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Heme Path > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

(8:14) translocation

A

Burkitt lymphoma

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2
Q

endemic in areas of Africa

A

Burkitt lymphoma

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3
Q

arises from the naïve B‐cells in the mantle zone area of the lymphoid follicle

A

Mantle cell lymphoma

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4
Q

Trisomy chromosome 2, 7, 10

A

good prognosis for ALL

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5
Q

It characteristically arises in epithelial tissues such as stomach, salivary glands, GI tract lungs and the orbit.

A

Extra nodal Marginal Zone B‐cell lymphoma

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6
Q

In some patients transformation to a more aggressive lymphoma occurs (e.g. Diffuse Large B‐cell lymphoma).

A

Follicular lymphoma

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7
Q

MYC translocations

A

diffuse large B‐cell lymphoma; with this mutation, these are particularly aggressive tumors

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8
Q

80% cure rate with ALK inhibitors

A

Anaplastic Large‐Cell Lymphoma(ALK+)

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9
Q

WBC count in ALL

A

increased

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10
Q

cluster around venules

A

Anaplastic Large‐Cell Lymphoma

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11
Q

What are the two subgroups of CLL? Which has a worse prognosis?

A

One group arises from post germinal center cell origin (Ig geneshypermutated), and one group arises from naive B-cells. The latter group, arising from naive B cells has a worse prognosis

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12
Q

tumor of CD4 cells

A

Cutaneous T‐cell lymphoma aka mycosis fungiodes

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13
Q

CD103 and annexin

A

markers of hairy cell leukemia.

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14
Q

This tumor is characterized by the (11:14) translocation .

A

Mantle cell lymphoma

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15
Q

powerful transcription regulator and it helps promote aerobic glycolysis and rapid cell growth

A

MYC; refers to Burkitt lymphoma and diffuse large b-cell lymphoma

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16
Q

Risk of transformtion to DLBCL

A

extranodal marginal zone lymphoma; follicular lymphoma, CLL/SLL,

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17
Q

Somatic hypermutation: memory B‐cell origin

A

extranodal marginal zone lymphoma

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18
Q

presents as enlarging mediastinal mass in younger women.

A

Mediastinal large B‐cell lymphoma; type of diffuse large B-cell lymphoma

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19
Q

fastest growing human tumor

A

Burkitt lymphoma

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20
Q

up regulation of the anti‐apoptotic protein BCL‐2

A

CLL/SLL

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21
Q

associated with HIV

A

Burkitt lymphoma, DLBCL - primary effusion lymphoma

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22
Q

occurs in patients with T‐cell immunodeficiency such as HIV and allogenic bone marrow transplant cases

A

immunodeficiency associated diffuse large B‐cell lymphoma

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23
Q

tumor cells infected with KSHV/HHV‐8

A

primary effusion lymphoma; type of diffuse large B‐cell lymphoma

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24
Q

present as a new enlarging abdominal mass which runs a much more aggressive course

A

diffuse large B‐cell lymphoma –> Richter’s syndrome transformed from CLL/SLL

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25
Q

Aggressive tumors
• Generalized lymphadenopathy
• Pruritis
• Eosinophilia
• Weight loss

A

Peripheral T cell Lymphoma

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26
Q

The tumor cells express pan B cell antigens CD19, CD20 and co‐express CD5

A

Mantle cell lymphoma; CLL/SLL

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27
Q

The tumor runs a rapid and fatal course without any treatment.

A

Diffuse large B‐cell lymphoma

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28
Q

Normal reactive processes are ___clonal

A

poly

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29
Q

Most of these cases show EBV coinfection.

A

diffuse large B‐cell lymphoma

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30
Q

This is a fusion of the (1) gene on chromosome 18 with the (2) locus on chromosome 14.

A
  1. BCL 2. IgH follicular lymphoma; some cases of Diffuse Large B‐cell lymphoma
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31
Q

translocations of the MYC gene on chromosome 8 mostly with the IgH gene on chromosome 14

A

Burkitt lymphoma

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32
Q

The tumor cells have a characteristic “cerebriform “appearance.

A

Cutaneous T‐cell lymphoma aka mycosis fungiodes

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33
Q

Acute lymphoblastic leukemia represents 80% or more of childhood leukemia and most are of (1)‐cell origin

A
  1. B
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34
Q

Bone marrow is often not involved in contrast to some of the other lymphomas we have discussed so far.

A

Diffuse large B‐cell lymphoma

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35
Q

malignant clone is ___clonal

A

mono

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36
Q

collections of malignant CD4 positive T‐Cells

A

Pautrier’s microabscesses; seen in Cutaneous T‐cell lymphoma aka mycosis fungiodes

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37
Q

associated with EBV infection of the neoplastic elements due lack of T cell immunity(can regress when restored)

A

DLBCL

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38
Q

relatively uncommon B‐cell neoplasm characterized by cells with characteristic hair like cytoplasmic extensions

A

Hairy cell leukemia

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39
Q

Most cases will show peripheral blood involvement as the prominent process and thus the term (1) is used. When lymphadenopathy is the prominent process the term (2) is used.

