Mature B-Cell Lymphomas

Question 1

In general, are B-cell lymphomas with small lymphocytes or large lymphocytes more aggressive?

Answer 1

Large lymphocytes

Question 2

Most common B-cell lymphomas in the world, commonly in males age 60-70, that arises from germinal center lymphocytes, esp. centroblasts.

Answer 2

Diffuse large B-cell lymphomas

Question 3

Most common extranodal site of diffuse large B-cell lymphoma?

Answer 3

GI tract (bone marrow and peripheral blood affected later / rarely)

Question 4

Most common non-Hodgkin lymphoma in the U.S., 2nd most common B-cell lymphoma in the world, often in females age 50, that arises from germinal center lymphocytes.

Answer 4

Follicular lymphoma

Question 5

Follicular lymphomas have a mix of centroblasts and centrocytes. Which cells are larger, so that having a larger proportion of them indicates a higher grade?

Answer 5

Centroblasts

Question 6

B-cell lymphoma associated with t(14;18) of bcl-2 and IgH genes. (bcl-2 is an apoptosis inhibitor)

Answer 6

Follicular lymphoma

Question 7

Compare diffuse large B cell lymphoma with follicular lymphoma in terms of: presenting pattern, aggressiveness, and curability.

Answer 7

Follicular lymphoma has a follicular pattern, is less aggressive, but usually incurable.
Diffuse large B cell lymphoma is more aggressive but curable.

Question 8

Prototype marginal zone lymphoma and also the most common gastric lymphoma, associated with H. pylori gastritis.

Answer 8

MALT (mucosal-associated lymphoid tissue) lymphoma

Question 9

Post-germinal center lymphoma associated with chronic inflammation and lymphoepithelial lesions.

Answer 9

MALT lymphoma

Question 10

Pre-germinal center B-cell lymphoma that is small cell but aggressive, and incurable. No centroblasts or large transformed cells.

Answer 10

Mantle cell lymphoma

Question 11

B-cell lymphoma associated with t(11;14) of bcl-1 (PRAD1) leading to cyclin D1 overproduction, ATM inactivation, scattered epithelioid histiocytes, and hyalinized small blood vessels

Answer 11

Mantle cell lymphoma

Question 12

Is the mantle zone pattern (nodular pattern of lymphoma cells surrounding germinal centers) or blastoid pattern (larger, lymphoblast-like cells) of mantle cell lymphoma more aggressive?

Answer 12

Blastoid pattern

Question 13

Term for the multifocal mucosal involvement of the GI tract, as in mantle cell lymphoma

Answer 13

Lymphomatous polyposis

Question 14

Term for when tumor cells invade glandular or mucosal epithelium, as in MALT lymphoma.

Answer 14

Lymphoepithelial lesions

Question 15

Neoplasm of small, mature, CD5+ B cells, often asymptomatic or with hypogammaglobulinemia and T cells that show impaired type IV hypersensitivity.

Answer 15

B-cell CLL/SLL (chronic/small lymphocytic lymphoma)

Question 16

Difference between B-cell CLL and SLL?

Answer 16

CLL (chronic) involves the blood and bone marrow only; SLL mainly involves lymph nodes and solid tumors

Question 17

2 terms for larger cells with round nuclear contours, less condensed chromatin and a single prominent central nucleolus; found in B-cell CLL/SLL.

Answer 17

Prolymphocytes (if in blood) or paraimmunoblasts (if in tissue)

Question 18

Term for osmotically fragile cells that characterize B-cell CLL/SLL.

Answer 18

Smudge cells

Question 19

2 possible transformations of B-cell CLL/SLL. Which is more common? Which is called the Richter transformation?

Answer 19

Transformation to prolymphocytic leukemia or to diffuse large B-cell lymphoma; former is more common, latter is the Richter transformation

Question 20

Highly aggressive but curable B-cell lymphoma that arises from follicular blast cells in the early germinal center; often presents with bulky, extranodal tumors in children.

Answer 20

Burkitt lymphoma

Question 21

B-cell lymphoma associated with t(8;14) of the myc gene on 8 and Ig heavy chain on 14.

Answer 21

Burkitt lymphoma

Question 22

3 forms of Burkitt lymphoma and the population associated with each.

Answer 22

Endemic BL: kids in Africa and New Guinea (EBV association)
Sporadic BL: worldwide, nonspecific
Immunodeficiency-associated BL: AIDS patients

Question 23

B-cell lymphoma arising from the lymph node medulla and resembling MALT lymphoma, but can develop Waldenstrom macroglbulinemia and a hyperviscosity syndrome.

Answer 23

Lymphoplasmacytic lymphoma

Question 24

B-cell lymphoma of small-to-medium lymphocytes with tartrate-resistant acid phosphatase and characteristic “fried egg” appearance.

Answer 24

Hairy cell leukemia

Question 25

Type of plasma cell neoplasia involving low monoclonal paraproteinemia, <10% plasma cells in the bone marrow, and lack of end-organ damage.

Answer 25

MGUS (monoclonal gammopathy of undetermined significance)

Question 26

Type of plasma cell neoplasia involving M-protein in the serum or urine, end-organ damage, and multifocal, destructive, lytic bone lesions.

Answer 26

Plasma cell myeloma / Multiple myeloma

Question 27

End organ damage in the plasma cell neoplasia multiple myeloma is remembered with the acronym CRAB, which stands for what?

Answer 27

hyperCalcemia, Renal insufficiency, Anemia, and Bone lesions

Question 28

Asymptomatic myeloma, nonsecretory myeloma, and primary amyloidosis (of AL amyloid) are associated with neoplasms of what cell type?

Answer 28

Plasma cells

Question 29

Which plasma cell neoplasia is the most aggressive: plasma cell leukemia, osseous plasmacytoma, and extraosseous/extramedullary plasmacytoma (of URT and soft tissue)?

Answer 29

Plasma cell leukemia