Lymphomas and Plasma cell disorders

Question 1

Focus on B-cell proliferation

Answer 1

Lymph node Cortex

Question 2

B lymphs and plasma cells

Answer 2

Lymph node Medulla

Question 3

Contains T cells and macrophages

Answer 3

Lymph node paracortex

Question 4

CD19, CD20, CD5

Answer 4

Naive B lymph CD markers

Question 5

CD3, CD5, CD2, CD7, CD4, and CD8

Answer 5

T cell CD markers

Question 6

• Formation of new B lymphocytes
• Processing of specific immunoglobulins
• Filtration of matter, debris, and bacteria

Answer 6

Lymph node functions

Question 7

In the pathology laboratory (moist)
- sliced into 3 mm-thick sections
-touch imprints
- thin sections

Answer 7

Lymph node processing

Question 8

Morphology
Immunophenotype
Molecular Characteristics
Clinical Characteristics

Answer 8

Lymphoma subtypes are distinguished by…

Question 9

Abnormal, destructive lymph node enlargement

Answer 9

Lymphoma characteristic

Question 10

Progression into a leukemia

Answer 10

Peripheralization

Question 11

1. Mature B cell lymphoma
2. Mature T cell lymphoma

Answer 11

Lymphoma categories

Question 12

Reed sternberg cell

Answer 12

Hodgkin’s lymphoma

Question 13

More common in kids

Answer 13

Hodgkin’s lymphoma

Question 14

Happens to ALL ages

Answer 14

Non-Hodgkins Lymphoma

Question 15

Unifocal origin with predictable spread along lymph node chain

Answer 15

Hodgkins

Question 16

Presents with painless, englarged cervical lymph nodes

Answer 16

Hodgkins

Question 17

Prognosis good if still localized (>90% cure)

Answer 17

Hodgkin’s lymphoma (HL)

Question 18

Multifocal origin with unpredictable spread

Answer 18

Non-Hodgkins Lymphoma (NHL)

Question 19

Malignant cell is B lymph in 95% of cases

Answer 19

Non-Hodgkins Lymphoma (NHL)

Question 20

“owl-eyes”

Answer 20

Reed- Sternberg cell

Question 21

Accurate staging crucial to treatment

Answer 21

Hodgkin’s lymphoma (HL)

Question 22

Staging not as crucial

Answer 22

Non-Hodgkins Lymphoma (NHL)

Question 23

Pleomorphic cells, some normal, some malignant

Answer 23

Hodgkin’s lymphoma (HL)

Question 24

Uniform, malignant cells

Answer 24

Non-Hodgkins Lymphoma (NHL)

Question 25

Presents with painless, enlarged cervical lymph nodes & at a more advanced stage

Answer 25

Non-Hodgkins Lymphoma (NHL)

Question 26

Prognosis worse

Answer 26

Non-Hodgkins Lymphoma (NHL)

Question 27

fever, weight loss, night sweats (poor prognostic indicator)

Answer 27

B-symptoms

Question 28

Popcorn cells

Answer 28

Nodular lymphocyte-Predominant Hodgkin Lymphoma (NLPHL)

Question 29

Cells are positive for CD20 and CD45

Answer 29

Nodular lymphocyte-Predominant Hodgkin Lymphoma (NLPHL)

Question 30

strong association w/ cmyc proto-oncogene rearrangement on chromosome 8

Answer 30

Non-Hodgkin’s Lymphoma (NHL)

Question 31

NHL typically_____ have a leukemic presentation at the end stage of the disease

Answer 31

does

Question 32

Essential to accurately stage disease to determine treatment and prognosis!

Answer 32

Diagnosis of HL

Question 33

Radiation and chemo. Can affect 90% cure rate if disease is localized!

