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MHD > Lymphomas > Flashcards

Lymphomas Flashcards

1
Q

What are the B cell Non-Hodgkin Lymphomas?

A

Follicular lymphoma
Mantle cell lymphoma
Burkitt lymphoma
Diffuse large B cell lymphoma

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2
Q

How would you diagnose a lymphoma?

A

You need an excisional tissue or lymph node biopsy

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3
Q

List some common B Cell markers

A

CD19

CD20

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4
Q

List some common T cell markers

A

CD3

CD2, 4, 5, 7, 8

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5
Q

Follicular Lymphoma

Symptoms

A

Painless lymphadenopathy

They may be totally asymptomatic

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6
Q

Follicular Lymphoma

What is the morphology of the cells?

A

Centrocytes
Small cells with cleaved or irregular nuclei

Centroblasts
Large cells with open nuclear chromatin and many nucleoli

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7
Q

Follicular Lymphoma

What chromosomal translocation is common? Why does this cause lymphoma?

A

t(14;18)
BCL2 / IGH fusion

BCL2 (anti-apoptotic) gets overexpressed along with the IGH gene

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8
Q

Follicular Lymphoma

What is seen on lymph node histology?

A

Tons of follicles all bunched up, not just underneath the capsule

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9
Q

Follicular Lymphoma

What is seen on gross imaging of the spleen?

A

Lots of white dots all over, which are many follicles proliferating

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10
Q

Follicular Lymphoma

How can you look at this disease with immunohistochemical stain?

A

Stain for BCL2 expression in the follicles

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11
Q

Mantle Cell Lymphoma

What is the appearance of the cells present?

A

Small cells with irregular nuclei

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12
Q

Mantle Cell Lymphoma

What chromosomal translocation is common? Why does this cause lymphoma?

A

t(11;14)
Fusion of the Cyclin D1 and IGH genes

Leads to overexpression of Cyclin D1, which causes increased cell proliferation

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13
Q

Burkitt Lymphoma

Who most commonly presents with this disease?

A

Kids and young adults

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14
Q

Burkitt Lymphoma

Symptoms

A

Tumors at extranodal sites (mandible tumors, abdominal tumors)

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15
Q

Burkitt Lymphoma

What is the appearance on histology?

A

Starry Sky Pattern

See lots of dark cells with some clear areas (benign macrophages clearing up apoptotic debris)

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16
Q

Burkitt Lymphoma

What chromosomal translocation is common? Why does this cause lymphoma?

A

t(8;14)
Fusion of the MYC and IGH genes

Causes overexpression of MYC

17
Q

What are some other causes of Burkitt Lymphoma (not due to chromosome translocation)?

A

B cell neoplasm
EBV infection
HIV infection

18
Q

What is the most common form of lymphoma in adults?

A

Diffuse large B cell lymphoma

19
Q

Diffuse Large B Cell Lymphoma

What are the two distinct subtypes? Which has better survival?

A

Germinal center B Cell (GBC)
Activated B Cell (ABC)

GBC has better survival

20
Q

Diffuse Large B Cell Lymphoma

What is the clinical presentation?

A

Rapidly enlarging symptomatic mass at single or extranodal site

21
Q

Diffuse Large B Cell Lymphoma

What genetic abnormalities may be present?

A

30% have t(14;18) - BCL2 overexpression (anti-apoptosis)

30% have BCL6 rearrangement

Some have MYC rearranged to increase cell proliferation

22
Q

Diffuse Large B Cell Lymphoma

What is the appearance on histology?

A 
Large cells (4x normal size)
Vesicular chromatin ("bubbly" appearance of chromatin)
23
Q

Peripheral T Cell Lymphoma NOS

Clinical Presentation

A 
Lymphadenopathy
Eosinophilia
Pruritis (itchy skin)
Fever
Weight loss
24
Q

Peripheral T Cell Lymphoma NOS

How would you make the diagnosis of this disease?

A

Demonstrate it is a T cell (CD3+) with immunophenotypic and genotypic analysis

Normal T cells would also express CD5, but the neoplastic T cells in PTCL NOS do not express CD5

25
Q

Hodgkin Lymphoma

Who tends to get this?

A

Young people (20s) and very elderly

26
Q

Hodgkin Lymphoma

Where does it arise?

A

Generally arises in one lymph node and spreads contiguously to the nearby lymphoid tissues

27
Q

Hodgkin Lymphoma

What are the characteristic cells?

A

Reed-Sternberg cells (Owl eyes)

28
Q

List the 4 classic Hodgkin Lymphomas

A

Lymphocyte rich
Mixed cellularity
Lymphocyte depleted
Nodular sclerosis

29
Q

What is the non-classic Hodgkin Lymphoma?

A

Nodular lymphocyte predominant

30
Q

Hodgkin Lymphoma

What are the neoplastic cells? What activates the reactive cells?

A

B cells are neoplastic.

Reactive cells most likely due to cytokines made by RS cells

31
Q

Hodgkin Lymphoma

What two antigens are expressed on the cell surface of classic Hodgkin Lymphoma?

A

CD15 and CD30

32
Q

Hodgkin Lymphoma

What two antigens are expressed on the cell surface of NON-classic Hodgkin Lymphoma?

A

CD20 and CD45

33
Q

Hodgkin Lymphoma

How would you make a diagnosis of nodular sclerosis?

A

If there is fibrosis present, you know it is nodular sclerosis

34
Q

Hodgkin Lymphoma

How would you make a diagnosis of Lymphocyte Rich?

A

Lots of reactive small lymphocytes

Not too many RS cells

35
Q

Hodgkin Lymphoma

How would you make a diagnosis of Mixed Cellularity?

A

Lots of RS cells with eosinophils, plasma cells, T lymphocytes, histiocytes

36
Q

Hodgkin Lymphoma

How would you make a diagnosis of Lymphocyte Depleted?

A

Lots of RS cells with few reactive lymphocytes

37
Q

What is the general appearance of Reed Sternberg cells?

A

“Owl eyes”
Binucleate
Big eosinophilic cells

May be mononuclear

Lacunar variant - more white space in cell(?)

38
Q

What is the classic cell seen in Nodular lymphocyte Predominant Hodgkin Lymphoma?

A

Popcorn cells

Express CD20 and CD45

MHD (57 decks)

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