Lymphomas Flashcards
Lymphoma classification
Hodgkins’s (classical, non-classical) and Non-Hodgkin’s (B cell (85%),T cell (15%) precursor or mature)
Classical Hogkins’s lymphoma
1% of all new cancers in US, bimodal distribution, highly curable; affects men except for nodular sclerosing type; strongly associated with EBV; characteristic Reed Sternberg cells (CD15+, CD30- B cell origin) that only makes up 1-5% of the tumor
Non-classical Hogkins’s lymphoma (nodular lymphocyte predominant Hogkins Disease, NLPHD)
5% of Hogkin’s lymphoma, characterized by nodular and polymorphous proliferation of L & H cells (Reed-Sternberg variants); CD15-,CD30-, CD20+, CD79a+, Bcl-6+, CD45+
HIV associated lymphoproliferative disorders
100x greater risk of lymphoma, B cell lineage -> Large cell lymphoma, Burkitt-like lymphoma, primary effusion lymphoma (usually do not express B cell antigens like CD19-, CD20-, but CD45+), associated with HHV-8 and EBV)
Non-Hogkin’s lymphoma
muliple, peripheral nodes, incidence usually between 20-40 yrs old
Precursor B-lymphoblastic lymphoma
Precursor B cell Non-Hogkin’s lymphoma; predominantly seen in children and young adults; cells show high nuclear cytoplasmic ratio; CD10+, CD19+, CD20+, CD34+, Tdt+, CD20+
Precursor B-lymphoblastic lymphoma cytogenetics
Hyperdiploidy (> 50 chromosomes), t(12;21) -> good prognosis; T(4;11), t(9;22) -> poor prognosis
CLL/ SLL (small lymphocytic lymphoma)
most common adult leukemia; smudge cells (broken down nucleus of CLL cells), CD5+, CD20+
CLL/ SLL (small lymphocytic lymphoma) cytogenetics
Del 13q12-14 -> favorable prognosis; Del 11q, 12+, del 17p -> unfavorable prognosis
Hairy cell leukemia
mature B cell Non-Hogkin’s lymphoma; cell have hair-like projections, cause marrow fibrosis -> massive splenomegaly, pancytopenia, monocytopenia; CD19+, CD20+, CD25+, CD103+
Hairy cell leukemia treatment
Interferon, cladribine (2-CDA), pentostatin (deoxycoformycin)
Extra nodal Marginal Zone Lymphoma/MALToma
often related to H. pylori; presence of (11;18) and IgH gene rearrangement
Follicular Lymphoma
mature small B cell Non-Hogkin’s lymphoma, indolent; Characteristic cleaved/twisted nuclei, resembling raisins; classic paratrabecular aggregates are seen in involved bone marrows; CD10+, Bcl-2+, Bcl-6+
Follicular Lymphoma cytogenetics
T(14;18)
Mantle cell lymphoma
mature small B cell Non-Hogkin’s lymphoma, most aggressive; typically affects elderly men; CD5+, cyclin D1+
Mantle cell lymphoma cytogenetics
T(11;14) (bcl-1;IgH)
Diffuse Large B-Cell Lymphoma (DLBCL)
mature large B cell Non-Hogkin’s lymphoma; common, 40% of all lymphomas, most in > 50 yrs; large cells usually have nuclei twice that of a small lymphocyte, and are typically bigger than tissue macrophage nuclei; c-Myc gene rearrangement in DLBCL; Bcl-2+, Bc1-6+, CD10+
Burkitt Lymphomas
mature medium B cell Non-Hogkin’s lymphoma, aggressive; associated with EBV, lesions; “starry sky” (sheets of lymphocytes with interspersed macrophages); SmIg+, CD10+, c-Myc rearrangement or overexpression
Precursor T-lymphoblastic lymphoma
Precursor T cell Non-Hogkin’s lymphoma; affects young adults; stage II thymocyte express CD3, CD4, CD8, CD1a, Tdt
Anaplastic Large Cell Lymphoma (ALCL)
mature T cell Non-Hogkin’s lymphoma, curable; involves lymph nodes and extranodal sites, large eccentric nucleoi mimic Reed Sternberg cells; ALK-1+, t(2;5)
Adult T cell lymphoma
mature T cell Non-Hogkin’s lymphoma, incurable affecting Japanese, Carribean, and West Africans; skin lesion, lytic bone lesions, hypercalcemia; associated with HTLV-1 infection; CD4+, CD25+, CD7-
Mycosis Fungoides/Sezary Syndrome
mature T cell Non-Hogkin’s lymphoma, incurable; epidermotrophic cutaneous T cell lymphoma (skin plaques) and Pautrier’s micro-abscess; CD3+, CD4+, CD7-, CD8-
Peripheral T cell lymphoma
mature T cell Non-Hogkin’s lymphoma, incurable; DNA analysis reveals rearrangement of at least one T cell receptor locus
