Lymphoma

Question 1

tangible bodies:

Answer 1

apoptotic bodies

Lymphs cells that are told to die

Question 2

mantle zone (outer)

Answer 2

naive b zone

Question 3

marginal zone

Answer 3

memory B cells

Question 4

Lymphadenopathy causes

Answer 4

reactive

Metatstatic malignancy

lymphoma

Question 5

Reasons for reactive lymphs

Answer 5

Always begnin

Specific lymphadenopathy
-Granulomatous (usually TB or Cocci)
Can also be non-caseating (sarcoidosis

Specific
Acute or Chronic Reactive

Question 6

Reactive LN (acute)

Answer 6

localized or generalized

Localized:
Ex: drainage from nearby infection
Note: children can have enlargement everywhere

Follicular w/ necrosis (PMNs) pyogenic

Foliilular hyperplasia necrosis with suppurative ganulomas (pus)
Cat scratch disease: bartonella
Yersina
Tularemia

Question 7

Bubo

Answer 7

enlarged lymph node, drains pus out of skin

Question 8

CT of abdomen with granulomas in small intestines Q

Answer 8

yersinia enterocolytica (appendicitis maybe)

Question 9

Mesentartic LN

Answer 9

usually yersinia

Symptoms match acute NS LN

Question 10

Chronic NS LN

Answer 10

enlardged, non tender:

1. follicular hyperplasia
2. paracortical hyperplasia
3. Sinus histiocytes

Question 11

are hyperplasias malignant?

Answer 11

NO

They are benign adaptation

Question 12

1. follicular hyperplasia (chronic)

Answer 12

B cell proliferation in apoptotic bodies in germinal centers

HIV

RA

Question 13

2. paracortical hyperplasia (chronic)

Answer 13

T cells, macrophages and eosinophils

MI, CMV, varicella-zoster

Response to viral infections

Could be a rxn from vaccination

SLE

Question 14

3. sinus histiocytosis (chronic)

Answer 14

Non malignant marcophages in node sinuses

Common cause for nodes draining cancer

Question 15

Mixed Pattern Reactive hyperplasia

Answer 15

toxoplasmosis

Follicular and interfollicular Mphage collections

Question 16

Lymphoma General

Answer 16

Neoplastic, monoclonal lymphocytes that form a mass

1/3 are leukemic

2/3 form masses
Nodal or extra nodal

Question 17

Lymphoma B vs T

Answer 17

80-85% are B cell

20-15% are T cell (worse)

Few NK cells (worst)

Question 18

Lymphoma cell stages

Answer 18

Lymbphoblasts (immature)
Bone marrow (leukemia for B cells)

Naive B cells
No longer once through germinal center

Mature B cell (CD23)

Mixture of V cells in follicle

Question 19

Principles of Lymphoma

Answer 19

immune diffincies
(makes immunity even worse)

Follicular lymphoma hones on germinal center

T cells lymphomas hone to skin

Question 20

Lymphoma diagnosis

Answer 20

Biopsy

Must correlate age, histology, clinical features etc

Immunophenotype
K or lambda light change are increased

Certain translocations can be definitive

Question 21

Lymphoma classifications

Answer 21

Hodgkins:
4-5 ypes

NHL:
Precursor B or T (immature)

Peripheral B or T (mature)
Multiple peripeheral T subtypes

Question 22

Ddx for single non-tender enlarged inguinal lymph node

Answer 22

chronic NS LN

Metastatic carcinoma (anal squamous)

Melanoma from leg

Metastatic carncinoma

Malignant Lymphoma
(adult lymphomas don't spread)

Question 23

BCL 6

CD 19,20

Answer 23

Diffiuse Large B-Cell Lymphoma

DLBLC

Question 24

Chromosome 8 (MYC)

T(8;14)

CD 10,19,20

Answer 24

Burkitt’s Lymphoma

Starry Sky

3 types: all involve HBV

Question 25

BCL 2

T(14;18)

CD 10, 19, 20

Answer 25

Follicular Lymphoma

Question 26

BCL 1

T(11;14) cyclinD

CD 5, 19, 20, 23…

Answer 26

Mantle Cell lymphoma

the wrong answer

Question 27

T(11;18) MALT1
T(14;18) MALT1
T(1;14) BCL10

Helicobacter

CD19

Answer 27

MALToma

Extranodal marginal cell lymphoma

Question 28

Hodgkin Staging

Answer 28

1. Single node goup
2. Conitiguous, same side of diaphragm
3. Both side of diaphragm and spleen
4. Organs other than Lymph nodes and Spleen