Lymphoma

Question 1

B cell lymphomas

Answer 1

90% lymphoid neoplasms in the world.

Question 2

Follicular Lymphoma

Answer 2

Nodular lymphoma, common in middle age. Peripheral and central lymphadenopathy, splenomegaly, BM 40-70% involved, only 10% in PBS. Two types of cells, centrocytes and centroblasts. Blasts are bad.

Question 3

Follicular Lymhoma Immunophenotype

Answer 3

CD10, CD20, CD19 and Bcl-2 positive. No CD5 or CD3

Question 4

Mantle Cell Lymphoma

Answer 4

Average age of onset 50-60 male predominant. Lmyphadenopathy, bone marrow involvement, liver involvement. Lymphocytosis in 30%. Splenomegaly in about half. Small bowel involvement.,

Question 5

Mantle Cell Lymphoma Immunophenotype

Answer 5

CD19, CD20, CD5, and Cyclin D1 positive. CD23 and CD3 negative.

Question 6

Endemic Burkitt Lymphoma

Answer 6

4-7 years old, EBV+, found in equitorial africa. 50% facial involvement.

Question 7

Sporadic BL

Answer 7

Throughout the world, children and young adults, 30-50% of all childhood lymphomas. Usually abdominal masses.

Question 8

Immunodeficiency BL

Answer 8

HIV associated, often initial manifestation of AIDS. Usually found in BM and lymph nodes.

Question 9

BL Morphology

Answer 9

Monomorphic, multiple peripherally placed nucleoli. Tingible body macrophages present “starry-sky pattern”

Question 10

BL Immunophenotype

Answer 10

CD10, CD19, and CD20 positive. Bcl-2 negative.

Question 11

Adult T cell leukemia/lymphoma

Answer 11

Mature T cell neoplasm. Caused by the Human T cell Leukemia virus type 1 (HTLV-1) found in central africa, caribbean and southwestern japan. It has a long latency period, in japan only 2.5% of carriers will develop this. Found only in adults.

Question 12

Adult T cell morphology

Answer 12

Flower or clover leaf cells, CD4+

Question 13

Adult T cell prognosis

Answer 13

Not good, most die within a year even with treatment. Alemtuzumab (anti CD52) new treatment. If the skin is the primary site of involvement the prognosis is better.

Question 14

Mycosis fungoides/Sezary syndrome

Answer 14

Skin always involved, malignant lymphocytes are CD4+ and have a cerebriform nuclei. Average survival is 9 years.

Question 15

T lymphoblastic leukemia/lymphoma

Answer 15

Medical emergency. 85% will have a mass (lymphoma) usually in the anterior mediastinum, and 15% as leukemia (T cell ALL). T ALL can also present with mediastinal mass.

Question 16

T lymphoblastic morphology

Answer 16

Sheets of blasts.

Question 17

T lymphoblastic IC

Answer 17

Positive for CD34, TdT, and CD1a, also Cytoplasmic CD3.

Question 18

Anaplastic Large Cell Lymphoma

Answer 18

10-20% of childhood lymphoma. Non-Hodgkin. 70% will present with stage III-IV disease. Can be aggressive.

Question 19

ALCL IC

Answer 19

ALK-1 positive is linked to a better prognosis, more common in childhood disease. ALK-1 negative is more common in older adults, poor prognosis. CD30+, EMA+, 75% CD3-

Question 20

ALCL Morphology

Answer 20

Hallmark cells, “Kidney Shaped Nuclei”