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Pathology of Lymphoma Flashcards

1
Q

What are the two major distinction between lymphomas?

A

B cell origin

T cell origin

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2
Q

What are the malignancies that come from the germinal center of a lymph node?

A

Follicular lymphoma
Burkitt lymphoma
Large cell lymphoma

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3
Q

What are the lymphomas that arise from the mantle zone of lymph nodes?

A

Naive B cell

Mantle cell lymphoma

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4
Q

What are the lymphomas that arise from the marginal zone of the lymph node?

A

Memory B cell
CLL/SLL
Marginal zone lymphoma

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5
Q

What are the clinical symptoms of follicular lymphoma? (3)

A
  • Widespread lymphadenopathy
  • Splenomegaly
  • BM
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6
Q

What are the two cells that compose follicle germinal center lymphomas?

A

Centroblasts and centrocytes

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7
Q

What is the characteristic of low grade follicular lymphoma? High grade?

A 
Low = mostly centrocyte 
High = greater than 15 centroblasts/hpf
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8
Q

What are the gross histological findings of follicular lymphoma?

A

High grade infiltration of lymph nodes s/t there is no discernable structure

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9
Q

What is the difference between centroblasts and centrocytes?

A

Centrocytes are smaller with more condensed nuclei

Centroblasts have a lot more cytoplasm

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10
Q

What are the four CD markers for follicular lymphoma?

A

CD19
CD20
CD10
Bcl-2

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11
Q

What are the two markers that are absent in follicular lymphoma?

A

CD5

CD3

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12
Q

What are the markers for T cells? (3)

A

CD3
CD4
CD8

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13
Q

What is the function of Bcl-2?

A

Anti-apoptotic protein

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14
Q

Who gets mantle cell lymphoma?

A

50-60 year old males

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15
Q

What are the symptoms of mantle cell lymphoma?

A

Generalized lymphadenopathy

HSM

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16
Q

What organs are affected in mantle cell lymphoma?

A

Spleen
Liver
Small bowel

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17
Q

What are the characteristic lab findings with mantle cell lymphoma?

A

Lymphocytosis

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18
Q

If there is small bowel involvement with mantle cell lymphoma, what is this called?

A

Lymphomatoid polyposis

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19
Q

What are the cell markers for mantle cell lymphoma?

A

CD19
CD20
CD5
Cyclin D1

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20
Q

What are the negative markers for mantle cell lymphoma?

A

CD23

CD3

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21
Q

What is cyclin D1?

A

Anti Apoptotic molecule that is characteristic of mantle cell lymphomas

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22
Q

What is endemic burkitt lymphoma?

A

EBV viral infection in young africans

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23
Q

What is sporadic burkitt lymphoma?

A

Worldwide childhood infection

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24
Q

True or false: only the sporadic type of Burkitt lymphoma has CNS involvement

A

False–all types

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25
Q

What is the presentation for endemic burkitt lymphoma?

A

Jaw enlargement, ovaries, kidney involvement

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26
Q

What are the symptoms of sporadic Burkitt lymphoma?

A

Abdominal masses in the ileo-cecal region

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27
Q

What are the symptoms of Immunodeficient Burkitt lymphoma?

A

Nodal localization and involvement of BM is frequent

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28
Q

“Starry sky pattern” on histology = ?

A

Burkitt’s lymphoma

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29
Q

What are the histological findings of Burkitt’s lymphoma?

A

Diffuse monomorphic infiltrate of intermediate sized round to slightly irregular lymphoid cells with multiple peripherally place nucleoli

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30
Q

What does tigible mean?

A

Stainable

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31
Q

What are the tingible bodies in histological samples of Burkitt’s lymphoma?

A

Macrophages in germinal centers

32
Q

What are the CD markers for Burkitt’s lymphoma? What is distinguishes it from follicular lymphoma?

A

CD10
CD19
CD20

NEGATIVE for bcl-2

33
Q

CD10+CD19+CD20+blc-2 =?

A

Follicular lymphoma

34
Q

CD10+CD19+CD20 = ?

A

Burkitt’s lymphoma

35
Q

CD19 + CD20 + CD5 + Cyclin D1 = ?

A

Mantle cell lymphoma

36
Q

What is the prognosis for Burkitt lymphoma?

A

Responds well to therapy (90% cure with low stage)

37
Q

True or false: aggressive Burkitt lymphoma is a medical emergency

38
Q

What is the viral cause of adult T cell leukemia/lymphoma?

A

HTLV-1 (HUman T-cell Leukemia virus type 1)

39
Q

Where is adult T cell leukemia/lymphoma endemic?

