NHLs Flashcards
older man with nonspecific symptoms of weight loss, anemic, easily fatigued. biopsy shows LNs with diffuse effacement containing small lymphocytes, admixed with larger activated lymphoctyes gathering in loose aggregates proliferating
CLL/SLL
most common cause of death in CLL
bacterial infections
older man with nonspecific symptoms of weight loss, anemic, easily fatigued diagnosed with CLL is now exhibiting swollen LN’s and splenomegaly.
Prolymphocyte evolution where CLL –> diffuse large B cell lymphoma, bad sign
survival drops to 1 year
markers for CLL
CD5, CD19, CD20, CD23, smudge cells, monoclonal lamda and kappa light chains indicating hypogammaglobulinemia
no ch translocations
CLL with smudge cells and spherocytes
autoimmune etiology
woman showing signs of an infection has a biopsy but it is returned showing disrupted LN architecture, lack of tingable body MOs in the germinal centers, monoclonality, BCL2 overexpression, but no CD5 expression
follicular lymphoma
characteristically takes the form of paratrabecular lymphoid aggregates
folliciular lymphoma
mortality and Follicular lymphoma
waxing and waning neoplasm
hallmark: 14; 18 translocation. What does this do?
BCL2 overexpressed in follicular lymphoma
predominantly nodular morphology and diffuse growth pattern observed in the LNs, within a network of reactive denderitic cells admized with macs and T cells. the majority of the cell population appear small with cleaved contours and scant cytoplasm, the remainers are large cells with open nuclear chromatin
what’s the memory hook for this?
follicular lymphoma: FL has 18 letters = t(14; 18)
BCL2+/BLC6 + / CD5 -
follicular lymphoma
- most common indolent B cell lymphoma
- most common B cell lymphoma overall
- folliciular lymphoma
- diffuse large B cell lymphoma
most common form of NHL
diffuse large cell b lymphoma
60 yo with ascites and indications of lymphoma (sweating, fever)
diffuse b cell lymphoma- KSHV/HHV8 type, malignant pleural effusion
someone who develops lymphoma after a bone marrow transplant
EBV type Diffuse Large B cell lymphoma
someone who develops diffuse large b cell lymphoma and has the MYC translocation
bad prognosis, worse than without
single male, 60. biopsy: anaplastic cells that do not express B or T cell markers but have IgH clonal arrangements
KSHV subtype diffuse large cell lymphoma
most commonly acquired mutation in DLBCL
BCL6 mutations that abrogate BLC6 activity
the one be cell tumor that almost always fails to express BCL2
burkitt
phagocytes have large abundant, clear cytoplasm, there’s a high mitotic index, involved tissues are effaced by diffuse infiltrate of intermediate sized lymphoid cells 10-25 micro meters in diameter w/round/oval nucleui, coarse chromatine.
bone marrow aspirates reveal clumped nuclear chromatin 2/5 nucleoli + royal blue cytoplasm contianing clear cytoplasmic vacuoles
burkitt lymphoma
genetics of burkitts
chromosome 8 translocation involving c-MYC
c-MYC is a transcription regulator involved in upregulation of warburg effect enzymes
“chromosome 8 = C-Myc 8urkitt”
c mycburkitts
fat stain reveals lot of fats in marrow biopsy
burkitts
MCV < 80 fl
- microcytic anemia
- iron deficiency (late),
- ACD,
- thalassemias,
- lead poisoning
- sideroblastic anemia
MCV 80-100
normocytic anemia (hemolytic and non-hemolytic)
MCV > 100 fl
macrocytic anemia, megaloblastic and non-megaloblastic
TAILS
microcytic anemia: thalassemia, anemia of chronic dz, Fe defiency, lead, sideroblastic anemia
