Lymphoma Flashcards
Divisions of lymphoma
Hodgkins and non-hodgkins
Divisions of non-hodgkins lympoma
Follicular lymphoma Mantle cell lymphoma Marignal zone lymphoma Burkitt lymphoma Diffuse large B cell lymphoma
What cells proliferate in follicular lymphoma?
small b cells
Pathophys of follicular lymphoma?
proliferatino of small B cells (CD20+) form follicle-like nodules
Translocation results in overexpression of Bcl2 and loss of apoptosis
Which translocation is present in follicular lymphoma?
t(14:18) - Bcl2 is translocated to location of it heavy chain locus result in overexpression and prevention of cell death
Treatment of follicular cell lymphoma
reserved for patients with symptoms
Rituximab (anti-CD20 antibody)
How to dinstinguish between follicular cell lymphoma and reactive follicular hyperplasia?
Follicular cell lymphoma has disruption of normal lymph architecture, lack of tangible body macrophages in germinal center, bcl2 overexpression and monoclonality
What proliferates in mantle cell lymphoma?
Small b cells (CD20+)
Which area of the lymph node expands in mantle zone lymphoma?
Mantle zone
Which translocation is present in mantle cell lymphoma?
t(11:14)
- cylcin D1 on chromosome 11 translocation to it heavy chain locus of chromosome 14 leading to overexpression of cyclin D1
What does the t(11:14) seen in mantle cell lymphoma result in?
Overexpression of Cyclin D1 and progression from G1 to S phase
What is marginal zone lymphoma a proliferation of?
small b cells (cd20+)
Which zone is expanded in marginal zone lymphoma?
Marginal zone
What is marginal zone lymphoma associated with?
Chronic inflammatory states including Hashimoto thyroiditis, Sjorgren, H pylori gastritis
what type of lymphoma is MALToma?
marginal zone lymphoma of mucosal sites
which translocation may be seen in marginal zone lymphoma?
t(11;18)
What non hodgkins lymphomas have overexpression of small B cells?
follicular lymphoma
Mantle cell lymphoma
Marginal zone lymphoma
Which non hodgkins lymphoma has overexpression of intermediate-b cells?
Burkets lymphoma
which cells proliferate in burkitts lymphoma?
intermediate-sized b cells (cd20+)
what is burkitt lymphoma associated with?
EBV
classic presentation of burkitt lymphoma
extranodal mass in child or young adult
What are the two forms of burkitt lymphoma?
African form - involves jaw
Sporadic form - involves abdomen
What translocation drives burkitt lymphoma?
t(8;14)
c-myc gene is translocated to igheavy chain locus on chromosome 14 resulting in overexpression of c-myc oncogene
What will burkitts lymphoma look like histologically?
high mitotic index and ‘starry sky’ appearance
what cells proliferate in diffuse large b-cell lymphoma?
large B cells (CD20+)
histological appearance of large b-cell lymphoma
diffuse growth in sheets
Hodgkins lymphoma has which type of cell?
Reed-sternberg cells
What are reed-sternberg cells?
Cell type seen in hodgkins lympoma
they are large B cells with multilobed nuclei and prominent nucleoli ‘Owl eyed’
Which markers are reed-sternberg cells + for?
CD15 and CD30
Pathophys of hodgkins lymphoma
reed-sternberg cells secrete cytokines which draws in other cell types
May result in B cell symptoms (fever, chills, weight loss, night sweats)
May lead to fibrosis
What are the subdivisions of Hodgkins lymphoma?
Mixed-cellularity hodgkins lymphoma
Lymphocyte-depleted hodgkins lymphoma
Nodular sclerosis
Lymphocyte-rich hodgkins lymphoma
Which type of hodgkins lymphoma is the most common?
Nodular sclerosis (70%)
Nodular sclerosis hodgkins lymphoma presentation?
enlarging cervical or mediastinal lymph node in a young adult female
Nodular sclerosis hodgkins lymphoma histology?
Bands of sclerosis with reed-sternberg cells in lacunar spaces
Which subtype of hodgkins lymphoma has the best prognosis ?
Lymphocyte-rich
Which subtype of hodgkins lymphoma is the most aggressive and which populations does it effect?
Lymphocyte-depleted
seen in elderly and HIV positive individuals
Which cell type is abundant in mixed-cellularity hodgkins lymphoma?
eosinphils drivin by IL-5 produced by RS cells
