PATH - Lymphomas Flashcards
Lymphoma
Discrete tumor mass arising from *lymph nodes.
Presentations often blur definitions.
Hodgkin Lymphoma
Localized, *single group of nodes
*contiguous spread (stage is strongest predictor of
prognosis)
*Reed-Sternberg cells
Constitutional (“B”) signs/symptoms: low-grade
fever, night sweats, weight loss.
Associated with *EBV
- worst type is lymphocyte-depleted
- Bimodal distribution
Many patients have a relatively good prognosis
Non-Hodgkin Lymphoma
*Multiple lymph nodes involved; extranodal
involvement common
*noncontiguous spread
May present with constitutional signs/symptoms
Majority involve *B cells; a few are of T-cell
lineage.
May be associated with *HIV and autoimmune diseases.
Reed‑Sternberg cells
Distinctive tumor giant cell seen in *Hodgkin lymphoma
*binucleate or bilobed with the 2 halves as mirror images (“owl eyes”)
RS cells are CD15+ and CD30+ B-cell origin
“2 owl eyes × 15 = 30”
Burkitt lymphoma
Non‑Hodgkin lymphoma of mature B cells
*t(8;14)—translocation of c-myc (8) and heavy-chain Ig (14)
*“Starry sky” appearance, sheets of lymphocytes
with interspersed “tingible body” macrophages
Adolescents or young
adults
Associated with *EBV
- Jaw lesion in *endemic form in Africa
- pelvis or abdomen in *sporadic form.
Diffuse large B-cell
lymphoma
Non‑Hodgkin lymphoma of mature B cells
Most common type of non-Hodgkin lymphoma in adults.
Usually older adults, but 20% in children
Follicular lymphoma
Non‑Hodgkin lymphoma of mature B cells
*t(14;18)—translocation of heavy-chain Ig (14) and BCL-2 (18)
Indolent course; *Bcl-2 inhibits apoptosis.
Presents with painless “waxing and waning”
lymphadenopathy
Follicular architecture:
small cleaved cells (grade 1), large cells (grade 3), or mixture (*grade 2)
affects Adults
Mantle cell lymphoma
Non‑Hodgkin lymphoma of mature B cells
*t(11;14)—translocation of cyclin D1 (11) and heavy-chain Ig (14)
Very aggressive, *MALE adult patients typically present with late-stage disease.
Primary central nervous system lymphoma
Non‑Hodgkin lymphoma of mature B cells
Most commonly associated with *HIV/AIDS
-Considered an AIDS-defining illness
affects Adults
Variable presentation: confusion, memory loss,
seizures.
Mass lesion(s) on MRI, needs to be distinguished from toxoplasmosis via CSF analysis or other lab tests
Adult T-cell lymphoma
Non‑Hodgkin lymphoma of mature T cells
Caused by *HTLV (associated with IVDA)
Adults present with cutaneous lesions
especially affects populations in Japan, West Africa, and
the Caribbean.
Lytic bone lesions, hypercalcemia.
Mycosis fungoides/Sézary syndrome
Non‑Hodgkin lymphoma of mature T cells
Mycosis fungoides presents with skin patches/plaques (cutaneous T-cell lymphoma), characterized by *atypical CD4+ cells with
*“cerebriform” nuclei.
May progress to *Sézary
syndrome (T-cell leukemia).
