Lymphoma Flashcards
Low grade NHL May transform to aggressive large cell lymphoma:
Transformation associated with aggressive course, short survival .
Aggressive type of NHL ,Relapse systemically
if receive only local therapy .
Histologically,…………. are most frequently associated with immunosuppression and autoimmune diseases
DLBCLs
B” symptoms
(fevers, night sweats, or unexplained weight loss )
Laboratory tests required at lymphoma
serum β-2 microglobulin level
serum lactate dehydrogenase (LDH)
Positron emission tomography (PET) using 18F-fluorodeoxyglucose(FDG PET) is useful for ……………….
aggressive lymphomas
Lumbar puncture in
Burkitt’s
Lymphoblastic
Diffuse
BL=burkitt’s lymphoma
tingible body macrophages =“starry sky”
Endemic BLs are EBV positive, whereas the majority of non-endemic BLs are EBV negative
Burkitt’s+ diffuse
هردگيان هم HIV هم EBV
DLBCL
50% of patients will have an elevated LDH
Most common histologic subtype of NHL diagnosed, representing about one-third of all cases
Patients whose tumors (DLBCL)overexpress the……………. might be more likely to relapse than others.
BCL-2 protein
Patients with prominent mediastinal involvement are sometimes diagnosed as a separate subgroup having primary mediastinal DLBCL.
This latter group of patients has
A younger median age (i.e., 37 years)
A female predominance (66%).
DLBCL
The most popular regimen in the United States is CHOP plus rituximab.
CNS prophylaxis with either intrathecal chemotherapy or high-dose systemic
typically express the B-cell antigens CD19, CD20, and CD79a
MALT lymphoma
Most MALT lymphomas are gastric in origin.
Indolent behavior; potentially curable
MALT lymphoma is often localized.
Patients with gastric MALT lymphomas who are infected with H. pylori can achieve remission in the 80% of cases with eradication of the infection.
but molecular evidence of persisting neoplasia is not infrequent.
Extranodal Marginal Zone B Cell Lymphoma of Malt Type
gastric association of this lymphoma
Is associated with H.pylori infection
Follicular lymphoma
The most common presentation for FL is with new, painless lymphadenopathy
Most patients do not have an elevated LDH or fevers, night sweats, or weight loss.
Mantle
لةگشتى خراوتر
🤬🤬🤬🤬🤬🤬🤬
😡😡😡😡😡😡😡😡😡
regularly overexpress the BCL-1 protein, also known as cyclin D1.
The most common presentation is palpable lymphadenopathy, frequently accompanied by systemic symptoms.
with frequent bone marrow and peripheral blood involvement.
Possibly worst of all lymphomas
Mycosis fungoides
The skin lesions progress from patch stage to plaque stage to cutaneous tumors.
Develop generalized erythroderma and circulating tumor cells, called Sézary’s syndrome.
common in males and in blacks.
Hodgkin’s Lymphoma
Classical HL (cHL)
Nodular lymphocyte predominant HL (NLPHL)
بدوين أخيري (HL),نةشيويةي وة N
common in whites.
is a malignancy of mature B lymphocytes.
Phenotype
CD45 = Leukocyte Common Antigen
CD20 = B-cell marker
Reed-sternberg cells (HRS)
By immunohistochemistry they are often PAX-5 positive .
have low to no expression of other B-cell antigens like CD19 and CD20.
They express CD15 and CD30 in 85 and 100% of cases .
Hodjkin
Cutaneous disorders such as erythema nodosum.
paraneoplastic cerebellar degeneration and other distant effects on the CNS
nephrotic syndrome.
immune hemolytic anemia and thrombocytopenia
hypercalcemia
A concern in hodgkin
Comorbid diagnoses that may impact therapy should be reviewed, including a history of pulmonary disease and congestive heart failure
Unfavourable early stage of Hodgkin
Increased LDH, b2-mic, ESR: Worse
Treatment of Hodgkin :-
Bulky disease
Advanced stage
Bulky disease: Combination therapy often used:-Chemotherapy plus radiation to bulky mass.
with advanced stage disease treated with chemotherapy alone.