A
  1. chronic lymphocytic leukemia 2. small lymphocytic lymphoma
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40
Q

TdT

A

expressed in both preB and preT cells; differentiates ALL from AML

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41
Q

autoimmune hemolytic anemia or autoimmune thrombocytopenia

A

CLL/SLL patients may develop autoantibodies

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42
Q

– Large cells 5x size of normal lymphocyte
– Prominent nucleoli
– Numerous mitosis

A

Diffuse Large B‐cell lymphoma

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43
Q

Other s/s of CLL

A

hepatosplenomegaly

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44
Q

What are the clinical features of ALL?

A

due to replacement of normal bone marrow cells with the leukemic cells: anemia, infections, petechiae, bruising, bleeding; bone pain, hepatosplenomegaly, lymphadenopathy, testicular enlargement, CNS involvement in children

T-ALL: mediastinal mass

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45
Q

Most patients with CLL will show an elevated (1) count consisting mostly of (2), with reduced numbers of?

A
  1. white blood cell 2. small well differentiated lymphocytes. 3. platelets, RBCs, neutrophils
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46
Q

Small well diff. lymphocytes and smudge cells

A

CLL/SLL

47
Q

Some cases of CLL/SLL will over time transform into (1) and present as a new enlarging abdominal mass which runs a much more aggressive course.

A
  1. diffuse large B‐cell lymphoma
48
Q

B‐cell neoplasms expressing T cell marker CD5

A

CLL/SLL and mantle cell lymphoma

49
Q

Apoptotic cells “Starry Sky” Appearance

A

Burkitt lymphoma

ALL

50
Q

painless generalized lymphadenopathy in patients over 50 years old.

A

Follicular lymphoma

51
Q

“starry sky” appearance

A

Burkitt lymphoma

52
Q

Bone marrow involvement either focal or diffuse is commonly seen.

A

Follicular lymphoma

53
Q

Gain of function mutation NOTCH1

A

T cell ALL and CLL/SLL

54
Q

CD25+ (IL‐2 receptor)

A

Adult T cell lymphoma/leukemia

55
Q

erythroderma which may progress to plaque formation and finally to tumor formation in the skin

A

Cutaneous T‐cell lymphoma aka mycosis fungiodes

56
Q

Diffuse infiltrate large lymphocytes; Numerous apoptotic bodies; Starry sky appearance

A

Burkitt lymphoma

57
Q

arises from germinal center B -cells

A

follicular lymphoma

58
Q

CyclinD1 thus is upregulated, promoting cell cycle progression from G1 to S‐phase.

A

Mantle cell lymphoma

59
Q

How do you distinguish CLL from mantle cell lymphoma?

A

11:14 translocation and cyclin D1 overexpression in mantle cell lymphoma

60
Q

Primary effusion lymphoma is another subtype occurring also in HIV patients.

A

diffuse large B‐cell lymphoma

61
Q
A
62
Q

It is a disease of older men who present with (1) from tumor involvement of these sites.

A
  1. pancytopenia and massive splenomegaly; refers to hairy cell leukemia
63
Q

Mantle cell lymphoma presents with?

A

weakness, fatigue and generalized painless lymphadenopathy. Widespread involvement of bone marrow, liver, spleen and the gastrointestinal tract is common.

64
Q

Deletions 11q and 17q are associated with worse prognosis

A

CLL/SLL

65
Q

Widespread involvement of bone marrow, liver, spleen and the gastrointestinal tract is common.

A

Mantle cell lymphoma

66
Q

In follicular lymphoma there are no (1) found within the follicles which themselves are composed of nodular aggregates of neoplastic lymphocytes.

A
  1. apoptotic bodies
67
Q

BCR-ABL fusion gene from a (9;22) translocation is associated with a good prognosis

A

ALL

68
Q

Some tumors show trisomy 12 or deletions of 11, 13, or 17.

A

CLL/SLL

69
Q

activating BRAF mutations

A

Hairy cell leukemia

70
Q

The average age at presentation is 60 years but notably the disease accounts for about 15 % of childhood lymphomas.

A

diffuse large B‐cell lymphoma

71
Q

Refractory cases respond well to BRAF inhibitors.

A

Hairy cell leukemia

72
Q

Lack of apoptotic bodies in the node

A

Follicular lymphoma

73
Q

If localized, can be treated with excision

A

Extra nodal Marginal Zone B‐cell lymphoma

74
Q

In the young adult patients (15‐20 yrs. old) the tumors are more frequently of the (1) cell type.

A
  1. pre‐ T refers to ALL
75
Q

Which is more prominent in CLL/SLL? Tumor cell growth or survival?

A

Prolonged cell survival

76
Q

Rituximab (anti‐CD20) is very effective in controlling the disease

A

Follicular lymphoma

77
Q

Platelet count in ALL

A

decreased

78
Q

The pan B‐cell markers are expressed on the tumor cells and the MYC translocation is identified in all cases.

A

Burkitt lymphoma

79
Q

(14:18) chromosomal translocation.

