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01 Hematology > Lymphomas > Flashcards

Lymphomas Flashcards

1
Q

Where are follicles typically located in a normal lymph node?

A

Within the cortex

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2
Q

What is the B cell area of the normal lymph node?

A

Cortex

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3
Q

What is the T cell area of the normal lymphnode?

A

Paracortex

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4
Q

What type of cells line lymph node?

A

Histocytes

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5
Q

What is the plasma cell area of the normal lymph node?

A

Medulla

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6
Q

Where are metastatic carcinomas mostly likely to be found in a lymph node?

A

Subcapsular space

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7
Q

What are the most active part of the lymph node?

A

Germinal Centers

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8
Q

What is the main clinical finding in lymph node disease?

A

Lymph node enlargement

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9
Q

What is lymphadeopathy?

A

Lymph node enlargement

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10
Q

How can consistency be used to distinguish malignant lymphadenopathy from reactive lymphadenopathy?

A

The harder the lymph node the more likely it is malignant

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11
Q

Lymphadenopathy in which lymph nodes is most highly correlated with malignancy?

A

Supraclavicular lymphadenopathy

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12
Q

What are the most common sites of nonspecific acute lymphadenitis?

A

Cervical and Inguinal

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13
Q

What are the causes of nonspecific acute lymphadenitis?

A

Reaction to microbologic agents, systemic viral infections,

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14
Q

What is cat scratch lymphadenitis?

A

Axillary or cervical lymphadenopathy that occurs after infection with bartonelle henselae typically transmitted via cat scratch

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15
Q

What histology is associated with cat scratch lymphadenitis?

A

Stellate microabscesses, necrotizing granulomas

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16
Q

What are the histologic patterns seen in chronic non-specific lymphadenitis?

A

Follicular hyperplasia, paracortical hyperplasia, and sinus histocytosis

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17
Q

What is dermatopathic lymphadenitis?

A

Prototypic example of paracortical hyperplasia of lymphnodes draining chronically irritated skin

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18
Q

What are lymphomas?

A

Proliferation of lymphoid cells in discrete tissue masses

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19
Q

What is the cell lineage of the majority of lymphomas?

A

80-85% B cell origin

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20
Q

True or False: By definition all lymphomas are monoclonal proliferations

A

True

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21
Q

What are the two major categories of lymphoma?

A

Hodgkin or Non-Hodgkin

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22
Q

What are the general major differences between Hodgkin and Non-Hodgkin lymphoma?

A

Hodgkin is typically localized to a single axial group of nodes and spreads in an orderly fashion and rarely involves mesenteric nodes or the Waldeyer ring; NHL has more frequent involvement of multiple peripheral nodes with noncontiguous spread that commonly involves the walderyer ring and mesenteric nodes

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23
Q

What surface antigens are B cell markers?

A

CD19, CD20, CD22, CD79a, surgace Ig

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24
Q

What surface antigens are T cell markers?

A

CD1a, CD2, CD3, CD4, CD5, CD7, CD8

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25
Q

What surface antigens are NK cell markers?

A

CD2, CD7, CD16, CD56

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26
Q

What is the characteristic cytogenetic abnormality in mantle cell lymphoma?

A

t(11;14)

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27
Q

What is the characteristic cytogenetic abnormality in follicular lymphoma?

A

t(14;18)

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28
Q

What is the characteristic cytogenetic abnormality in Burkitt lymphoma?

A

t(8;14)

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29
Q

What is the characteristic cytogenetic abnormality in anaplastic large cell lymphoma?

A

t(2;5)

30
Q

What is the exception to the generally indolent nature of Mature B-cell neoplasms?

A

Mantle cell is very aggressive

31
Q

What is the most common leukemia in the modern world?

A

Chronic lymphocytic leukemia

32
Q

What surface antigens will be present on CLL cells?

A

CD5, 19, 20, 22, 23

33
Q

The translocation associated with mantle cell lymphoma causes what cellular event?

A

Over expression of cyclin D1

34
Q

What is the immunophenotype of Mantle cell lymphoma?

A

Cd19+, Cd20+, CD5+, CD23-, Cyclin D1+

35
Q

What is the most common NHL in the US?

A

Follicular lymphoma

36
Q

Is follicular lymphoma more common in men or women?

A

Women

37
Q

What are the tumor cells in follicular lymphoma?

A

Centrocytes and centroblasts

38
Q

What is the immunophenotype of Follicular lymphoma?

A

CD 19+, 20+, 10+, 5-, Bcl2+

39
Q

What is the product of the t(14;18)?

