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Unit 2 SPATH UFCOM > N. B Cell Non-Hodgkins Lymphoma (L13 & Lab4) > Flashcards

N. B Cell Non-Hodgkins Lymphoma (L13 & Lab4) Flashcards

1
Q

What is NHL?

A

Clonal expansion of malignant T-, B- or NK lymphocytes due to genetic lesions
Stuck at a normal stage of differentiation

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2
Q

How is the incidence of NHL changing?

A

Increases 3-4% every year

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3
Q

How does the incidence of NHL change in relation to age?

A

Steadily increases after age 30

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4
Q

What is the general prognosis for NHL patients?

A

50% die of NHL

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5
Q

What condition predisposes a patient to aggressive NHL?

A

AIDs

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6
Q

What is being referenced when calling a lymphoma low or high “grade”?

A

Speed of growth & general prognosis

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7
Q

How can low grade lymphomas change overtime?

A

Can transform into a higher grade

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8
Q

What grade is assigned to small cell lymphomas? Medium size? Large cell?

A 
Small = low grade
Medium = High grade
Large = Intermediate grade
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9
Q

What cytogenic abnormality is seen with Follicular Lymphoma? What is the pathophysiology?

A

t(14:18)
Ig heavy chain on 14 is constituitively expressed
BCL-2 gets heavy chain promoter –> tons of BCL-2 –> anti-apoptotic

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10
Q

What cytogenic abnormality is seen with Burkitts Lymphoma? What is the pathophysiology?

A

t(8:14)
Ig heavy chain on 14 is constituitively expressed
C-Myc oncogene gets heav chain promoter –> tons of c-myc

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11
Q

What is the most common type of indolent B cell lymphoma?

A

Follicular hyperplasia

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12
Q

What is the normal cell equivalent of follicular lymphoma?

A

Small germinal center B cell (follicle like)

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13
Q

What grade is Follicular Lyphoma?

A

Low Grade

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14
Q

What should be suspected when the follicles in the lymph node touch each other?

A

Follicular Lymphoma (not reactive)

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15
Q

What cytogenic abnormality is seen with Mantle Cell Lymphoma? What is the pathophysiology?

A

t(11:14)
Ig heavy chain on 14 is constituitively expressed
Cyclin D gains heavy chain promoter –> lots of cyclin D

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16
Q

What is cyclin D staining diagnostic of?

A

Mantle Cell Lymphoma

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17
Q

What is the normal cell version of the neoplastic cell in Mantle Cell Lymphoma?

A

Naive B cells which are located in the mantle (dark area around the follicle)

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18
Q

What is the key clinical finding in mantle cell lymphoma? What can result from it?

A

Colon polyps

Obstruction of the colon

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19
Q

What grade is mantle cell lymphoma?

A

Intermediate grade

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20
Q

What is associated with Gastric Malt Lymphoma?

A

H pylori infection

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21
Q

What is the normal equivalent of the neoplastic cells that cause gastric MALT Lymphoma?

A

Small B cells from marginal zone

22
Q

What grade is Gastric Malt Lymphoma?

A

Low grade

23
Q

What is the 5 year survival rate for Gastric MALT Lymphoma?

A

95%

24
Q

What is he standard therapy for Gastric MALT Lymphoma? When is this not effective?

A

Chemo + antibiotics

If cytogenetic abnormality, just use chemo

25
Q

What type of lymphoma is largely extranodal?

A

Gastric Malt Lymphoma

26
Q

What is a type of Marginal Cell Lymphoma?

A

Gastric Malt Lymphoma

27
Q

Is large B cell Lymphoma curable?

A

Yes

Even though aggressive. Proliferating cells are more responsive to treatment

28
Q

What is a key clinical finding of Large B Cell Lymphoma?

A

Massively enlarged submandibular gland

29
Q

What is the normal non-neoplastic version of Large B Cell lymphoma?

A

Replicating Cells of the germinal center

30
Q

What is suspected with increased expression of BCL-2 & BCL-6?

A

Large B Cell Lymphoma

31
Q

What is the prognosis for Large B Cell lymphoma when their is overexpression of Bcl-6?

A

good

32
Q

What grade is Large B Cell Lymphoma?

A

High grade

33
Q

What grade is Burkits Lymphoma?

A

High Grade

34
Q

What is the endemib form of Burkits associated with?

A

Epstein Bar Virus (EBV)

35
Q

What should be suspected when there is a starry night appearance? Does this improve or hurt prognosis?

A

Burkitts Lymphoma

Improves prognosis

36
Q

What percentage of neoplastic Burkit cells are in cell cycle? What staining property does this lead to?

A

100%

Stains with Ki67

37
Q

What is the normal equivalent of the neoplastic cells in Burkits Lymphoma?

A

Small dark no cleaved B cells in center of germinal center

38
Q

What is the pathophysiology of Multiple Myeloma?

A

Plasma Cell Dyscrasia –> monoclonal plasma cells in bone marrow –> crowding in bone marrow –> pancytopenia (impaired immunity)

Bone fractures and pain

39
Q

What causes lytic bone lesions?

A

Multiple Myeloma

40
Q

How is renal insufficiency caused in multiple myeloma?

A

Monoclonal Ig lodges in glomerular capillary and damages

41
Q

What is paraproteins?

A

High levels of Ig in the urine due to Multiple Myeloma

42
Q

What is suspected with a Roleaux Formation?

A

Multiple Myeloma = excess Ig makes RBCs stick together

43
Q

What is suspected with an M spike? what does it mean?

A

Excess monoclonal Ab

Multiple Myeloma

44
Q

Complications of Multiple Myeloma?

A 
Infection (pneumonia)
Fractures
Neurologic Complications
Renal Injury
Hyperviscosity of blood
Amyloidosis
45
Q

If serum protein electrophloresis reveals a monoclonal gammaglobinopathy, what other test must be done to diagnos Multiple Myeloma?

A

Bone Marrow Biopsy

46
Q

If staining reveals almost exclusively kappa or lambda light chains, what should be expected?

A

Multiple myeloma

47
Q

Is there lymphadenopathy in multiple myeloma?

A

no

48
Q

What is it called when an asymptomatic individual has an spike?

A

Monoglobinopathy of Undetermined Significance (MGUS)

49
Q

What is Bence Jones Protein?

A

Free light chain Ig

50
Q

How often does burkitts lymphoma progress to leukemia?

A

Very rarely

51
Q

Do diffuse NHL lymphomas generally have a better or worse prognosis?

A

Worse

Unit 2 SPATH UFCOM (17 decks)

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