A

follicular lymphoma and some cases of Diffuse Large B‐cell lymphoma

80
Q

Tumor cells will show the pan B‐cell makers CD19, CD20 and also express CD11c and CD103 which usually are absent from other B‐cell neoplasms.

A

Hairy cell leukemia

81
Q

The disease spreads from the initial skin involvement to lymph node and visceral involvement.

A

Cutaneous T‐cell lymphoma aka mycosis fungiodes

82
Q

The more common lymphomas are by far of (1)‐cell origin and occur due to errors during the normal process of (2) in (1)‐cell differentiation and development

A
  1. B 2. somatic hyper mutation and immunoglobulin class switching
83
Q

Anti-CD20 therapy is generally used (i.e. rituximab)

A

CLL/SLL

84
Q

Those of pre‐ B cell origin originate in the (1)

A
  1. bone marrow; refers to Acute Lymphoblastic Leukemia/Lymphoblastic Lymphoma:
85
Q

presents as a rapidly enlarging mass at nodal or commonly extra nodal sites almost anywhere in the body (skin, bone, brain and GI tract, tonsils, liver and spleen)

A

Diffuse large B‐cell lymphoma

86
Q

mutations of BCL6, involved in normal germinal B‐cell maturation and growth arrest and apoptosis.

A

diffuse large B‐cell lymphoma

87
Q

The tumor cells express the pan B cell markers CD19, CD20, BCL6 AND BCL10.

A

follicular lymphoma

88
Q

Which are larger? Myeloid blast cells or lymphoblast cells?

A

Myeloid

89
Q

many patients suffer infections from hypogammaglobinemia

A

CLL/SLL

90
Q

Patients may remain in this erythroderma phase for long periods without spreading to viscera.

A

Sezary syndrome

91
Q

Those associated with Pylori can often be effectively treated using antibiotics.

A

Extra nodal Marginal Zone B‐cell lymphoma

92
Q

consists of medium to large size tumor cells with numerous mitotic figures and many apoptotic bodies from the rapid cell growth and turnover.

A

Burkitt lymphoma

93
Q

ALK gene rearrangements‐tyrosine kinases activity

A

Anaplastic Large‐Cell Lymphoma(ALK+)

94
Q

Retrovirus caused tumor of CD4+ cells; HTLV-1

A

Adult T cell Leukemia/Lymphoma

95
Q

B cell markers such as (1) and T cell markers such as (2) allow further separation of the lymphoblastic leukemia into B and T cell types.

A
  1. CD19 2. CD3
96
Q

RBCs in ALL

A

decreased: anemia

97
Q

Endemic types all latently infected with?

A

EBV; Burkitt lymphoma

98
Q

Those of pre‐T cell origin occur as (1) masses as they arise in the T‐cell areas of the (2) but eventually evolve to a (3) phase involving the peripheral blood.

A
  1. mediastinal 2. thymus 3. leukemic refers to pre-T cell ALL
99
Q

Hematopoietic stem cell transplantation is used in selected patients with some success.

A

Mantle cell lymphoma

100
Q

over expression of BCL2 protein and therefore increased cell survival.

A

follicular lymphoma

101
Q

The cells are large and express the pan B‐cell markers CD19, CD20 and sometimes BCL6 as noted above.

A

diffuse large B‐cell lymphoma

102
Q

Constitutional symptoms of fatigue, weakness anorexia and weight loss may be present along with recurrent infections.

A

CLL/SLL

103
Q

patient with erythroderma and circulating malignant CD4 cells in the peripheral blood.

A

Sezary syndrome

104
Q

lost function of PAX5

A

B cell ALL

105
Q

very aggressive tumors occurring frequently in children and younger adults.

A

Acute Lymphoblastic Leukemia/Lymphoblastic Lymphoma:

106
Q

This is a fusion of the cyclinD1 gene and the IgH locus.

A

(11:14) translocation Mantle cell lymphoma

107
Q

Usually begins at extranodal sites such as maxillary/mandibular masses or abdominal tumors of bowel, ovary and
retro peritoneum

A

burkitt lymphoma

108
Q

In SLL the prominent feature is (1) and biopsy of the involved lymph nodes will reveal complete replacement of the lymph nodes with these small well differentiated lymphoid cells

A
  1. generalized lymphadenopathy
109
Q

Skin lesions; Hepatosplenomegaly; Lymphadenopathy; Hypercalcemia; Circulating tumor cells

A

Adult T cell Leukemia/Lymphoma

110
Q

found frequently in patients with autoimmune disorders (1) and in patients with chronic infections (typically H. Pylori gastritis).

A
  1. Sjogren syndrome or Hashimoto thyroiditis; refers to Extra nodal Marginal Zone B‐cell lymphoma
111
Q

multifocal submucosa nodules
(lymphomatoid polyposis) in GI tract

A

Mantle cell lymphoma

112
Q

autoantibodies to RBCs and platelets leading to?

A

autoimmune hemolytic anemia and autoimmune thrombocytopenia; refers to CLL/SLL

113
Q

commonly at extra nodal sites such as the maxillofacial areas (endemic cases) or gastrointestinal tract (sporadic cases)

A

Burkitt lymphoma

Heme Path (21 decks)

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