A

Overexpression of Bcl2

40
Q

What is the origin cell of marginal zone lymphoma?

A

Memory B cell origin

41
Q

What are the causes of extranodal marginal zone lymphoma?

A

Chronic inflammatory conditions (infectious- helicobacter pylori; autoimmune- hasimoto’s sjogren’s

42
Q

What is the immunophenotype of Marginal zone lymphoma?

A

Cd 19+, 20+, 5-, 10-

43
Q

What two kinds of lymphomas are seen in HIV/AIDS pts? What are the differences in incidence?

A

Diffuse Large B cell lymphoma, and Burkitt; DLBC is seen in pts with low CD4 counts while burkitts cases are seen in pts with higher CD4 counts

44
Q

What is the malignant nature of Burkitt lymphoma?

A

Highly aggressive

45
Q

What age population is most at risk for Burkitt’s lymphoma?

A

Children and young adults

46
Q

What are the three different forms of Burkitt Lymphoma?

A

Endemic, Sporadic, and HIV-related

47
Q

What is the cell type of burkitt lymphoma?

A

Medium sized B cells

48
Q

What lymphoma is associated with a Starry Sky pattern of histiocytes?

A

Burkitt Lymphoma

49
Q

What is a Ki67 stain?

A

Stains cells that are cycling

50
Q

What is the most common translocation in burkitt lymphoma? What is the result of this event?

A

t(8;14); Over expression of c-myc

51
Q

What is the immunologic marker of T-cell clonality in lymphomas?

A

There is no immunologic marker specific to T cell clonality- the loss of normally expressed antigens (commonly CD5,-7) implies T cell morphology

52
Q

What are the two categories of Anaplastic Large Cell Lymphomas based on? Which has a poorer prognosis?

A

Presence/ absence of Anaplastic Lymphoma Kinase protein indicating a t(2;5)/NPM-ALK; ALK- has poorer prognosis

53
Q

What neoplasia often presents with lethal midline granuloma ?

A

Extranodal NK/ T-Cell Lymphoma, Nasal Type

54
Q

What is the diagnosis of NHL with T cell morphology that doesn’t fit the criteria for Extranodal NK/Tcell Lymphoma, Sezary Syndrome, or ALCL?

A

Peripheral T-cell Lymphomas (PTCL)

55
Q

What paraneoplastic features may be seen in peripheral T cell Lymphoma?

A

Eosinophilia, Pruritus, Hemophagocytic syndrome

56
Q

What are the 2 distinct types of Hodgkin Lymphoma? Which is the more frequent type?

A

Nodular Lymphocyte Predominant HL and Classic HL (more common)

57
Q

What abnormal cell morphology is seen in nodular lymphocyte predominant HL?

A

Popcorn cells

58
Q

What is the most important prognostic factor for Classic HL?

A

Disease Stage

59
Q

What are Reed-Sternberg cells?

A

Binucleated clonal B cells used to diagnose CHL

60
Q

True or False: Hodgkin Lymphomas are clinically distinct from B cell lymphomas.

A

True

61
Q

What is the most common subtype of CHL?

A

Nodular Sclerosis CHL

62
Q

What histologic features characterize Nodular Sclerosis CHL?

A

Collagen bands and fibrosis in node, lacunar RS cells

63
Q

What subtype of classic hodgkins lymphoma has the best prognosis?

A

Lymphocyte Rich CHL

64
Q

What is the most aggressive subtype of CHL?

A

Lymphocyte Depleted CHL

65
Q

What type of CHL is histologically a mixture of lymphocyte, plasma cellsosinophils and RS Cells?

A

Mixed Cellularity CHL

66
Q

What is the order of CHL subtypes from poorest to best prognosis?

A

Lymphocyte depleted

67
Q

What are the functions of the spleen?

A

Phagocytosis of blood cells and particulate matter; Ab production; Hematopoiesis; Reserve pool of blood elements

68
Q

What is DiGeorge Syndrome

A

Congenital aplasia of the thymus?

69
Q

Thymic hyperplasia is most frequently seen in what condition?

A

Myasthenia gravis

70
Q

What is the term for thymic epithelial cell neoplasms ? Malignant thymic neoplasms?

A

Thymomas; Thymic carcinoma

71
Q

What are histiocytoses?

A

Proliferation of dendritic cells, macrophages, or monocyte-derived cells

72
Q

What condition is associated with Birbeck granules?

A

Langerhans cell histiocytosis

01 Hematology (16 decks)

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