Pathology Flashcards
Various pathology topics
What is the most common lymphoma in adults?
Diffuse Large B Cell Lymphoma - 35% of adult lymphoma Non-Hodgkins lymphoma.
What are the two most common non-hodgkin lymphomas of adults?
Diffuse Large B cell lymphoma and follicular lymphoma
Who is affected by follicular lymphoma?
Adults older than 50 years
Equal affect between males and females
painless, generalised lymphadenopathy, the bone marrow is often effected at diagnosis.
Median survival is 10 years but there is no cure.
Involves rearrangement of BCL2
What are the different special subtypes of Large B cell lymphoma?
`1 - EBV associated in AIDS, iatrogenic immunosupression and the elderly.
2 - Kaposi sarcoma herpesvirus - HHV8
3 - Mediastinal large b cell lymphoma in young women and shows a predilection for spread to the abdominal viscera and CNS
What are the clinical features of Large B cell lymphoma?
Median age diagnosis is 60 years. though can occur at any age.
Presentation is with a rapidly enlarging, symptomatic mass at one or several sites.
Extra nodal presentation are common. G.I. tract is the most common site, but can be anywhere.
They are aggressive and rapidly fatal.
What characterises Hodgkin lymphoma?
They are a distinct group of neoplasms characterised by the presence of a tumour giant cell the RS cells (Reed-Sternberg)
How do Hodgin Lymphomas arise?
They arise in a single lymph node or a chain of lymphnodes and typically spread in a stepwise fashion to anatomical contiguous nodes.
There are 5 subtypes.
What are the main clinical differences between hodgkin and non hodgkin lymphomas?
Hodgkin lymphoma is more often localised to a single axial group of nodes (cervical, mediastinal, paraaortic) vs NHL which is more frequently invovled at multiple peripheral nodes.
HL has orderly spread by contiguity while NHL has noncontiguous spread
HL rarely effects the mesenteric nodes or waldeyer ring, compared to NHL where mesenteric nodes and waldeyer ring are commonly invovled
HL rarely invovles extranodal areas where this is common in NHL.
What are B symptoms?
Fever, weight loss and nightsweats (+/- pruritus and anaemia)
How do you clinically stage Hodgkin and Non-Hodgkin lymphoma?
The Ann Arbor classification:
1 - single lymph node or extralymphatic organ or tissue
- 2 or more nodes on the same side of the diaphragm , or with limited contiguous extra lymphatic spread 2E
- both sides the diaphragm, spleen and contiguous extralymphatic organ
- Multiple/disseminated foci.
What is the breast made up of?
What is the functional unit?
Luminal cells, myoepithelial cells, intralobular stroma, and interlobular stroma.
The functional unit is the lobule which is supported by the specialized intralobular stroma.
The inner luminal epithelial cells produce milk during lactation.
The basally located myoepithelial cells have contractile function to aid in milk ejaction and also help support the basement membrane.
Epithelial hyperplasia is benign hyperplasia of the luminal cells.
Fibroadenoma is benign change of the intralobular stroma
Hemangioma benign change of the interlobular stroma.
DCIS is malignant change of the luminal cells.
Phyllodes tumor maligant change of the intralobular stroma
Angiosarcoma malignant change of the interlobular stroma.
What are the key colorectal cancer syndromes?
FAP - Familial Adenomatous Polyposis (mutation in the APC gene).
Lynch syndrome (HNPCC) - Hereditary Nonpolyposis Colorectal Cancer - mismatch repair protein failures.
What are the key colorectal cancer syndromes?
FAP - Familial Adenomatous Polyposis (mutation in the APC gene). _ autosomal dominant.
Lynch syndrome (HNPCC) - Hereditary Nonpolyposis Colorectal Cancer - mismatch repair protein failures.
Plus
Obesity and IBD and big risk factors.
What is Beck’s triad?
Hypotension,
Muffled Heart sounds
Elevated JVP
- For Cardiac Tamponade
