Lymphoma

Question 1

• Lymph node structure: Paranchyma? (3) Sinuses? (3) Follicle has? 2nd follicle parts? (2) Cells? (2)
• B Cell markers? (3) T Cell Markers? (4) Germinal B Cell markers? (2)
  1. ) CLL/SLL: CLL peripheral blood? SLL has what involvement? Most common leukemia? Who is affected more? Sign/symptoms? Effacement? Morphology? + Markers? (4) - Markers? (3)
  2. ) Follicular lymphoma: Lymphoma of? Common in who? Often present in what stage? Positive for? Does what? Translocation? + Markers? (5) - Markers? (2)
  3. ) Mantle Cell Lymphoma: Common in who? Most present? Effacement? Unlike? + Markers? (4) - Markers? (3) Role of cyclin D? Common trans?

Answer 1

• capsule, cortex, medulla; subcapsular, corticol, medullary; mostly B cells; mantle zone (all B), germinal layer (B,T,Macs)
• B = 19,20,22; T = 3,4,5,8; Germ = CD10, BCL6
  1. ) Lots of lymphocytes; extramedullay; yes; elderly men; often asymptomatic; yes; small cells with clumped chromatin; 5,19,20,23; 10, FMC7
  2. ) Germ center; elderly; late; BCL2, supress apoptosis; t14:18; 19,20,10, BCL6, BCL2; 5,23
  3. ) Elderly men; Late; Yes; Follicular; 5,19,20, BCL2 (cyclin D1); 23,10, BCL6; helps cell progress to G1/S; t11:14

Question 2

4. ) Burkitts Lymphoma:
   a. ) Endemic: Common where? Presents with? Mostly due to?
   b. ) Sporadic: Where? Old/young? EBV involved?
   c. ) Immunodeficiency: Mostly in who?
   - Cells? Borders? + Markers? (5) - Markers? (2) Common trans? Treatable?

Answer 2

a. ) Malaria areas; abdominal/jaw; EBV
b. ) Illeocecal region; young; a littke
c. ) HIV patients
- Basophillic with lipid vacoules; 19,20,10,BCL6,MYC; 5,23; t8:14; yes

Question 3

5. ) Plasma Cell Neoplasms: Secrete what? Detectable via? Usually start where? Then go?
   a. ) Plasma Cell Myeloma: Monoclonal plasma cells make up what % nucleated cells in bone? Symptoms? (4) Age? Have multiple? Lab findings? Peripheral smear? Also RBC form? Must be done for diagnosis?
   b. ) Monoclonal gammopathy of undetermined significance: No evidence of? Ab in blood/serum? Bone lesions? Plasmacytosis?
   c. ) Solitary plasmacytoma of bone: CRAB? Single? M protein? Localized what?
   d. ) Extraosseus plasmacytoma: Localized plasma cell tumor where? Mostly in older who?

Answer 3

• Single immmunoglobin; M protein electro.; bone; extramedullary
  a. ) >10%; CRAB = hypercalcemia, renal failure, anemia, bone lesions; older adults; bone lesions; high M protein; 15% plasma cells with eccentric nucleus; Rouloux formation; bone marrow biopsy
  b. ) PCM; yes; no; no
  c. ) No; bone lesion; low or absent; tumor of bone
  d. ) Outside bone marrow; males

Question 4

6. ) Hodgkins Lymphoma: 2 types? Germinal B cell orgin? Diagnostic cell? Morphology of these? (3) + Markers? (2) - Markers? (1)
   a. ) Nodular sclerosis variant: Most frequent what? Mostly in young? Thickened capsule around? EBV involved? Lacunar cells?
   b. ) Mixed cellularity variant: EBV involved?
   c. ) Lymphocyte rich variant: RS cells?
   d. ) Lymphocyte depleted variant: RS Cells? EBV?

Answer 4

• nodular lymphocyte predominate, classical; yes; Reed Sternberg; large multiple nuclei, eisinophillic nucleoulus, ample cytoplasm; CD15,20; CD45
  a. ) Subtype; females; follicle; sometimes; yes
  b. ) Often
  c. ) No
  d. ) Numerous; almost always