Lymphoma and Leukemia Flashcards
Burkitt’s Lymphoma is B or T cell?
B cell
Burkitt’s cells mark with CD what?
19 and 20
What kind of pattern does Burkitt’s stain?
Starry sky pattern and has macrophages.
Where is Burkitt’s lymhpoma found in the body?
Extranodal (it rarely begins in the lymph nodes)
CD 3,4,5,8
T cells
CD 19/20
B cells
CD 34
Stem cells
CD 45
All leukocytes
Associated with Burkitt’s
EBV
What does the 8:14 translocation (t 8:14) cause in Burkitt’s Lymphoma?
Proliferation of c-myc (a transcription factor) and activation of IgH.
C-myc is an _____
Oncogene
List two mechanisms that create chromosomal abnormalities in lymphomas and leukemias.
1) Activation of oncogenes.
2) Deactivation of anti-oncogenes.
Where does Burkitt’s present?
Jaw
Clinical presentations of Hodgkins Lymphoma
(1) Pel-Ebstein Fever with night sweats.
(2) Pruritis.
(3) Painless lymphadenopathy except may be painful after drinking alcohol.
Pel-Ebstein Fever
Cyclic fever associated with Hodgkins Lymphoma; high temp for a few days then back to normal.
How does Hodgkins Lymphoma present?
Cervical and mediastinal lymphadenopathy.
Describe the spread of disease in HL.
The disease spreads to continuous lymph nodes in an orderly manner, and gets to the spleen last.
Reed-Sternberg Cells
Cells found in the lymph nodes of people with HL.
Most common type of HL
Nodular Sclerosis type
This type of lymphoma is stage I/II and commonly found in young adults and women
Nodular sclerosis type HL
This type of HL is found in older men over the age of 50 and is Stage III/IV
Mixed cellularity type of HL
Two types of HL
1) Nodular sclerosis type
2) Mixed cellularity type
Malignant cell in HL
Reed-Sternberg (RS) cell
Found mostly in RS cells
Epstein Bar viral genome
Hodgkins and RS cells are what type?
B cells
Cells in HL label with what marker?
CD 15
Lacunar cells
A type of RS cell found only in nodular sclerosis type HL
Look at slide 39 for a pic of the RS cell
Do it!
Cells found in nodular sclerosis HL
Lacunar cells with bands of collagen.
Cells in mixed-cellularity type HL
RS cells, lymphocytes, eosinophils.
T/F: Hodgkins Lymphoma can skip a node during its progression.
False: HL does NOT skip any nodes, unlike non-Hodgkin’s Lymphoma.
Oral manifestations of Lymphoma
Involves the palate, tonsils, and Waldeyer’s ring.
Waldeyer’s Ring
An interrupted circle of protective lymphoid tissue at the upper ends of the respiratory and alimentary tracts.
Stage I HL
one lymph node or one group of lymph nodes.
Stage II
2 or more lymph nodes on the same side of the diaphragm.
Stage III
Lymph nodes on both sides of the diaphragm.
Stage IV
One or more non-nodal organs involved.
Cells found in acute leukemia.
Blasts/immature/undifferentiated cells.
Where does acute leukemia spread?
Liver, spleen, lymph nodes, and sometimes meningeal infiltration.
Occurs in acute leukemia because bone marrow cells suppress normal hematopoiesis.
Anemia and thrombocytopenia.
Acute leukemia
Have lots of immature lymphocytes in your bone marrow.
How to test for acute leukemia?
Bone marrow aspiration.
Clinical signs of Acute Myelocytic Leukemia (AML)
Bleeding gums and petechiae.
Fatigue, fever, skin palor.
Non-intraoral sign of acute myelocytic leukemia.
Hepatosplenomegaly (swollen spleen and liver).
Why do the gums bleed in AML?
Because so many blasts in the bone marrow cause thrombocytopenia, so there isn’t enough blood clotting factors made, such as thrombin.
Percentage of blasts in bone marrow for AML?
30%
Normal percentage of blasts in the bone marrow?
3%
Enzyme found in primary granules.
Myeloperoxidase
Stain to test for AML.
Stain for Myeloperoxidase.
These are seen in AML with Granulocytic maturation in the peripheral blood.
Auer rods.
How many blasts are seen in normal blood?
Zero
Often seen in a smear of AML.
Auer rods
Most common leukemia in the US.
Chronic Lymphocytic Leukemia
Average onset age for CLL.
60 (mostly men).
Found in smear of CLL.
Smudge cells.
CLL cells mark with what?
19 and 20, a 5 (a T cell marker).
Bisphosphonates
Inhibit bone resorption by osteoclasts - so it’s used as treatment for multiple myeloma.
CRAB
HyperCalcemia, Renal failure, Anemia, Bone lesions are symptoms of multiple myeloma.
What are amyloids?
They are light chain depositions that can be found in the kidney.
Staining for amyloids.
Congo Red Stain - turns apple green when polarized.
Primary amyloidosis
A plasma cell neoplasm derived from a monoclonal immunoglobulin light chain.
Oral manifestations of amyloidosis.
Grossly enlarged tongues.
Describe Waldenstrom’s macroglobulinema.
A type of non-Hodgkin’s lymphoma where the body makes a lot of IgM (macroglobulin) and causes hyperviscosity, mostly seen in the eye.
Reynaud’s phenomena
Due to obstruction of small blood vessels, shutting down circulation to some areas. Causes color changes in the body.
