Non Hodgkin Lymphoma Flashcards
Basics of Leukemia
Malignancy of hematopoietic cells
Starts in bone marrow (can spread to blood, nodes)
Myeloid or Lymphoid
Acte or Chronic
Basics of Lymphoma
Malignancy of hematopoietic cells
Starts in lymph nodes (can spread to marrow, blood)
Lymphoid only
Hodgkin or Non Hodgkin
What is the most common cause of lymphadenopathy?
benign reaction to infection
Most common cause of malignant lymphadenopathy?
Metastatic carcinoma
Where are most follicles located?
In cortex, under the capsule (lymphocytes with germinal centers)
Where does cell differentiation and maturation occur
Germinal center and mantle zone
Follicular hyperplasia
B cell response to immune stimulus
Tingible macrophages
Large irregular follicles
Tingible macrophages in Lymphoma…
NONE
Interfollicular hyperplasia
Expanded area between follicles
Mixture of cells
Partial effacement (normal architecture obliterated)
T cell response to some type of stimuli.
Non Hodgkin Lymphoma
Malignant proliferation of lymphoid cells (blast or mature cells) in lymph nodes
Skips around
Mostly B cells
Non Hodgkin vs Hodgkin
Non Hodgkin tends to skip around more, has a worse prognosis because it is unpredicable
Symptoms of NHL
painless, firm lymphadenopathy
extranodal manifestations
B symptoms
What are B symptoms
Weight loss
Night Sweats
Fever
A
no B symptoms
Low Grade NHL
Older patients
Indolent (not a lot of mitosis)
Small, mature cells
Non destructive
High Grade NHL
Children
Aggressive
Big ugly cells
Destructive
Types of Low Grade (4)
- Small lymphocytic lymphoma
- Malt lymphoma
- Follicular lymphoma
- mycosis fungoides
Types of High Grade (3)
- Large Cell lymphoma
- Lymphoblastic lymphoma
- Burkitt Lymphoma
Small Lymphocytic Lymphoma
CLL
small mature lymphocytes
B cell, CD5+
What is Richter’s Transformation?
Change from low grade lymphoma/leukemia to a high grade process - cells get bigger and become more aggressive
Marginal Zone Lymphoma
Actually a bunch of lymphomas
Marginal zone pattern
MALT lymphoma
What is MALT Lymphoma associated with?
H. Pylori
If catch early, antibiotic and goes away
Mantle Cell Lymphoma
Mantle zone pattern
Small angulated lymphocytes
T (11;14) cyclin D and IgH
Aggressive
Mantle Cell translocation?
T(11;14)
Follicular Lymphoma
Follicular pattern (later diffuse)
Small cleaved cell (1), mixed (2) or large cell (3)
T (14;18) IgH and Bcl-2
Butt cells
Butt cells
Follicular lymphoma
Follicular lymphoma translocation?
T (14;18)
Stage I
Single Node
Stage II
Two or more nodes on the same side of the diaphragm
Stage III
Lymph nodes on both sides of the diaphragm
Stage IV
Diffuse extranodal involvement
A
No additional symptoms
B
weight loss, night sweats, fever
Mycosis Fungoides/Sezary Syndrome
Skins lesions (MF), present as flat lesions like eczema Starts as patch - then plaque - nodule Blood involvement (SS) Cerebriform lymphocytes T cell immunophenotype
Cerebriform lymphocytes
Mycosis Fungoides / Sezary Syndrome
Diffuse Large Cell Lymphoma
Large B cells
Extranodal involvement
Grows rapidly
Bad prognosis
Lymphoblastic Lymphoma
Two types: B and T
Lymphoblasts in diffuse pattern
same thing as ALL
How does lymphoblastic lymphoma present?
Teenage Male
Mediastinal Mass (Thymus)
T-lymphoblastic
Burkitt Lymphoma presentation
Child with fast growing extranodal mass
Burkitt Lymphoma pattern?
Starry sky
FAST GROWING
Burkitt Lymphoma translocation
T (8;14) cmyc and IgH
Adult T cell Leukemia/Lymphoma
Japan/Caribbean basin
HTLV-1
Skin lesions, hypercalcemia
Aggressive
