Malignant Lymphomas and Hodgkin's Disease Flashcards
Describe the features of Precursor B lymphoblastic leukemia/lymphoma.
- agressive
- particularly occur in childhood
- TdT positive
- related to B cell ALL
Describe the features of B small lymphocytic lymphoma/B cell CLL.
- Diffuse, uniform, small lymphocytes
- long survival, but difficult to cure by chemotx
- tissue equiv of CLL, often involves multiple nodes, spleen
- prolymphocytic varieties, include larger cells and may be more agressive
Describe the features of Lymphoplasmacytic Lymphoma.
- similar to small lymphocytic lymphomas but shows plasmacytoid differentiation. slow growing
- IgM monoclonal spike, may have hyper viscosity: Waldenstrom’s Macroglobulinemia
- pay have t(9;14) Pax 5 gene-b cell specific activating protein
Describe the features of Mantle Cell Lymphoma
- mantle zone cells (periphery of follicles)
- agressive
- t(11;14), bcl-1 genes for cyclin D1, upregulated, promotes G1 to S transition in cell cycle
Describe the features of follicular center cell (FCC) lymphomas.
-one of most common forms of B cell lymphoma
-forms follicle like nodules
-t(14;18) translocation, with increased bcl2 protein, inhibits apoptosis
-B cell markers +CD10
-the more large cells, the more aggressive
Grade 1: small cell type–very few large cells
-mainly small lymphocytes with nuclei showing deep cleaves
-most have follicular pattern
-marrow involvement is detectable in over 70% at presentation
-few cells in S phase so cure difficult
Grade 2/3 mixed small and large cell types
-may progress to diffuse large cell lymphomas
Describe the features of marginal zone lymphoma.
- called MALToma in GI tract (MALT=mucosa associated lymphoid tissue)
- some MALTomas are on the borderlands of hyperplasias and respond to antibiotic tx, means that proliferation is antigen driven.
- contain many plasma cells and blur with lymphoplasmacytic lymphoma
Describe the features of plasma cell (multiple myeloma).
- in bone marrow, multiple lytic lesions, usually not in nodes
- typically shows monoclonal Ig spike in serum
- plasma cell is the end stage fully differentiated effector B cell
Describe the features of large B cell lymphoma. (DLBCL)
- includes large B cell immunoblastic large cells containing prominent nucleoli, and abundant cytoplasm. Prognosis untreated is poor, may respond well to chemo tx
- some show t(14;18)
- some show bcl-6 gene defects
- common, about 30% of adult lymphomas
Describe the features of Burkitt lymphoma
- agressive, one of most common lymphomas of children
- endemic in africa and new guinea, assoc with malaria & EBV
- t(8;14), myc oncogene
- Starry night appearance
Describe the features of precursor T- T lymphoblastic leukemia/lymphoma.
- children and young adults, esp males
- present often as mediastinal mass, then becomes leukemic
- diffuse proliferation of primitive cells resembling embryonic T lymphoblasts
- have high mitotic rate, aggressive
- related to T cell ALL
- Express TdT and T cell markers
Describe peripheral T cell lymphoma
- various appearances; probably more than one disease type, CD3 phenotype useful in diagnosis
- may resemble diffuse large B cell lymphoma, from which they must be distinguished via CD3 v. CD20
Describe cutaneous T cell lymphomas, including mycosis fungicides.
- small cells with folded nuclei
- frequently composed of cells with T helper CD4
- related to leukemia like condn Sezary syndrome
Describe Adult T cell lymphoma/leukemia
uncommon
-japan, africa, caribbean, HTLV1 related
Describe anapestic large cell lymphoma- ALCL
- CD30+ cells
- t(2,5) translocation, npm/alk gene
- cutaneous variant, less aggressive than nodal form
What are the general pathologic features of Hodgkin lymphoma?
- Reed Sternberg cells: owl face
- also have large mononuclear cells
- RS cells mixed with lymphocyte,s plasma cells, histiocytes, eosinophils, neutrophils, fibroblasts “reactive”
- if assoc with B symptoms (due to RS secreting cytokines): night sweats, fever, wt loss: poor prognosis
- markers: CD15+ and CD30+
