Non-Hodgkin Lymphoma Flashcards
Causes of lymphadenopathy
Most common cause overall: benign reaction to infection
Most common malignant cause: metastatic carcinoma
Lymphoma far down on the list
follicular hyperplasia things you must know
Large, irregular follicles Mixture of cells in germinal centers Tingible body macrophages B-cell response to some immune stimulus Benign
Interfollicular hyperplasia things you must know
Expanded area between follicles
Mixture of cells
Partial effacement
T-cell response to some immune stimulus
total effacement
can’t see anything/follicles - worry about malignancy
Non-hodgkin lymphoma things you must know
Malignant proliferation of lymphoid cells (blasts or mature cells) in lymph nodes
Skips around
Many subtypes
Most are B cell
sxs of NHL
Painless, firm lymphadenopathy
Extranodal manifestations
“B” symptoms: weight loss, night sweats, fever
Low grade NHL
Older patients
Indolent (incurable!)
Small, mature cells
Non-destructive
high grade NHL
Children, sometimes
Aggressive (curable?)
Big, ugly cells
Destructive
Types of NHL: Low Grade
Small lymphocytic lymphoma
Malt lymphoma
Follicular lymphoma
Mycosis fungoides
Types of NHL: High Grade
Large cell lymphoma
Lymphoblastic lymphoma
Burkitt lymphoma
Small Lymphocytic Lymphoma, things you must know
Small mature lymphocytes
Same thing as CLL
B-cell lesion, but CD5+ (weird!)
Long course; death from infection
Richter’s transformation
Low grade –> high grade, more aggressive
bad prognosis
Marginal Zone lymphoma things you must know
Actually a bunch of lymphomas
Marginal zone pattern
Malt lymphoma
Helicobacter pylori
Malt lymphoma is a
marginal zone lymphoma
mucosa-associated lymphoid tissue
Mantle Cell Lymphoma things you must know
Mantle zone pattern
Small angulated lymphocytes
t(11;14) – cyclin D1 and IgH
More aggressive
mantle cell cytogenetics
t(11;14)
cyclin D1 and IgH - cyclin D1 over expressed –> cell divides more often than should
follicular lymphoma things you must know
Follicular pattern (later diffuse)
Small cleaved cell, mixed or large cell
Grade 1, 2, or3
t(14;18) - IgH and bcl-2
cytogenetics follicular lymphoma
t(14;18) - IgH and bcl-2
Tells cells not to undergo apoptosis
follicular lymphoma grading
1 - small cell
2 - mixed
3 - large cell
prognosis is dependent on grading
morphology follicular lymphoma
butt cells
markers follicular lymphoma
CD20
staging and prognosis Follicular Lymphoma
1 - single node 2 - two or more on same side of diaphragm 3 - two or more on both sides diaphragm 4 - diffuse extranodal involvement A- no additional symptoms B- weight loss, night sweats, fever
Mycosis fungoides/Sezary syndrome things you must know
Skin lesions/Blood involvement
Cerebriform lymphocytes
T-cell immunophenotype
Pautrier microabsesses
tumor cells of MF/SS
morphology MF/SS
cerebriform lymphocytes
Diffuse large-cell lymphoma things you must know
Large B cells Extranodal involvement Grows rapidly Bad prognosis total effacement
Lymphoblastic Lymphoma things you must know
Two types: B and T
Lymphoblasts in diffuse pattern
Same as ALL
T-lymphoblastic lymphoma often in teenage male with mediastinal mass
Lymphoblastic lymphoma same as
ALL
T cell Lymphoblastic lymphoma common presenation
teenage male w/ mediastinal mass
Burkitt lymphoma things you must know
Child with fast-growing, extranodal mass
Starry-sky pattern
t(8;14) = c-myc and IgH
Occasionally involves blood
morphology burkitt lymphoma
starry-sky pattern (sky = tumor cells, stars are TBM contradiction but tumor needs them to eat up quickly turning over cells)
cytogenetics burkitt lymphoma
t(8;14) = c-myc and IgH
adult T-cell leukemia/lymphoma things you must know
Japan/Caribbean basin
HTLV-1
Skin lesions, hypercalcemia
Very aggressive
morphology adult t-cell leukemia/lymphoma
weird flowery cells
