Lymphoma

Question 1

Cutaneous B cell lymphomas are lymphomas whose primary site is in the skin

Answer 1

True

Question 2

B cell lymphomas make up a minority of NHLs whose primary site is in the skin

Answer 2

False, majority

Question 3

What are poor prognostic factors of B cell lymphoma

Answer 3

Multifocal disease,
High serum level of LDH
Value of staging tumour burden in primary cutaneous MZL and primary cutaneous FCL has not been shown to have an impact on prognosis

Question 4

Solitary and grouped pink to plum coloured papules, plaques or tumours — aka “Crosti’s lymphoma”

Answer 4

True - primary cutaneous follicle centre lymphoma

Question 5

Primary cutaneous follicle centre lymphoma has recurrences up to 50% and commonly disseminates to LN or internal organs

Answer 5

False- Rarely disseminates

Recurrence rate correct

Question 6

Nodular and diffuse infiltrates occur in parts of the dermis with PCFCL

Answer 6

False - in the entire dermis, deeply extending to fat

Question 7

PCFCL epidermis usually involved on histo

Answer 7

False , usually spared

Question 8

IHC of PCFCL

Answer 8

BCl-6 positive, CD20, CD79a, PAX-5 all positive

NEGATIVE CD5, CD43, BCl-2 —> this is a major difference to follicular lymphomas arising fro WITHIN lymph nodes

Question 9

Prognosis excellent , LN/organ involvement rare w cutaneous marginal zone B cell lymphoma

Answer 9

True

Question 10

CMZBCL can be strongly associated with scabies

Answer 10

False - has been linked with Borrelia and can occur in areas affected by ACRODERMATITIS chronica atrophicans

Question 11

Trisomy 3 and 18 protect against CMZBCL

Answer 11

False- predispose

Question 12

Resolution of cutaneous marginal zone B cell lymphoma can result in anetoderma

Answer 12

True

Question 13

Cutaneous marginal zone B cell lymphoma often very tender

Answer 13

False - usually asymptomatic

Question 14

CMZBCL often ulcerate

Answer 14

False - rarely

Question 15

IHC of CMZBCL

Answer 15

CD20, CD79a, BCl-2 positive,

NEG BCl-6, CD5, CD10

Question 16

Primary cutaneous large B cell lymphoma occurs exclusively in elderly patients, predominantly men

Answer 16

False - predominantly women

Question 17

Primary cutaneous large B cell lymphoma, leg type IHC

Answer 17

CD20, CD79a, PAX-5, BCl-2 , MUM-1 , FOXP1

Question 18

CDKN2A mutations confer a better prognosis with PCLBCL

Answer 18

False -worse

Question 19

Intravascular diffuse large B cell lymphoma Often Present as macular erythematous and violaceous patches and plaques on trunk and thighs

Answer 19

False - indurated

Question 20

Intravascular diffuse large B cell lymphoma IHC

Answer 20

Positive for BCl-2, MUM-1 , FOX-P1

Question 21

Sezary syndrome triad

Answer 21

Circulating neoplastic T cells >1000/mcl
Erythroderma
With/without associated lymphadenopathy

Question 22

Transformed MF is characterised by moprphological change of small to medium sized atypical T lymphocytes to a large cell variant

Answer 22

True

Question 23

Need >75% of neoplastic T cell 4 x size of normal lymphocytes to diagnose large cell transformation

Answer 23

False, >25%

Question 24

Negative prognostic factors for MF

Answer 24

MAFIA BEL large sezary clone 30-
Male
Age
Folliculotropic variant
Initial treatment poor response
Advanced skin burden (T score)

B2 microglobulin
Eosinophilia
LDH

Large cell transformation
Sezary cell count high
Peripheral blood T cell clone detectable
CD30 neg

Question 25

Extracorporeal plasmapharesis is helpful for Sezary B0-B2

Answer 25

True

Question 26

Imiquimod is a treatment option for MF

Answer 26

true - 5% mon to fri for 12 weeks

Question 27

Alemtuzumab is an antiCD30 drug

Answer 27

False anti-CD52

Question 28

Folliculotropic MF displays overt epidermotropism

Answer 28

False - folliculotropic instead of epidermotropic

Question 29

Long term follow up is necessary for LyP as risk of progression to more aggressive lymphoma eg. P C-ACL, MF or Hodgkin in 20%

Answer 29

False <5%

Question 30

LyP spontaneously disappear over 3-8 weeks

Answer 30

True

Question 31

SC panniculitis like T cell lymphoma occurs in the trunk>extremities

Answer 31

False vice versa