Lymphomas

Question 1

Follicular Lymphoma

Answer 1

t(14;18) –> BCL2-IgH fusion gene
Neoplastic small B-cells, CD19+, CD10+, CD20+, BCL2, BCL6
Overexpression of BCL2 –> inh apoptosis
Progress to Diffuse Large B-cell Lymphoma (DLBCL)
Disruption of LN architecture, lack tingible body macrophages

Question 2

Follicular Hyperplasia

Answer 2

B-cells

see tingible body macrophages which indicate apoptosis occuring in the GC

Question 3

Mantle Cell Lymphoma

Answer 3

t(11;14) –> Cyclin D1-IgH
Neoplastic small B-cells, CD5+, CD19+, CD20+ BCL2
[CD23- and CD10-]
Overexpression of Cyclin D1 –> promotes G1/S transition
Lymphomatoid polyposis - enlarged peyer’s patches
Aggressive Poor PX

Question 4

Marginal Zone Lymphoma

Answer 4

t(11;18) --> MALT-1-IAP
t(1;14) --> BCL10-IgH
t(14;18) --> MALT1-IgH
CD19+, CD79a+, BCL2, 
[CD5-, CD10-, CD23-, Cyclin D1-]
Ax w/ chronic inflammatory states
PX good if agent is removed

Question 5

Burkitt Lymphoma

Answer 5

t(8;14) --> cMYC-IgH
Intermediate B-cell lymphoma
Ax w/ EBV
Numerous tingible body macrophages
African at risk; ax w/ jaw
Overexpression of cMYC oncogene promotes cell growth
Starry-sky appearance, very high mitotic activity
immune defic related

Question 6

DBCL

Answer 6

Large B-cell Lymphoma
large nucleoli w/ open chromatin, prominent nucleoli
Neoplastic B-cells CD20+ grow diffusely in sheets
Rearrangement BCL6, BCL2, c-MYC
Aggressive
Most common form of HL
arise sporadically or from follicular lymphoma
Late adult hood - enlarging LN or extranodal mass

Question 7

Reactive prolif of lymphocytes

Answer 7

polyclonal

Kappa: Lambda ratio 3:1

Question 8

Neoplastic prolif of lymphocytes

Answer 8

monoclonal

Kappa:Lambda ratio 20:1

Question 9

Cat Scratch Dz

Answer 9

Bordatella henselae
Self-limited lymphadenitis of Head and Neck
Initially sarcoid-like, granulomas
Later Stellate Necrotizing granulomas

Question 10

Follicular Hyperplasia

Answer 10

stimulus B-cell popl
expansion of GC w/ increased tingible bodies
d/t RA, Toxo, early HIV
B CD20

Question 11

Paracortical Hyperplasia

Answer 11

stimulus T-cell popl
expansion of paracotical regions
d/t infectious Mono, acute viral, rxn to Dilatin
T CD3, diffuse

Question 12

Sinus Histiocytosis

Answer 12

prominence of lymphatic sinusoids
hyperplaseia of Macrophage lining the sinuses
axillary nodes draining a region of breast cancer

Question 13

Highly prolif lymphoma
Evade apoptosis
Both

Answer 13

burkitt
CLL
Mantle cell

Question 14

LAD

Answer 14

painful LAD seen w/ acute infection

painless LAD seen w/ chronic inflammation, metastatic carcinoma, or lymphoma