epidermal junction

82
Q

Mycosis fungoides with blood infiltration

A

Sezary syndrome

83
Q

Immunophenotype of Sezary cells

A

CD4+
CD8-
Aberrant loss of pan T cell markers

84
Q

Histology of Sezary cells

A

Hyper-convoluted cerebriform nuclei

HML II (15 decks)

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