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Hematology > lymphoma > Flashcards

lymphoma Flashcards

1
Q

primary lymphoid organs

A

thymus and bone marrow

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2
Q

secondary lymphoid organs

A

more likely to be involved with lymphoma; lymph nodes, spleen, GLAT, MALT

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3
Q

where are proliferating b-cells found in the lymph node

A

germinal center in the follicles

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4
Q

lymph node groups

A

cervical, supraclavicular, axillary, mediastinal, inguinal, femoral, mesenteric supraclavicular

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5
Q

follicular hyperplasia

A
  • proliferation of B lymphocytes - increased need for antibody production - occurs with strep throat
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6
Q

benign reactive lymphadenopathy

A
  • reaction to an immune stimulus - pathologic pattern relates to the type of cell stimulated, normal nodal architecture is preserved - commonest cause of enlarged lymph nodes
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7
Q

t cells express what type of CD

A

CD4 or CD8

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8
Q

normal lymph nodes will consist of a mixture of

A

b cells and t cells

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9
Q

b cells will express ___ and _____ light chains

A

kappa and lambda

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10
Q

paracortical hyperplasia

A
  • proliferation of t lymphocytes - increased need for cell mediated immunity - expansion of paracortical regions - example mononucleosis
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11
Q

sinus histiocytosis

A
  • proliferation of histocytes (tissue macrophages) - stimulation of antigen presenting cells - example lymph node draining a carcinoma
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12
Q

most common cause of lymph node enlargement

A
  1. follicular pattern 2. paracortical pattern 3. sinus histiocytosis
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13
Q

lymphoma definition

A

malignant neoplasm of lymphocytes associated with a solid mass or infiltrate

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14
Q

is non-hodgkins or hodgkins more prevelant in the USA

A

non-hodgkins

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15
Q

incidence of non-hodgkin lymphoma worldwide

A

more common in Europe, USA, New Zealand, and Australia

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16
Q

non-hodgkin lymphoma risk factors

A
  1. infections 2. medical conditions that compromise the immune system 3. toxic chemicals 4. age 5. risk factors are important but most patients do not have any risk factors
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17
Q

lymphoma pathology classification

A
  1. WHO world health organization- grade and stage 2. working formulation- breaks lymphomas down based on natural history low grade you can live a long time, high grade few months to live
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18
Q

in north america what types of lymphoma are most common B/T cell

A

B cell lymphoma

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19
Q

how long do patients with low grade lymphoma have to live without treatment?

A

many years

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20
Q

how long do patients with intermediate grade lymphoma have to live without treatment?

A

few years

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21
Q

how long do patients with high grade lymphoma have to live without treatment?

A

few months

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22
Q

example of high grade lymphomas

A
  1. Burkitt Lymphoma 2. Lymphoblastic lymphoma
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23
Q

example of intermediate grade lymphomas

A
  1. mantle cell lymphoma
  2. diffuse large cell lymphoma
  3. hodgkin
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24
Q

example of low grade lymphomas

A
  1. small lymphocytic lymphoma 2. follicular small cleaved lymphoma
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25
Q

lymphoma is associated with _____ growth pattern in the lymph node?

A

abnormal

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26
Q
A

left- follicular gorwth pattern

right- diffuse gorwth pattern

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27
Q

small lymphocytic lymphoma is essential the same as ____ leukemia

A

chronic lymphocytic leukemia

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28
Q

small lymphocytic lymphoma is usually present in what age group

A

adult

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29
Q

is small lymphocytic lymphoma low/intermittent/high grade

A

low grade

30
Q

what type of cell does small lymphocytic lymphoma affect?

A

mature B cells

31
Q

what is the immunophenotype for small lymphocytic lymphoma?

A

CD 19 20 22 23

CD 5

32
Q

what is the poor cytogenic prognosis for small lymphocytic lymphoma?

A

trisomy 21

33
Q

what is a good cytogenic prognosis for small lymphocytic lymphoma?

A

13q14

34
Q

what age group is typically affected by follicular lymphoma?

A

middle aged to elderly adults

35
Q

is follicular lymphoma low/intermediate/high grade?

A

low grade

36
Q

follicular lymphoma usually involves what cell type?

A

b cells

37
Q

what translocation is follicular lymphoma assoicated with?

A

T (14, 18)

38
Q

what gene is upregualted in follicular lymphoma?

A

BCL2

39
Q

what is the role of upregulated follicular BCL2?

A

inhibit apoptosis

40
Q

follicular lymphoma is assoicated with kappa/lambda b cells?

A

kappa

41
Q

small lymphocyte lymphoma is similar to what leukemia?

A

chronic lymphocytic leukemia

42
Q

what markers are present on small lymphocyte lymphoma?

A

CD5, CD19, CD20, CD22, CD23

43
Q

what gene abnormality is present in diffuse large b cell lymphoma?

A

BCL6

44
Q

what is the most common lymphoma?

A

diffuse large b cell lymphoma

45
Q

what translocation is present in mantle cell lymphoma?

A

T (11;14)

46
Q

follicular lymphoma can progress to

A

diffuse large b cell lymphoma

47
Q

diffuse large b celll ymphoma occurs in

A

childern and adults

48
Q

mantle cell lymphoma is known to have ______ present which are like machrophages

A

histocytes

49
Q

what markers are present and not present in mantle cell lymphoma?

A

CD 5 is present but CD 10, 23 and lambda are not

50
Q

what gene does mantle cell lymphoma upregulate?

A

cyclin D

51
Q

cyclin D

A

pushes cells from G1 into S phase

52
Q

hodkins lymphoma is characterized by

A

reed sternberg cells

53
Q

reed sternberg cells

A

resemble the alien eyes and are activated b cells

54
Q

reed sternberg cells secrete _____ which attract ______

A

cytokines; inflammatory cells

55
Q

what age groups is Hodgkins assoicated with?

A
  • Peak incidence in 20s, smaller peak at age > 50 years of age
56
Q

what two lymphomas are EBV involved in?

A

Hodkins and Burkitts

57
Q

what lymphoma are nodular sclerosis seen in?

A

Hodkin Lymphoma

58
Q

what markers are seen in Hodgkins?

A

positive for CD30, CD15, and

negative for CD45

59
Q

what lymphoma is not good for flow cytometry nor cytogenetics diagnostic?

A

hodgkins

60
Q

sysytemic symptoms of lymphoma?

A

B symptoms

  1. sweat
  2. weight loss
  3. fever
61
Q

two lymphomas that primarliy affect childern

A

burkitt and lymphoblastic

62
Q

what leukemia is lymphoblastic lymphoma similar to?

A

ALL

63
Q

what lymphoma has mediastinal mass presentation?

A

lymphoblastic lymphoma

64
Q

immunophenotype for lymphoblastic lymphoma

A

immature T cells express CD3 4 and 8

65
Q

what translocation is usually in burkitt lymphoma?

A

T (8;14)

(8,22)

and

(2;8)

66
Q

what proto oncogene is upregualted in burkitt lymphoma

A

c-myc

67
Q

what virus is Burkitt lymphoma associated with?

A

EBV

68
Q
  • Endemic Burkitt
A

(Africa > 95% EBV genome positive)

69
Q
  • Non-endemic burkitts
A

(worldwide 15-20% EBV positive)

70
Q

what pattern do macrophages form in burkitt lymphoma?

A

starry night

71
Q

what lymphoma forms cytoplasm vacuoles?

A

Burkitts Lymphoma

Hematology (23 decks)

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