A

Central africa
Caribbean
Southwestern japan

40
Q

True or false: T cell leukemia/lymphoma is only found in adults

41
Q

What is the latency period of HTLV1?

42
Q

What is the common presentation of adult T cell lymphoma? (3 physical findings + 2 lab findings)

A 
Lymphadenopathy
Skin lesions
HSM
Lymphocytosis
Hypercalcemia
43
Q

What are the histological features of adult T cell leukemia/lymphoma?

A

Immature = smooth, even chromatin

Mature = multilobed nuclei

44
Q

What type of T cell is found in adult T cell lymphoma?

A

CD4+ cells

45
Q

What is the virus that is found in Adult T cell leukemia?

46
Q

Flower cells = ?

A

Adult T cell leukemia

47
Q

What is the prognosis for adult T cell leukemia/lymphoma?

A

Rapidly progressive, death within 1 year despite chemo

48
Q

What is the new therapy for Adult T cell lymphoma?

A

anti-CD52 (Alemtuzumab)

49
Q

True or false: adult T cell leukemia/lymphoma with primarily skin involvement is more aggressive

A

False–more indolent

50
Q

What organ is always involved in mycosis fungoides/Sezary syndrome?

51
Q

What is the cell type that is involved in mycosis fungoides/Sezary syndrome?

A

Cd4+ T cells

52
Q

What is the prognosis for mycosis fungoides/Sezary syndrome?

A

Indolent disease

53
Q

What are the histological characteristics of mycosis fungoides/Sezary syndrome?

A

Folded nuclear membrane

54
Q

What are the three stages of mycosis fungoides/sezary syndrome?

A

Premycotic patch
Plaque (with epidermal involvement)
Tumor phase (dermis involvement)

55
Q

What are the very late stages of mycosis fungoides/sezary syndrome?

A

BM

Lymph nodes

56
Q

Sezary syndrome presents with 2 simultaneous manifestations. What are they?

A

Leukemia

Generalized exfoliative erythroderma

57
Q

Leukemia+Generalized exfoliative erythroderma = ?

58
Q

What are the two major immature T cell lymphoid neoplasms/lymphomas?

A

T lymphoblastic leukemia

Anaplastic large T cell lymphoma

59
Q

What are the two clinical manifestations of T lymphoblastic leukemia/lymphoma?

A

85% as lymphoma with anterior mediastinal lymph nodes

15% as leukemia ( T-ALL)

60
Q

What is the presentation of T cell ALL?

A

Abrupt onset with depression of normal marrow, fatigue, infx, bleeding etc.

Mediastinal mass

61
Q

What are the CNS ssx of T cell ALL?

A

HA
vomiting
nerve palsy d/t meningeal spread

62
Q

What are the histological characteristics of T-ALL?

A

Sheets of blasts in lymph node, soft tissue, or bone marrow

63
Q

What are the cell markers for T-ALL? (4)

A

CD34
TdT
CD1a
CD3 (cytoplasmic)

64
Q

TdT cell marker = ?

65
Q

CD34 + TdT + CD1a = ?

66
Q

Which has a worse prognosis: B-ALL or T-ALL?

67
Q

What are the three factors that determine the prognosis of T-ALL?

A
  1. Under 2 yo
  2. Philadelphia chr
  3. WBC >100
68
Q

Who usually gets anaplastic large cell lymphoma?

A

Young males

69
Q

What are the cell markers for Anaplastic large T cell lymphoma

A

CD30

ALK-1

70
Q

Is anaplastic large cell lymphoma hodgkin’s or non-hodgkin’s?

71
Q

What sites are involved in anaplastic large cell lymphoma?

A

LN
Extranodal sites
Mediastinal disease

72
Q

Which age group has ALK-1 positive anaplastic large cell lymphoma? Negative? Which has a good prognosis, and which has a poor prognosis?

A

Positive = children/young adults, good prognosis

Negative = edler adults, bad prognosis

73
Q

What are the histological characteristics of anaplastic large cell lymphoma?

A

pleomorphic with characteristic “hallmark” cells

74
Q

What are the four characteristics of hallmark cells in large cell lymphoma?

A
  1. medium size
  2. Abundant cytoplasm
  3. Kidney shaped nuclei
  4. Paranuclear eosinophilic region
75
Q

What is large granular lymphocytic leukemia?

A

T cell/NK cell type

Associated with RA

76
Q

What are extranodal NK/T cell lymphoma, nasal type?

A

EBV associated tumor cells invade small vessels causing extensive ischemic necrosis

Hematology (32 decks)

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