Answer 33

Hodgkins treatment

Question 34

slow-growing

Answer 34

Low grade NHL

Question 35

extranodal disease

Answer 35

Intermediate grade NHL

Question 36

rapidly growing - rapidly fatal

Answer 36

High grade NHL

Question 37

ranks according to aggressivity: low, intermediate or high grade

Answer 37

NHL (1982)

Question 38

All produce monoclonal light chain immunoglobulin gene rearrangements, or both

Answer 38

Mature B cell lymphomas

Question 39

Derived from circulating IgM, IgD B-cells

Answer 39

Small Lymphocytic Lymphoma/CLL

Question 40

positive for CD19, CD20, and CD23 (+/- CD5)

Answer 40

Small Lymphocytic Lymphoma/CLL

Question 41

Linked to t(11;14) defect

Answer 41

Mantle Cell Lymphoma

Question 42

CD5, CD19, CD20; but negative for CD23!

Answer 42

Mantle Cell Lymphoma

Question 43

Linked to t(14:18) and (q32;q21) - positive for CD19 and CD20

Answer 43

Follicular Lymphoma

Question 44

- Diffuse proliferation of large lymphocytes (Twice the size of normal lymphs) - Most common lymphoma (30-40%)

Answer 44

Diffuse large B cell Lymphoma (DLBCL)

Question 45

- “Starry sky” - CD10, CD19, and CD20 - MYC gene

Answer 45

Burkitt Lymphoma

Question 46

Diagnosis is considered a medical emergency

Answer 46

Burkitt Lymphoma

Question 47

skin presentation stage of a T cell lymphoma

Answer 47

Mycosis Fungoides

Question 48

Typically see pruritus, followed by weepy erythroderma

Answer 48

Mycosis Fungoides

Question 49

Mycosis fungoides is THE most ____ cutaneous lymphoma

Answer 49

common

Question 50

P.B presentation stage of T cell lymphoma

Answer 50

Sezary syndrome

Question 51

Sezary syndrome has _____ prognosis

Answer 51

BAD

Question 52

"butt cells"

Answer 52

Sezary Syndrome (not specific for this)

Question 53

Topical chemo. & superficial radiation for _____ _______

Answer 53

mycosis fungoides

Question 54

HAART

Answer 54

Highly Active Antiretroviral Therapy

Question 55

increases CD4 counts, unfortunately does not ↓ rate of incidence of HIV-related lymphomas

Answer 55

HAART

Question 56

- HIV infection increases general lymphoma risk (by ~ 60X) - Many types (NHL, HL, Burkitt’s, etc.) may occur, especially late in AIDS - Usually very aggressive

Answer 56

HIV-Related Lymphoma

Question 57

MM occurs when a tumor of ________ overgrows in the bone marrow

Answer 57

malignant plasma cells

Question 58

plasma cells that contain ____ ______(rounded accumulations of IG in rER), are called Mott cells/grape cells/morula cells

Answer 58

Russell bodies

Question 59

Plasma cell seen in IgA myeloma is called a ___ ___

Answer 59

flame cells

Question 60

_______(starch-like protein deposits) are deposited throughout body, causing multiple organ defects

Answer 60

Amyloid

Question 61

_____ – new drug; strengthens bones

Answer 61

Aredia

Question 62

Occurs when absolute # of circulating plasma cells exceeds cutoff (>2000/uL)

Answer 62

Plasma Cell Leukemia (PCL)

Question 63

proteasome inhibition causes more _______ in malignant cells than in normal cells!

Answer 63

apoptosis

Question 64

Malignant plasmacytoid lymphocytes

Answer 64

Waldenstrom's Macroglobulinemia (WM)

Question 65

- Oversecretion of IgM - Abnormally increased CD20 cell surface markers

Answer 65

Waldenstrom's macroglobulinemia

Question 66

moderate rouleaux in p.b.

Answer 66

Multiple Myeloma

Question 67

Length of survival - WORSE

Answer 67

Multiple myeloma

Question 68

More common prevalence

Answer 68

Multiple Myeloma

Question 69

Rare hepatosplenomegaly

Answer 69

Multiple Myeloma

Question 70

Marked lytic bone lesions

Answer 70

Multiple Myeloma

Question 71

May occur as end-stage sequela of MM or by itself

Answer 71

Plasma Cell Leukemia