Lymphomas Flashcards
what histologic feature is preserved with a benign lymphadenopathy?
normal node architecture is preserved
follicular hyperplasia cell type and a response to what?
b cell proliferation because of need for antibody production due to an infection
what is enlarged in follicular hyperplasia?
germinal centers…growing dem B cells
cell markers of benign lymphadenopathy growth
kappa and lambda markers for B cells
CD4 and CD8 cells..not cells with both markers
what is the driving factor for paracortical hyperplasia and what cell is growing?
need for cell mediated immunity and needing more T cells
what are histiocytes?
tissue macrophages in sinus of lymph nodes
sinus hystiocytosis cause
increased need for APCs leads to increase in histiocytes in lymph node…lymphadenopathy due to growing sinuss
5 infectious risk factors for lymphoma
HIV helicobacter pylori Hep B Hep C EBV
what class of diseases can increase lymphoma risk?
an diseases or treatment that leads to immune suppression or compromise
SCID…HIV
3 toxic chemicals in that increase risk of lymphoma
pesticides, herbicides and benzene
what about B cells makes classifying cancer so difficult?
B cells can be malignant at any stage of their development
low grade lymphomas
small lymphocytic
follicular small cleaved lymphoma
intermediate grade lymphoma
diffuse large cell lymphoma
high grade lymphomas
burkitt
lymphoblastic
what histologic feature do you lose in lymphomas
architecture of the node..no germinal centers or sinuses
SLL
small lymphocytic lymphoma
SLL grade
LOW
cell markers for SLL
CD23 and CD5…B cells will be either kappa or lambdo…not a mix of both
cytogenetics of SLL with good prognosis
13q14
cytogenetics of SLL with bad prognosis
trisomy 12
what ages for SLL?
all older patients!!!
is SLL curable?
nah…like CLL
follicular lymphoma cell type, age group and grade
Mature B cells
Adults and elderly
LOW GRADE
cytogenetics for follicular lymphoma
t(14;18)
what gene is moved with t(14;18) in follicular lymphoma?
BCL2 in front of IgH region
B cell markers in follicular lymphoma
CD19,20,22
CD10
kappa or lambda…no mix
is follicular lymphoma curable?
no…indolent course
what can follicular lymphoma progress to?
progress to diffuse large cell lymphoma
What cell is malignant in mantle cell lymphoma?
B cell
what is the histologic marker for mantle cell lymphoma?
will see larger histiocytes mixed in with the malignant B cells
mantle cell grading and treatment
it is incurable…like low grade
but aggressive like a intermediate grade cancer
leads to bad prognosis
mantle cell B cell markers
CD5, CD19 positive
CD23 and CD10 negative
one of either kappa or lambda chains…never both
mantle cell lymphoma cytogenetics
t(11;14)
what gene does t(11;14) translocate?
cyclin D1 in front of IgH…tumor will express high cyclin D1 levels
what can you do in mantle cell lymphoma with the cytogenetics to diagnose?
can actually do a stain for cyclin D1 and will see increased staining
what age does diffuse large B cell lymphoma affect?
any age…kids and adults
can DLBCL be cured? what is the grade?
yes…intermediate grade
what is unique about DLBCL in its onset?
often noticed in places other than nodes…brain and GI
what gene alteration is associated with DLBCL?
Bcl-6
grade of Burkitts lymphoma?
HIGH
what is the endemic form of burkitts lymphoma caused by? and where is this mainly?
EBV in africa
what age does burkitts lymphoma infect?
mainly kids…but can be adults, especially those with HIV
cytogenetic alterations of burkitts lymphoma
t(8;14), t(2;8), or t(8;22)
what gene is affected in Burkitts lymphoma?
c-myc, a protooncogene
what cell is the burkitts lymphoma?
mature B cell
what is the histiologic feature of Burkitts lymphoma and what causes it?
called starry sky from the macros with debris around them
what unique feature do the B cells have in bone marrow from Burkitts lymphoma have?
cytoplasmic vacuoles
lymphoblastic lymphoma cell involved
almost always an immature T cell but can be B cell just rare
who can get lymphoblastic lymphoma?
mainly kids, teens and young adults
what is a unique physical finding for lymphoblastic lymphoma?
a mediastinal mass
T cell markers in lymphoblastic lymphoma
CD3 with coexpression of CD4 and CD8 and TdT
what is required for lymphblastic lymphoma diagnosis?
FLOW cytometry
what is the distinctive cell in Hodgkins lymphoma?
a Reed-Sternberg cell
what type of cell is the ReedSternberg cell in Hodgkins lymphoma?
activated B cell
what is the age of presentation for hodgkins lymphoma?
bimodal distribution of 20’s and then older than 50
how does hodgkins lymphoma spread?
typically stays in same line or area before moving elsewhere…so will find line of nodes affected
what can we not use to diagnose hodgkins lymphoma and why?
flow cytometry and cytogenetics
cant use flow because there are so few malignant cells in the tumor
what is in a Hodgkins lymphoma tumor?
not many Reed Sternberg cells…mainly recruited cells like other lymphocytes, eosinophils, histiocytes and fibroblasts
4 subtypes of hodgkins lymphoma
nodular sclerosis
lymphocyte rich
lymphocyte poor
mixed cellularity
cell marker for Reed Sternberg cell in hodgkins lymphoma?
CD15 and CD30 positive
CD45 negative