P. T Cell Non-Hodgkins Lymphoma (L14)

Question 1

What are the T cell lymphomas/leukemias?

Answer 1

Anaplastic large cell lymphoma (ALCL)

Mycoses Fungiodese/Sezary Syndrome

Question 2

T cell lymphoma or leukemias generally involve what type of tissue?

Answer 2

Involve extranodal sites like skin, midline facial area & liver

Question 3

How well does cytology predict prognosis in T cell lymphomas/leukemias?

Answer 3

not very well

Question 4

What is the most common T cell lymphoma?

Answer 4

Mycosis fungoides

Question 5

How does the prognosis of nodal T & B cell lymphoma compare

Answer 5

T is much worse. Usually high grade

Question 6

ALK staining is characteristic of what neoplastic disorder?

Answer 6

Anaplastic Large Cell Lymphoma (ALCL)

Question 7

What cytogenic abnormality is associated with ALCL? How does prognosis change for a patient + for ALK?

Answer 7

t(2:5) –> ALK

Better prognosis than a patient that is -

Question 8

What tissues can be effected by ACLC? Which has a better prognosis?

Answer 8

Lymph nodes = worse prognosis

Skin = better prognosis

Question 9

What grade is ACLC and how often is it cured?

Answer 9

High grade but curable about 75% of the time

Question 10

How does a lymph node biopsy appear in ACLC?

Answer 10

Very few germinal centers

Tightly packed with highly mitotic cells

Question 11

How does the likelihood of ACLC change with age?

Answer 11

There is a bimodal age increase

Question 12

What CD is expressed in ACLC?

Answer 12

30, just like Reed Sternberg

Question 13

What type of lymphoma is associated with CLL?

Answer 13

Small Lymphocytic Lymphoma (SLL)

Question 14

What are smudge cell on a peripheral smear diagnostic of?

Answer 14

CLL

Question 15

What is the pathophysiology of CLL?

Answer 15

Proliferation of small lymphocytes in bone marrow, lmph nodes, spleen and blood

Question 16

What is the appearance of tumor cells in CLL? Are there neoplastic T or B cells

Answer 16

normal

95% T & 5% B

Question 17

What causes the complications seen in CLL?

Answer 17

Pancytopenia

Question 18

CLL can progress into what 2 more aggressive disorders? Where do these disorders mainly act?

Answer 18

PLL = blood

Richter’s Syndrome = Lymph nodes

Question 19

How does the presence of memory B cells change the prognosis of CLL?

Answer 19

improves

Question 20

How does the presence of undifferentiated naive B cells change the prognosis of CLL?

Answer 20

worse

Question 21

What tissue is characteristically effected by Hairy Cell Lymphoma?

Answer 21

B cell proliferative disorder in bone marrow & spleen

Question 22

What is suspected if see cells with hair like cytoplasmic projections?

Answer 22

Hairy Cell Leukemia

Question 23

How is the prognosis for Hairy Cell Leukemia?

Answer 23

Very good

Question 24

What is the clinical manifestation of Hairy Cell Leukemia?

Answer 24

Pancytopenia
Splenomegaly
Dry bone marrow apirate

Question 25

What is the most common type of Cutaneous T Cell Lymphoma

Answer 25

Mycoses Fungoides

Question 26

Skin lesions in mycoises fungoides have what appearance?

Answer 26

mushroom like

Pathy rashes that are itchy

Question 27

What is suggested by a microabscess? What does it look like?

Answer 27

Mycosis Fungoides

Patch of neoplastic cells in a clear space surrounded by darker epidermal cells

Question 28

Mycosis Fungoides can progress to what?

Answer 28

Sezary Syndrome = cells get into blood (leukemia)

Question 29

What grade is Mycosis Fungoides?

Answer 29

Low grade

Question 30

What is suspected when there are ciribriform nuclei?

Answer 30

Sezary Syndrome

Question 31

What 2 neoplastic disorders have a bimodal age distribution?

Answer 31

Hodgkins
Anaplastic Large Cell Lymphoma
(ALL sort of but really just in young)

Question 32

What 2 neoplastic disorders express CD 30?

Answer 32

Reed Sternberg of Hodgkins

Anaplastic Large Cell Lymphoma